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PMYL Civil Engineering - Site Safety Check Sheet
BEFORE COMPLETING THIS FORM- SIGN IN ON THE WPP/RAMS/TB then immediately photograph all Close Calls, General Site Images for uploading as a part of this form - REPORT MUST CONTAIN AT LEAST 2 CURRENT IMAGES TAKEN AT THE TIME OF THE INSPECTION
*
Indicates required field
Inspectors Name
*
First
Last
Supervisor Name / Person In charge at time of Audit
*
First
Last
Date DD/MM/YYYY
*
Example 20/04/1965
Address
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Line 1
Line 2
City
State
Zip Code
Country
Site Name and Task Being Undertaken and location on site
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Site Name - Example Holgate depot Task: Example Linear drainage as per TB number 0001 Location on site ; Example West side of carraigeworks
All Staff in Correct PPE
*
Select
Yes
No
Task Specific PPE prersent and being used
*
Select
Yes
No
Ear Defenders, correct gloves, Glasses Etc Etc
Valid in date and signed Task Brief
*
Select
Yes
No
Everyone Signed in
*
Select
Yes
No
Working in accordance with the WPP/TB /RAMS?
*
Select
Yes
No
WPP/TB /RAMS Adequate for task
*
Select
Yes
No
Havs in Operation nad recorded?
*
Select
Yes
No
Not Applicable
Plant Daily Checks Undertaken and viewed on the server
*
Select
Yes
No
Permits in place and check on server
*
Select
Yes
No
Plant on Drip Trays
*
Select
Yes
No
Fuel Contained Properly
*
Select
Yes
No
Site Tidyness
*
Select
Excellent
Good
Below Average
Not Good
Very Bad
Select Fencing
*
Select
In Good Order
In Bad Order
Marks out of 10 Overall
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1
2
3
4
5
6
7
8
9
10
List all close calls here
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Close Calls Close Out during Inspection
*
Select
Yes in Full
Part
Non closed out
Upload File
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Max file size: 20MB
Upload File
*
Max file size: 20MB
Upload File
*
Max file size: 20MB
Upload File
*
Max file size: 20MB
Upload File
*
Max file size: 20MB
Upload File
*
Max file size: 20MB
Submit
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Hull Grab GT Endurance
