Professional Documents
Culture Documents
Report
Project S50
Contract EES01 Contract No. RTC/041/2012
Revision No
Rev 01
See ‘Safety Information Sheet 14’ for further information and guidance on items 1 – 58.
Add project specific items as items 59+.
Page1 | 6
Section Health & Safety
Status Controlled PSH Management System Master
Reference S050 Documents Control Details
Rev Date October 31, 2015
S050 - Safety, Health, Welfare & Environment Inspection
Report
Are there as a minimum 2 emergency Is a Scaff-tag system in place and
4.e.
muster points on site?
✓ 35.e
correctly used?
✓
4.f.
Is your site emergency plans updated ✓ 35.f
Is all scaffold free from electrical
✓
with all the above information? cables directly touching it?
5. First aid 35. Ladders and steps
Are there adequate 1st Aid facilities on
✓ Are ladders the right way to the job?
5.a
site and regularly maintained?
35.a Don’t work from ladders if there is a ✓
better way.
Are there adequate ratio of competent ✓ Are the ladders in good condition and
5.b 1st Aiders to number of personnel on 35.b ✓
inspected regularly?
site?
6. Prescribed signs & notices 36. Cranes & lifting equipment ✓
6.a Are relevant HSE notices in place?
✓ 36.a
Are there lifting procedures and plans ✓
in place for the lift?
6.b
Project HSSE notice board populated ✓ 36.b
Are all the lifting personnel trained and ✓
with the correct information? competent to carry out their roles?
Is the lifting controlled i.e. stop people
36.c from walking or working beneath a ✓
raised load?
36.d Are all the cranes suitable for the job? ✓
Does all cranes have current report of ✓
36.e thorough examination and inspection
records?
Has the suitability of the ground been
36.f ✓
checked?
Do all man riding baskets have the 3rd
37.g
party certificate attached?
✓
Monitoring & Control 37. Other plant ✓
7. Supervision of work 38. Permanent electrical plan
Are all site operations adequately
7.a
supervised?
✓ 38.a Approved EP in place? ✓
8. Registers and Certificates ✓ 39. Temporary electrical supplies
Are all site registers maintained, signed
8.a
and dated?
✓ Concession for temporary in place? ✓
9. Accident Book or equivalent 40. Power tools
Are all accident/incident correctly
9.a
records in the JV SMS forms?
✓ 40.a Are PT PAT? ✓
10. Induction Training 41. Confined spaces N/A
Have all person correctly being inducted Have all necessary precaution been
10.a on the project and in particular site- ✓ 41.a taken before confined space operation
specific induction and training? can begin?
Is there an emergency evacuation
Are these induction registers or records
10.b
kept and available for inspections?
✓ 41.b procedure in place including a means
of raising the alarms?
11. Dissemination of information 42. Noise
Are all HSSE information correctly
Have you identified & assessed
11.a cascaded to all personnel on the ✓ 42.a
workers exposure to noise?
✓
project?
Page2 | 6
Section Health & Safety
Status Controlled PSH Management System Master
Reference S050 Documents Control Details
Rev Date October 31, 2015
S050 - Safety, Health, Welfare & Environment Inspection
Report
Is suitable hearing protection provided
42.b
and worn in noisy areas?
✓
12. Plant authorisation ✓ 43. Abrasive wheels
Are all dangerous parts guarded and
43.a
secured?
✓
Are all operators trained and
43.b
competent?
✓
44.c Are all test certificates available? ✓
13. Compliance with H&S Plan 44. COSHH & hazardous substances
Are there safe working procedures are
Are there approved and updated site
13.a
specific HSE plans?
✓ 44.a being followed in line with COSHH risk ✓
assessments and data sheets?
Are COSHH items correctly identified
Are emergency plans in place for site
13.b
specific hazards or circumstances?
✓ 44.b and stored in a secured designated ✓
COSHH store?
44.c
Are designated COSHH areas suitably ✓
signage and fire rated CMS in place?
Is there a trained competent COSHH
44.d ✓
Coordinator on site?
14. Compliance with risk assessments 45. Manual handling
Have worker been informed and
Are there approved and updated site-
14.b
specific RA plans?
✓ 45.a trained on safe manual handling ✓
procedures?
15. Compliance with method statements 46. Health Matters
Are welfare facilities located in
All site operations have the correct MS
15.a
in place?
✓ 46.a proximity of work areas and ✓
adequately maintained?
Are mess areas clean and tidy and are
46.b workers provided food in an ✓
acceptable manner?
47 Temporary Covers ✓
Stores & Workshops Environmental issues
16. Stores layout ✓ 47. Noise & vibration ✓
17. Flammable liquids, LPG, other gases ✓ 48. Light pollution control measures ✓
Are they covered, restrained, gas
17.b
bottles capped and kept in a cool area?
✓
18. Woodworking machines ✓ 49. Air pollution control measures ✓
Site General 50. Dust suppression ✓
19. Site access and egress ✓ 51. Waste management ×
19.a A minimum of 2 site access/egress in
. place?
✓ 51b Waste segregated? ✓
19.b Local areas of access/egress
. considered site wide?
✓ 51c Hazmat placed in hazmat skips? ✓
20. Site security & demarcation ✓ 52. Work in watercourses and flood plains ✓
20.a
Are there adequate site control and ✓
deterrent procedure in place?
21. Pedestrian routes & roadways ✓ 53. Water/ground pollution prevention ✓
Page3 | 6
Section Health & Safety
Status Controlled PSH Management System Master
Reference S050 Documents Control Details
Rev Date October 31, 2015
S050 - Safety, Health, Welfare & Environment Inspection
Report
Protection of ecology, archaeology &
22. Tidiness ✓ 54.
heritage
✓
23. Storage & disposal of materials ✓ 55. Traffic management ✓
24. Overhead power cables N/A 56. Contaminated land ✓
25. Electricity 57. NEW - Adequacy of spill kits ✓
25.a
Are all CSM as practicably not in direct ✓
contact with metallic surface?
25.b
Are all fixed appliances earthed and ✓
certificated?
Do tools correctly colour coded, visually ✓
25.c inspected by user daily and regularly
tested by competent person?
Are trip devices e.g. residual current
25.d devices (RCD) checked and maintained ✓
where main voltage is required?
Are CMS protected from damages and
25.e ✓
are all connections properly made?
NEW - Environmental
26. Public safety ✓ 58.
consents/licences/permits/etc.
✓
27. Chapter 8 compliance ✓ Other Contract Specific Items (specify)
59. PPE ×
Any items marked as unsatisfactory must be referenced on page 2 of the S50, along with proposed remedial
actions and times for completion.
All items marked as unsatisfactory on page 1 must be referenced below, along with actions required to
remedy substandard conditions, a risk category according to the potential for injury/damage (see table
below), and a person accountable for completion of the actions. When all actions required are complete, the
completion date should be filled in to signify thus
Page4 | 6
Section Health & Safety
Status Controlled PSH Management System Master
Reference S050 Documents Control Details
Rev Date October 31, 2015
S050 - Safety, Health, Welfare & Environment Inspection
Report
Date
Ref. Description of unsatisfactory condition & action required Cat. Acc.
Actioned
Page5 | 6
Section Health & Safety
Status Controlled PSH Management System Master
Reference S050 Documents Control Details
Rev Date October 31, 2015
S050 - Safety, Health, Welfare & Environment Inspection
Report
Observation Pictures
Ref Description of unsatisfactory condition Close out Photo Status
& action required
Open
51.
Page6 | 6
Section Health & Safety
Status Controlled PSH Management System Master
Reference S050 Documents Control Details
Rev Date October 31, 2015