SITE OF WORK INFORMATION

ACCESS POINT INFORMATION

  • ACCESS POINT NAME

  • ELR

  • MILEAGE

POSSESSION / BLOCKING DETAILS

  • WON ITEM

  • BLOCKING POINT / LX INFORMATION

SSOW METHOD INFORMATION (auditor to complete)

  • WERE ANY LINES AT SITE OPEN TO TRAFFIC WHILST PLACING / REMOVING PROTECTION?

  • WHAT SSOW METHOD IS APPROPRIATE WHILST WORKING?

  • WHAT SSOW METHOD IS APPROPRIATE WHILST WALKING TO SITE OF WORK?

PERSONAL PROTECTIVE EQUIPMENT

MANDATORY PPE

  • WAS AUDITEE OBSERVED CARRYING OUT THIER DUTIES ON OR NEAR THE LINE?

  • IS A HARD HAT BEING WORN?

  • IS A HI-VIZ VEST OR COAT BEING WORN?

  • IS A PAIR OF HI-VIZ TROUSERS BEING WORN?

  • IS A PAIR OF SAFETY BOOTS BEING WORN?

  • IS A PAIR OF SAFETY GLASSES BEING WORN?

  • IS A HARD HAT AVAILABLE?

  • IS A HI-VIZ VEST OR COAT AVAILABLE?

  • IS A PAIR OF HI-VIZ TROUSERS AVAILABLE?

  • IS A PAIR OF SAFETY BOOTS AVAILABLE

  • IS A PAIR OF SAFETY GLASSES AVAILABLE?

  • IS A TORCH AVAILABLE FOR USE AT NIGHT?

PPE QUALITY

  • IS ALL PPE CLEAN?

  • DOES HI-VIZ COAT OR VEST HAVE THE VITAL LOGO ON THE BACK?

COMPETENCY

SENTINEL CHECK

  • DOES AUDITEE HAVE THEIR SENTINEL CARD?

  • SCREENSHOT FROM SENTINEL CHECK

  • DOES AUDITEE HOLD THE CORRECT COMPETENCY FOR THE DUTY BEEN UNDERTAKEN?

ON TRACK DOCUMENTATION

ON TRACK DOCUMENTATION (SWP)

  • SWP REFERENCE NUMBER

  • DOES AUDITEE HAVE A SWP

  • IN WHAT FORM IS SWP

  • IS SWP UP TO DATE

  • IS SWP SUITABLE FOR THE DUTY AND LOCATION BEING CARRIED OUT

SAFETY CRITICAL COMMUNICATION

  • HAS ANY SAFETY CRITICAL COMMUNICATION BEEN OBSERVED?

  • WAS KEY INFORMATION REPEATED BACK?

  • WAS CONVERSATION ACCURATE, BRIEF AND CLEAR?

  • WAS LINE, APP/BEY, SIGNAL/POINTS CLEARLY REFERENCED?

  • HOW WOULD YOU RATE THIS CONVERSATION? 0 -VERY POOR, 5 - VERY GOOD

PROTECTION EQUIPMENT

  • DUTY BEEN UNDERTAKEN

DETONATOR PROTECTION

  • ARE ALL DETONATORS IN DATE?

  • ARE ALL DETONATORS IN GOOD CONDITION?

  • HAVE THESE DETONATORS BEEN REPLACED ON SITE?

  • HAS A REQUEST BEEN SUBMITTED TO THE OFFICE FOR REPLACEMENT DETONATORS TO BE ARRANGED?

  • HAS DETONATOR PROTECTION BEEN PLACED AT THE CORRECT LOCATION?

  • SCREENSHOT FROM TRACK LOCATOR OF LOCATION OF DETONATOR PROTECTION OR PHOTO OF TRACK DIAGRAM WITH DETONATOR PROTECTION MARKED

  • ARE ALL PLB's IN GOOD WORKING ORDER?

LEVEL CROSSING PROTECTION

  • IS IT NIGHT OR DAY?

  • ARE TIL DAWN'S IN PLACE?

  • IS A TORCH CAPABLE OF SHOWING A GREEN ASPECT OR BARDIC LAMP AVAILABLE?

  • ARE RED AND GREEN FLAGS AVAILABLE FOR WHEN IT GETS LIGHT

  • ARE FLAGS IN PLACE?

  • ARE TIL DAWNS AVAILABLE FOR WHEN IT GETS DARK?

  • IS A TORCH CAPABLE OF SHOWING A GREEN ASPECT OR BARDIC LAMP AVAILABLE?

  • REASON FOR NOT CHECKING DETONATOR PROTECTION

COMMENTS

  • AUDITOR COMMENTS

  • COMPLETED ON

  • AUDITOR SIGNATURE

  • AUDITEE SIGNATURE

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