Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Team Leader/LDP

  • Work Type

RO/NRO

  • RO Post Checks

  • RO Pre start quality

  • Is the Ro Live?

  • NRO Post Checks

  • NRO Pre start quality

  • Is the NRO Live?

  • CP Competency Checks

  • AE Competency Checks

  • Permit for Deep Excavation

  • Cable Avoidance

  • Training Records

PC Roles

  • Discussion held with SDS/SMS

  • MWC Roles Maturity Discussion held with SDS/SMS

Site Arrival

  • Inducted and site register signed?

  • Are safe digging techniques being employed and mark up to a sufficient standard?

Pre Con Pack

  • Are utility drawings in place

  • Vulnerable customer list available?

  • Pre Con risk map available?

CPP

  • Is this correctly completely with the correct names and available on site?

  • Are the team producing all things necessary for pack completion? ie DR4,DAF,SHALLOW MAINS,TEST CERTS,

  • RA's and Permit to dig available?

Welfare Facilities

  • Drinking Water available?

  • Are facilities fit for purpose and clean?

  • Are there facilities to dry clothing?

  • First aid and eyewash available and in date?

Site Setup

  • Can road users and Pedestrians navigate through the site safely and free from trip hazards/

PPE

  • Is the correct PPE being worn?

  • Task specific PPE available?

  • Is PPE acceptable, clean/not torn.

PLANT AND VEHICLE MANAGEMENT

  • Mechanical plant in safe working order/Plant check sheet filled in?

  • Plant/vehicles parked in a safe manner door to footpath, wheels turned to kerb etc?

  • Are trailers safely parked and chocks used?

  • SSW for plant being adhered to/ Banksman for excavators/Grab lorry's

Fatigue Management

  • Are the Team aware of their LDP fatigue management systems

  • Are the team aware of the LDP HAVS management system and is it being followed?

EMERGENCY PROCEDURES

  • Are the team aware of the Gas escape procedure if found/reported to them?

  • Have the team got access to Hazard/Near Miss reporting system?

PIPE AND FITTINGS

  • Are pipe and fittings being stored correctly, Dry stored and no open fittings or open ends on service pipe?

  • Is there a reasonable amount of fittings onsite to complete the task, No large access of fittings onsite.

MSL/1 COMPLIANCE

  • Are works being completed to Cadent standards/Procedures?

SAFETY EQUIPMENT

  • Are the extinguishers in good condition,pressurised and within inspection date?

  • Are there enough extinguishers available to cover span of works?

  • Are Dust masks available/in date and fit for use?

  • Can operatives demonstrate how to carry out equipment checks?

  • Are face fit certs available? BA/Dust masks

  • Is the Team clean shaven?

SERVICE LAYING AND TESTING

  • Are activities being carried out to cadent standards?

  • Service testing being carried out as per Cadent Standards?

MAINS TESTING

  • Are mains testing being carried out to Cadent Procedures?

Continuity Bonds

  • Are the team working on electrical insulation ie IJ's, Standpipe Insulation, Temp con bonds?

NRSWA

  • Is there at least one streetworks card available?

  • Is the Chapter 8 (Redbook) available Oct 13 with June 14 updates? (Paperback or electronically)

  • Does the team understand the permit conditions and are they being followed?

  • Are the correct permit numbers being displayed inc correct contact number?

  • Is the permit in progress and have the contacted planner to check?

  • Spoil away within 24hrs and reinstatement tight up

VYN

  • Can the team demonstrate they are doing a min of 2 VYNS a day

  • SLG as per Redbook?

  • If TM is manned, are the appropriate personnel onsite?

  • Are intelligent lights being used where appropriate

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.