SITE INSPECTION FORM
Site Name
Conducted On
Location
Client Name
Description Of Work
Has COSS / SWL / PWT Briefed all staff on the safe system of work and identified to the staff?
YES
NO
NA
Sentinel and other competence cards available and verified.
YES
NO
NA
First Aider on site and identified to Staff?
YES
NO
NA
Are all relevant permits available? (Hot work, confined space, permit to dig, Height etc)?
YES
NO
NA
Work Package Plan / Task briefing available, of the correct issue, signed / verified and adequate?
YES
NO
NA
Environmental Assessment(s) available and understood?
YES
NO
NA
Risk Assessment’s available and understood?
YES
NO
NA
Is the correct amount of site supervision available for the staff?
YES
NO
NA
Has the safe system of work been, verified and understood?
YES
NO
NA
Has AC / DC isolated and verified, and has possession of the line been taken?
YES
NO
NA
Are staff fit for work and aware of the D&A policy?
YES
NO
NA
Are planned protection arrangements suitable to the associated task?
YES
NO
NA
Is there sufficient amount of staff on site to undertake planned tasks?
YES
NO
NA
Have staff had sufficient amount of rest as per the working time directive?
YES
NO
NA
If no to previous question has a Risk Assessment been completed?
YES
NO
NA
Is PPE available for the associated task and in clean good condition?
YES
NO
NA
Has PPE got the correct company logo displayed?
YES
NO
NA
Is protective footwear worn and appropriate?
YES
NO
NA
Is eye protection worn, of appropriate type and used where appropriate?
YES
NO
NA
Do contact lens wearers have spectacles on their person?
YES
NO
NA
Are gloves worn and suitable for the task (minimum of Cut 5)?
YES
NO
NA
Are ear defenders available and used where appropriate?
YES
NO
NA
Are dust masks used where appropriate?
YES
NO
NA
Is wet weather clothing available and adequate?
YES
NO
NA
Are safety helmets in good condition and in date?
YES
NO
NA
Is Arc Flash PPE and undergarments available for the activity and to the minimum flash rating requirements?
YES
NO
NA
Vehicle registration number’s
Driver Name:
Are vehicles parked safely without causing obstruction?
YES
NO
NA
Have the ignition keys been removed from all parked vehicles?
YES
NO
NA
Are pins for tow bar securing bolts or equivalent available and used?
YES
NO
NA
Are vehicles clean & tidy?
YES
NO
NA
Vehicle free from damage?
YES
NO
NA
Are there any digging activities being conducted?
YES
NO
NA
Are operatives competent in the safe use of the Cable Avoidance Tool (CAT)?
YES
NO
NA
Are located service routes marked?
YES
NO
NA
Is there a valid buried service report available?
YES
NO
NA
Are safe digging practices observed? (Dig at Caution)
YES
NO
NA
Are Emergency contact details available?
YES
NO
NA
Is plant or equipment being used?
YES
NO
NA
Are operators trained and authorised in the powered plant being used?
YES
NO
NA
Is plant and equipment serviceable?
YES
NO
NA
Is plant and equipment suitable for Job?
YES
NO
NA
Are machine guards and safety arrangements in place and being used?
YES
NO
NA
Are staff protected from Hand Arm Vibration?
YES
NO
NA
HAVS: controls identified in WPP and TBS?
YES
NO
NA
HAVS: equipment rotation employed for High Risk plant?
YES
NO
NA
Has any exposure been recorded
YES
NO
NA
Is Mechanical Plant being used on site?
YES
NO
NA
Are operative(s) trained and authorised for use of mechanical plant
YES
NO
NA
Has plant got the correct maintenance and test date (Annual / 6 monthly test certificates for lifting equipment etc.)?
YES
NO
NA
Is the correct pre-use Inspection carried out
YES
NO
NA
Suitable for task and is the supplied item of plant the same as the one planned in the WPP / TBS?
YES
NO
NA
Safe System of Work – Does the WPP / TBS cover the SSOW for the operation of the item of plant including access / RRAP points, communications and emergency procedures?
YES
NO
NA
Is a First Aid Kit available, in a compliant condition?
YES
NO
NA
Is there an available eye wash station?
YES
NO
NA
Does the team have an identified trained first aider?
YES
NO
NA
Is there Welfare available?
YES
NO
NA
Are the welfare arrangement adequate?
YES
NO
NA
Do staff understand the accident/incident reporting procedure?
YES
NO
NA
Are there COSHH data sheets available for all substances?
YES
NO
NA
Have operatives been briefed on hazardous substances they use or come into contact with?
YES
NO
NA
Have operatives been briefed on hazardous substances they use or come into contact with?
YES
NO
NA
Is noise controlled appropriately and are staff protected?
YES
NO
NA
Are drip trays and funnels used where necessary?
YES
NO
NA
Is plant and machinery fuelled away from the vicinity of drainage systems, watercourse or vulnerable groundwater or habitat?
YES
NO
NA
Is the team adequately equipped to prevent/deal with spillage?
YES
NO
NA
Are environmental emergency contact details readily available?
YES
NO
NA
Is plant / equipment turned off when not in use?
YES
NO
NA
Evacuation plan available and current?
YES
NO
NA
Fire extinguishers available and of the correct classification?
YES
NO
NA
Is there trained staff to deal a situation?
YES
NO
NA
Is working at height required?
YES
NO
NA
Are staff erecting height equipment trained and competent?
YES
NO
NA
Is scaffold tagged / MEWP in date?
YES
NO
NA
Is correct PPE being worn when applicable such as harnesses?
YES
NO
NA
Does the work have an appropriate Risk Assessment with effective control measures?
YES
NO
NA
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