Residential Installation Audit
HSEQ Audit
Contract
*
Please Select
Youfibre
Voneus
Date
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Operative 1
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First Name
Last Name
Name of Operative 2
*
First Name
Last Name
Name of Operative 3
First Name
Last Name
Name of Line Manager
*
First Name
Last Name
Name of Auditor
*
First Name
Last Name
Name of Supervisor
*
First Name
Last Name
Email Of Supervisor
example@example.com
Is Company Vehicle Parked Safely & Locked?
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Yes
No
Comments
Is Smart Awards Card present on site?
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Yes
No
Comments
Does team have access to first aid kit and eye wash?
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Yes
No
Comments
Does team have access to appropriate gas testing unit that is fit for purpose?
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Yes
No
N/A
Comments
Does team have access to sharps bin?
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Yes
No
N/A
Comments
Has Risk Assessment been completed for the works? Are details relevent to the task
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Yes
No
Comments
POWRA should be emailed to operative on completion, please take photoraph.
*
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Is External Point of Work Set Up in a Safe Manner?
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Yes
No
N/A
Comments
When working from the ladder are the following mitigations in place - If not please note in comments box below what mitigations were not in place.
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Rows
Pass
Fail
N/A
Hard hat worn with chin strap by Operative working at height
Shoulder strap available/ used for SDS drill
Tool Pouch available/ used for hand tools
Ladder slip matt and standoff available/used or ladders footed if practicable
Work at base of ladder avoided when first operative is up ladder
Hard hat worn by operative workin at ground level while work at height is ongoing
Hard hat worn by operative workin at ground level while work at height is ongoing
Comments
External Point of Work Photograph
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Is the Operatives Ladder tagged with correct inspection tag?
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Yes
No
Comments
Are operatives FPE items tagged with correct inspection tags? (Ensure to check MEWPS for fall restraint lanyard)
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Yes
No
N/A
Comments
Does Operative have suitable PPE in place?
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Yes
No
Comments
PPE
*
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Is Internal Point of Work Set Up in a Safe Manner?
*
Yes
No
N/A
Comments
File Upload
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Has the Operative Utilised a Service Location Device Correctly?
Yes
No
N/A
Comments
Service Location Device
*
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Has the Intenal Point of Work been left in a clean state free from debris and waste?
Yes
No
NA
Comments
Internal Point of Work
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Has the external Point of Work been left in a clean state free from debris and waste?
*
Yes
No
N/A
Comments
External Point of Work
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All tooling & Equipment not in use returned and secured in the vehicle?
Yes
No
N/A
Comments
Are all aspects of working at height being completed in a safe manner?
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Yes
No
N/A
Does the job require operatives to span over LV services?
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Yes
No
N/A
If spanning over LV is required is a MEWP present?
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Yes
No
N/A
Rows
Pass
Fail
N/A
Plastic Stay Guard
Gloves IR, (Note, all operatives that are assisting with spanning over LV services should have access to their own gloves IR and utilse them accordingly).
Sash Line
Pullies 4 & 6
Come Along Clamp
Measuring Height Rods
Gas Testers fully charged and in working order
Comments - If any items are not present please note below.
Working at Height 1
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Working at Height 2
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Working at Height 3
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Do operatives have access to Overhead Power Glovebox Guide?
Yes
No
Overhead Power Glovebox Guide
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Comments
*
Do operatives have access to LV Power Crossing Guide Guide?
Yes
No
LV Power Crossing Guide
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Comments
*
Do operatives have access to RAMS?
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Yes
No
RAMS
*
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Comments
Are NOPS cards Present?
*
Yes
No
Nops Cards
*
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Comments - What work was being completed? Good or bad points? Has any coaching been issued?
*
Audit Pass/ Fail
Pass
Fail
Submit
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