WIP Health and Safety Inspection (CWI)

• Conducted on

  Date

• Inspector Name

• Team Leader/Site Foreman Name

• Location
  Address

• Vehicle parked safely?

  Yes

  No

• Is the van causing access issues?

  Pass

  Fail

  N/A

• Warning signs displayed?

  Yes

  No

• Hose ramp in use?

  Yes

  No

• Safety barriers/barrier tape used to create exclusion zone where required?

  Yes

  No

  N/A

• Photos of Parking

  Media

Van Condition

• External condition & cleanliness

  Good

  Fair

  Poor

• Cab condition & cleanliness

  Select Good Fair Poor

  • Good
  • Fair
  • Poor

• Rear of van condition & cleanliness

  Good

  Fair

  Poor

• Condition of tyres

  Good

  Fair

  Poor

• Are tools and equipment free of defects and in good working order?

  Yes

  No

• Electrical tools & equipment PA tested within the last 6 months?

  Yes

  No

• Condition of ladders

  Good

  Fair

  Poor

• Ladder displaying inspection tag?

  Yes

  No

• Fire Extinguisher free of defects and in good working order?

  Yes

  No

• Fire Extinguisher serviced within the last 12 months & service sticker visible?

  Yes

  No

• Suitable spill kit & drip tray in vehicle?

  Yes

  No

• Fuel stored in suitable Jerry Can?

  Yes

  No

• Fully stocked first aid kit including eyewash?

  Yes

  No

• Are all items in date?

  Yes

  No

• Fuel stored, transported & used safely?

  Yes

  No

  N/A

• Adhesives stored & used safely?

  Yes

  No

  N/A

• Sand & cement stored & used safely?

  Yes

  No

  N/A

• Other substances stored & used safely?

  Yes

  No

  N/A

• Hard Hat worn appropriately and in acceptable condition?

  Yes

  No

  N/A

• FFP3 Mask being worn correctly and in acceptable condition?

  Yes

  No

  N/A

• Mask filter clean and free from damage/wear and tear?

  Yes

  No

  N/A

• Visor/safety glasses worn appropriately and in acceptable condition?

  Yes

  No

  N/A

• Suitable gloves worn for specific tasks e.g. Chemical resistant gloves when handling hazardous substances such as cement, vibration absorbing gloves when operating Rotary Hammer Drill?

  Yes

  No

  N/A

• Ear Defenders worn appropriately and in acceptable condition?

  Yes

  No

  N/A

• Safety Boots worn appropriately and in acceptable condition?

  Yes

  No

  N/A

• Harness worn appropriately and in acceptable condition?

  Yes

  No

  N/A

• Lanyard used correctly and in acceptable condition?

  Yes

  No

  N/A

• Ladder Yoke used correctly and in acceptable condition?

  Yes

  No

  N/A

• Ladder Strap used correctly and in acceptable condition?

  Yes

  No

  N/A

• Eye Bolt used correctly and in acceptable condition?

  Yes

  No

  N/A

Photos

• PPE

  Media

• Use of Tetra System

  Media

• RAMS available and specific to tasks undertaken?

  Yes

  No

• POWRA conducted by site foreman/supervsior?

  Yes

  No

• Pre checks conducted e.g. Boiler, flues, chimney, vents etc?

  Yes

  No

• Project specific construction phase H&S plan available?

  Yes

  No

• COSSH Assessments & SDS available?

  Yes

  No

• Incident reporting procedures available?

  Yes

  No

• Asbestos discovery/disturbance procedure available?

  Yes

  No

• Sign in/out register completed and up to date?

  Yes

  No