Title Page

  • Site conducted

  • Conducted on

  • Manager

  • Location

ASBESTOS - YES to PROGRESS

  • Have you checked the 'Alpha Tracker' for ACM's in the properties you will be working on?

  • Either check it (where available) or ensure you have a copy of the Asbestos ?Report for the property

  • Do you have a copy of the Asbestos report for the properties you are working on?

  • DO NOT PROGRESS WITH ANY WORK - YOU MUST OBTAIN AN ASBESTOS REPORT FOR ALL PROPERTIES

  • Have you scrutinised the Asbestos report to check for ACM's

  • DO NOT PROGRESS WITH ANY WORK - YOU MUST FULLY CHECK THE REPORT TO ENSURE THE AREAS OF WORK ARE FREE FROM ACM'S

  • Have all operatives been given instruction on what to do if they identify any potential ACM's

  • ENSURE ALL OPERATIVES ARE INFORMED OF THE PROCESS OF WHAT TO DO UNDER THESE CIRCUMSTANCES

SITE SET UP - YES to PROGRESS

  • Have you identified a set down area for materials

  • Identify an area that is accessible for operatives and safe deliveries of materials

  • Do you have sufficient barriers, hazard tape & signage to prevent unauthorised access to the set down/storage area

  • You must ensure that before deliveries commence that you have sufficient number of barriers/tape/signage to protect the area

  • Have you ensured that pedestrians are protected and have an accessible route to travel

  • You must provide alternatives for pedestrians where their normal access has been disrupted by the works

  • Have you organised a Waste area where skips will be kept

  • You must ensure that the area does not put tenants/members of the public at risk, reduce the risk by using barriers/netting/signage etc to prevent waste from chute's becoming a danger to the public. You must also ensure that there is sufficient signage to advise the public of the potential dangers.

  • Have you checked the condition of the waste chute and it's attachments

  • You must check the condition to ensure there are no splits/cracks in the chute and that the fixings on the top are secure

  • Do you have welfare in place that offers; First Aid kit, hot & cold running water, seating area, toilet facilities

  • You must either provide sufficient welfare or an optional list of available welfare close to the site

The SCAFFOLD - YES to PROGRESS

  • Have you conducted a Handover of the scaffold and completed the correct form

  • You must check the scaffold and fill in the correct Scaffold Handover form before anyone accesses the scaffold

  • Have you ensured that the scaffold is not blocking any gas flues?

  • Check for all types of flues - Horizontal/Vertical/Balanced flues, ensure the flue has nothing covering it and that upcoming works cannot block the same flues.

  • Is the scaffold compliant and ready for use

  • You must complete the 'Remedial Actions' part of the scaffold handover form and give the form to the scaffold contractor for rectification

  • Where remedial actions have been identified and completed, have you re-checked the scaffold to ensure it is now compliant and that all works have been completed

  • You must check the scaffold to ensure all works have been completed, you must also fill in the 'Remedial actions' part of the Scaffold Handover form to confirm you have reinspected the scaffold and that you have now accepted the handover

  • Does the Scaffold have a fully completed green tag in place

  • You must contact the scaffold contractor and advise them to complete and fix a tag to the scaffold (you can commence work on the scaffold as long as the scaffold contractor can confirm the details are held in the scaffold register)

  • Has the ladder (access to the scaffold) been tied off correctly (both stiles tied with blue rope)

  • You must ensure that the ladder is footed and a second person ties off the ladder correctly

YES to PROGRESS Sign Off - You are now safe to progress once the above questions have all been answered with a YES.

  • Date of completion

  • Additional images from site

  • Signed by;

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.