Vol 5 - Standard Form SHEQ Inspection
Doc: Issue: Date: Page: 1 of 2
Instruction for use: All items marked as unsatisfactory on page 1 must be referred to on page 2 along with the category, action to be taken, by whom and the date for completion / close out. When remedial action has been taken, the person who received the report must confirm in writing close out with the person who carried out the inspection. Note: Guidance on completing the form can be found on SF054 Contract Name: SAMPLE Site Location: SAMPLE Client: Matrix Compliance Check List Key Ref. 1 2 3 4 5 6 Inspected Item Offices and Welfare Mess facilities, drinking water Office cleanliness and integrity Toilets Fire prevention and safety First aid kits Prescribed signs and notices Monitoring and Control 7 8 9 10 11 12 13 14 15 Supervision of work Registers and Certificates Assist Reports (retained on site) Induction Training (SHEQ) Dissemination of information Plant authorisation Compliance with SHEQ Plans Compliance with risk assessments Compliance with method statements Site General 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 Stores/ Control of goods and materials Site access and egress Site security and demarcation Traffic Mgt Plan and Rights of Way Overhead power cables Public safety Chapter 8 compliance (street works) Personal protective equipment Emergency contact Site Specific Excavations, shafts and tunnels Access to electrical areas Barriers and fencing Scaffolding and mobile towers Ladders and steps Cranes and lifting equipment Other plant Permanent electrical plant Temporary electrical supplies Power tools Sub totals (Satisfactory) Note: For Audit close out refer to SP17 52 53 54 55 56 57 58 59 60 a) b) c) d) e) 42 43 44 45 46 47 48 49 50 51 41 Contract No: SAMPLE Project Manager: SAMPLE Date: Satisfactory
Unsatisfactory Ref. 35 36 37 38 39 40
Inspected Item Confined Spaces Noise, vibration and lighting Abrasive wheels...
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