Title Page

  • Conducted on

  • Prepared by

  • Location
  • HSW RAG Inspection

  • Inspector

  • Engineer Name

  • Engineer Trade

  • Date of Inspection

  • Job Number

  • Patch

  • SEM

  • On arrival

  • Is the vehicle parked correctly?

  • Are the wing mirrors turned in?

  • Does the Engineer have their HomeServe ID card available?

  • Dynamic Risk Assessment (DRA) completed correctly?

  • Was the Safety Handout card shown to the Customer?

  • On the job

  • Are correct shoe covers being worn?

  • Is the correct PPE worn for the task carried out?

  • Is the PPE worn in good condition?

  • Volt Pen used onsite?

  • RCD used onsite as required?

  • Is the toolbox/bag of reasonable weight?

  • Action taken to protect Customer's property from damage?

  • Internal door barriers in use (if required)?

  • External work

  • Are two sets of external barriers available?

  • Are barriers in use?

  • Have appropriate photos been taken?

  • Are hose ramps available and in use?

  • Is the correct digging method being applied?

  • Are the Jetter hoses in good condition?

  • Is the Jetter service light green?

  • Is the Jetter free from visible leaks?

  • If the Jetter is not in use, is the tank empty?

  • Is the correct Jetter burst disc intact?

  • Are the drainage rod storage end caps in use?

  • Is the Engineer carrying an in date WJA card?

  • If applicable, when using scaffold to work at height, has the engineer viewed the safety certificate issued by the SubContractors?

  • If using a mobile scaffold tower to work at height, is it suitable, sufficient and fit for purpose?

  • Van check

  • Is a First Aid Kit available and in date?

  • Is an Eye Wash available and in date?

  • Are two fully stocked Asbestos Kits available?

  • Is a fully stocked PPE Kit available and in good condition?

  • Are all Chemicals/Substances stored correctly?

  • Are all Chemicals/Substances HML Approved?

  • Are Gas bottles stored correctly and secured?

  • Is all electrical equipment PAT tested and in date?

  • Is equipment calibrated where required?

  • Are all power tools supplied by HML?

  • Are tools/equipment stored correctly?

  • Are tool guards and safety features intact?

  • Are the correct discs fitted to the tools?

  • Are fire extinguishers serviced and in date?

  • Does the Engineer have a Bosch multiscanner available?

  • How many sets of ladders/hopups is the Engineer carrying on their van?

  • List here the types of ladders carried on the van

  • Is the ladder asset tagged?

  • Is the ladder showing correct markings?

  • Is the ladder stored correctly and in good condition?

  • Does the Engineer have nonslip ladder mats available?

  • Does the Engineer have crawl boards available and in good condition?

  • Is waste bagged and stored correctly?

  • Is the van free from bungee cords/bungee netting?

  • Van condition

  • Vehicle Registration

  • Is rear storage clean and tidy?

  • Is the Engineer adhering to the clean cab policy?

  • Is the Engineer aware of the FNOL reporting process?

  • Is the dashboard free from any safety critical warning lights and are lights/indicators working?

  • Is the dashboard free from any nonsafety critical warning lights?

  • Is there sufficient screen wash available?

  • Is a dash cam available, information correct and shows signs of use?

  • Are external panels in good condition and free from damage?

  • Are the windows and mirrors clean and free from chips and cracks restricting the driver's vision?

  • Are the windows and mirrors clean and free from chips and cracks that do not restrict the driver's vision?

  • Are the tyre treads above the legal minimum requirement of 1.6mm?

  • In your opinion, is the vehicle roadworthy?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.