Health & Safety WIP

Map Group (uk) H&S Workplace Inspection

"WIP"
Please continue through each section to answer all the questions correctly. You will be guided through this form and if at any stage we feel that there is a need to stop your inspection we will let you know
RNDID
Audit Type*
If you are completing this audit as an engineer please leave as "Self Audit" otherwise please select the auditor from the list
Auditor*
If your not in the list select Other
If Other, Please specify name*
IMPORTANT! - On the next page your phone/device may ask you to consent to providing your current GPS coordinates/location. It is advisable to accept this as it will pre-populate the next answer for you to save you time

The location is important to our clients so please ensure its accurate
Local Authority*
Autocompleted Address
DateTime
Inspection Date*
Upon arrival at site if you feel additional photographic evidence is required please upload photos using the buttons below
Optional Photo 1a

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Optional Photo 2a

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Lets get a few more details of who you are inspecting. Please fill out the required fields below so that we know who we are dealing with
How many operatives being audited?*
Team Member 1

First NameLast Name
Team Member 2

First NameLast Name
Team Member 3

First NameLast Name
Team Member 4

First NameLast Name
Team Manager*
Choose Other if the TM isn't listed
Find the managers email address (Click the button below)
Other Team Manager
Manager Email*
Client Name*
If not listed select Other
If Other, Please specify Client Name*
Works Type*
WorkStream*
Are you a Direct Labor?*
Sub Contractor Name*
If Other, Please specify Sub Contractor Name*
Vehicle Registration*
Please use the format in capitals without spaces i.e NU18UOV

STOP NOTICE ISSUED? - Where work is stopped due to inspection safety failings, list reasons in the comments below*
Stop Notice Details
stopnoticecalc

Audit Setup

Please select from the options below based on the type of audit required. Some sections are mandatory and cannot be omitted. If a section is not applicable to your role please choose NO for each answer.
Section 1 - Organisation Arrangements.*
Mandatory
Section 2 - Operational Environment & Safe Systems of Work.*
Mandatory
Section 3 - Accident & Incident Reporting.*
Mandatory
Section 4 - Training & Certification.*
Mandatory
Section 5 - Personal Protective Equipment.*
Mandatory
Section 6 - Welfare & First Aid.*
Mandatory
Section 7 - Testing & Detection Equipment.*
Mandatory
Section 8 - Portable Appliance Testing & Pre-User Checks.*
Optional
Section 9 - Chamber Keys, Rods & Manual Handling.*
Mandatory
Section 10 - Working at Height & Fall Protection Equipment.*
Optional
Section 11 - Confined Space Training & Equipment.*
Optional
Section 12 - Hoist (MEWP) Operations.*
Optional
Section 13 - Vehicle & Trailer.*
Mandatory
Section 14 - Environmental.*
Mandatory
Section 15 - Civils*
Optional

Please ensure that all questions are answered accurately and that additional comments/photos are added to the end of the form.

1. Organisation Arrangements.
1.1 Do operatives know who to contact for advice on health & safety issues?*
1.2 Can operatives provide an example of a H&S issue/subject which should be reported to a manager/H&S Dept? *
1.3 Are operatives aware of workplace inspections which are/have been completed by management/H&S Dept?*
1.4 Have all safety rules been clearly communicated to operative?*
(Company/site Induction)
1.5 Do operatives have regular visits from their Supervisor? *
(Check site diary)
Comments 1

2. Operational Environment & Safe Systems of Work.
2.1 Has the daily site diary/hazard assessment been completed correctly?*
Do operatives understand how to complete site diaries correctly?
2.2 Complete Map vehicle pack available on the vehicle? *
Including risk assessments, safety at street works & road works (red book), and Map Group spillage & containment procedure etc.
2.3 Correct/sufficient NRSWA equipment available on vehicle to safely undertake workplace activities?*
(Signs, cones, gate guards)
2.4 If activity requires, is sufficient NRSWA equipment deployed correctly to safeguard traffic & pedestrians?*
2.5 Do operatives understand "Safe Systems of Work" for the activities they are undertaking?*
2.6 Are operatives aware that disciplinary procedures apply to all employees who do not comply with/ignore SSOW, SOP, method statements?*
2.7 Courtesy Boards in place to cover working activity?*
Comments 2

3. Accident & Incident Reporting.
3.1 Can operatives explain the correct procedure for reporting an accident, incident, near miss or RTA?*
3.2 Can operatives explain when an accident, incident, near miss or RTA should be reported?*
3.3 Are operatives aware of the emergency procedure in the event of a vehicle fire?*
Comments 3

4. Training & Certification.
4.1 Have operatives received the Map Group (uk) Health & Safety induction including training?*
4.2 Have operatives received adequate training for the activities they are conducting?*
4.3 Have operatives received H & S refresher training during their employment with Map Group (uk)? *
4.4 Can the operatives demonstrate knowledge of the latest Map Group (uk) toolbox talk?*
4.5 Do operatives hold relevant Openreach safety & craft accreditation for work undertaken.*
E.g (A9/SA002, K8 etc...)
4.6 Are all operatives registered for SMART awards?*
OP1 Smart ID
OP1 Smart ID Expiry

DayMonthYear
Date
OP2 Smart ID
OP2 Smart ID Expiry

DayMonthYear
Date
OP3 Smart ID
OP3 Smart ID Expiry

DayMonthYear
Date
OP4 Smart ID
OP4 Smart ID Expiry

DayMonthYear
Date
4.7 Are valid Street Works cards available on site?*
OP1 SWQR Number
OP1 SWQR Expiry

DayMonthYear
Date
OP2 SWQR Number
OP2 SWQR Expiry

DayMonthYear
Date
OP3 SWQR Number
OP3 SWQR Expiry

DayMonthYear
Date
OP4 SWQR Number
OP4 SWQR Expiry

DayMonthYear
Date
4.8 Is valid certification available on site & relevant to the operative(s) day to day activities & equipment being utilised?*
E.g. (NPORS, CPCS, EUSR) - Take photos below
Evidence of certification 1

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Evidence of certification 2

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Comments 4

5. Personal Protective Equipment.
5.1 Is PPE utilised correctly at time of inspection?*
5.2 Is relevant PPE available on site?*
e.g Safety helmet, chin strap, eye protection, ear protection, dust mask, gloves, safety boots, Hi Vis clothing (long sleeved Openreach), waterproofs.
5.3 Is PPE in an acceptable condition & when not in use, stored correctly?*
5.4 Have all operatives being audited been fitted for RPE?*
(face fitting - FFP3)
Comments 5

6. Welfare & First Aid.
6.1 Is a first aid box available (including eyewash)?*
(adequately stocked & within expiry date)
6.2 Are adequate welfare facilities available & are operatives aware of local welfare facilities e.g. toilets etc?*
(hand wipes/paper towel)
6.3 Is a sharps disposal receptacle available on the vehicle?*
6.4 Leptospirosis (Weils disease) card issued & available on site?*
6.5 Have operatives completed the online first aid course provided by Map Group (uk)?*
Comments 6

7. Testing & Detection Equipment.
7.1 Are GDU's available on site?*
7.2 Are all GDU's charged & within calibration expiry date?*
GDU displaying no errors
GDU Failure Comments 7
7.3 Is the GDU positioned correctly?*
(In chamber, street furniture, excavation to sustain accurate monitoring & provide adequate warning)
7.4 Can operative(s) demonstrate GDU knowledge? *
(safe operation & emergency procedures in accordance with company training/policy)
7.5 Is a working pipe locator available?*
(are operatives competent in utilising equipment when required,(included on A16 assessment))
7.6 Is a Martindale (socket tester) available?*
(are operatives competent in utilising equipment when required?,(included on A16 assessment))
7.7 Is a voltage detection pen available?*
(are operatives competent in utilising equipment when required?, (included on A16 assessment))
7.8 Is tooling insulated and in a good condition?*
Comments 8

8. Portable Appliance Testing & Pre-User Checks.
8.1 Is ALL electrical equipment PA Tested?*
(within next test date & displaying a test label)
8.2 Can operatives explain procedure for pre-user checks performed on electrical equipment?*
(e.g checking for signs of damage)
8.3 Is all electrical equipment supplied by Map Group (uk) or approved supplier?*
Comments 9

9. Chamber Keys, Rods & Manual Handling
9.1 Is a 'Key Joint Box No. 5 Pit Cover Lifter' & cover roller bar available?*
(in serviceable condition)
9.1a Are operatives competent in utilising the No. 5 pit cover lifter & roller bar when required ?*
(included on A9/SA002 assessment)
9.2 Are other chamber keys e.g. T-Keys & street furniture keys in a serviceable condition?*
9.3 Is a LMC4 (mechanical lifter) available?*
(Is it in a servicable condition & are operatives competent in utilising equipment, included on A9/SA002 assessment)
9.4 Is a cobra available?*
(Is the cobra / bullet & cage in a serviceable condition & are operatives competent in utilising equipment, included on K8 assessment)
9.5 Are operatives a ware of manual handling restrictions? *
(e.g. conducting chamber/pit cover removal activities, included on A9/SA002 assessment)
Comments 10

10. Working at Height & Fall Protection Equipment.
10.1 Have operatives been trained in the safe use of ladders & step ladders & aware of the WAH Policy.*
(included on A16 assessment)
10.2 Are Ladders, step ladders, platforms, top & bottom end stability devices available?*
(in acceptable condition, inspected & colour coded (tagged)
10.3 Is WAH equipment being utilised correctly?*
(in a safe manner & a safe working zone created around working area)
10.4 Has operative(s) been trained in the safe use of fall protection equipment?*
(included on A8/SA001 assessment)
10.5 Is a harness, lanyard & pole belt available, in acceptable condition?*
(inspected & colour coded (tagged)
10.6 Is fall protection equipment being utilised correctly?*
(in a safe manner & a safe working zone created around working area)
10.7 Are height telescopic measuring rods available?*
Serviceable and used where required (Applicable to overhead teams and surveyors)
10.8 Is sash line and dispenser available and used where required?*
Comments 11

11. Confined Space Training & Equipment.
11.1 Have all operatives attended a 'Working In Confined Spaces Training Course'?*
(hold relevant certification required to work in confined spaces)
11.2 Is rescue equipment available & in acceptable condition?*
(tripod, winch, escape set (oxygen/mask)
11.3 is rescue equipment within the LOLER testing period?*
Within 12 months of purchase or colour coordinated inspection status
11.4 Are rescue harnesses available?*
(in acceptable condition, inspected & colour coded (tagged))
11.5 Is a 'permit to work' available for confined space working activities?*
Comments 12

12. Hoist (MEWP) Operations.
12.1 Have operatives attended an IPAF course?*
(hold valid in date certification required to operate the hoist (MEWP))
12.2 Are LOLER test certificates available on site?*
12.3 Have all relevant safety checks been performed prior to utilising the hoist?*
(Can operatives explain what safety checks were performed?)
12.4 Is a hoist lanyard available?*
(in acceptable condition, inspected & colour coded (tagged)?)
Comments 13

13. Vehicle & Trailer.
13.1 Is the vehicle/trailer suitable for its intended use & legal requirements for use on the highway?*
(e.g. tyres, beacons, chevrons etc)
13.2 Is the break away cable & jockey wheel attached?*
(in acceptable condition for intended use & legal requirements for use on the highway)
13.3 Is there a visible "no smoking" sign displayed within the vehicle?*
(the 'no smoking policy' adhered to?)
13.4 Is the vehicle loaded safely, evenly & not exceeding the maximum gross weight?*
13.5 Can operatives explain when & how a mobile phone can be safely utilised when operating a vehicle?*
(in accordance with Map Group procedure)
13.6 Is the vehicle parked safely & secure (locked) when unattended?*
13.7 Are 3 slings available? *
(suitable & serviceable for use to secure excavators on trailer)
Comments 14

14. Environmental.
14.1 Is a spill kit, drip tray, funnel & metal fuel canister available on the vehicle? *
14.2 Are operatives aware of the procedure for dealing with an environmental spillage & actions required to contain?*
14.3 Is a water testing kit available?*
Can operatives explain the procedure & how to correctly utilise the testing kit ? (included on A9/SA002 assessment)
14.4 Is a compressed air sticker displayed on rear doors?*
(when compressed air is transported/stowed within vehicle)
14.5 Is a flammable liquid sticker displayed on rear doors?*
(when fuel is transported/stowed within vehicle)
Comments 15

15. Civils
Utility Identification
15.1 Is full job pack available on site?*
including Hazardous Awareness Sheet? (Paper or Electronic)
15.2 Eligible in date utility prints available on site?*
(Paper or Electronic)
15.3 Utilities identified?*
(evidence of spray markings)
15.4 Do operatives know how to identify High Pressure Pipelines on the utility prints?*
15.5 Are operatives aware of the Hot Job procedure?*
(Skull & Crossbones watermark indicates a job within the ZOI of a utility, extra caution must be taken)
15.6 Is there a CAT & Genny on site?*
(Calibrated and fully functional)
Cat & Genny Calibration Date*

DayMonthYear
Date
15.7 Can operatives demonstrate the full use of the CAT & Genny?*
15.8 Can operatives identify risks within their working area?*
(e.g overhead power-lines, bridges, railway lines etc...)
Dust Suppression
15.9 Are proper dust suppression techniques being used?*
15.10 Is suitable dust suppression equipment available?*
Comments 16

Please add additional comments where applicable to support the audit submission
Issues Requiring Escalation To Management/H&S
Actions Performed By Manager To Rectify Failings
Auditor Comments
Engineer/Gang Comments
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Lead Operative Signature

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Auditor Signature

Clear
Score
Pass
Fail
Result
DL Result
Direct Labor
DL 1
Should be Empty:

Map Group (uk) H&S Workplace Inspection

Utility Identification

Dust Suppression