HSMS - Forms

managing safely

Health and Safety Management System

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Forms

The following records shall be held at each Workplace, where applicable:

Italics denote records and forms, which are either, printed or, generated to comply with procedures within the health and safety management system.

Section A - An Introduction

Company Procedures Manual

Section B - Administration

B2.4.1L1 Master List of Controlled Documents
B2.4.2S1 Transmission Slip
B2.4.3M1 Employee's Distribution Matrix
B2.4.4M1 Third Parties' Distribution Matrix

Section C - Health and Safety Policy

Health and Safety Policy
C2.1M1 Health and Safety Policy Distribution Matrix

Section E - Implementation and Operation

E1 Structure and Responsibility

E1.5.2ii Copies of Letters of Appointment

E2 Training, Awareness and Competence

E2.2.1F1 Employee's Induction Form - printed form
E2.2.1L1 List of Training Required
E2.2.1M1 Training Matrix
E2.3.2D1 Authorisation to Operate a Forklift Truck
E2.3.2D2 General Authorisation to Operate Plant and Equipment
E2.3.2D3 Notice - Authorisation to Operate a Forklift Truck
E2.3.2D4 Notice - Authorisation to Operate Plant and Equipment

E4 Control Procedures

E4.01 Risk Assessment

E4.01.1F1 Risk Assessment Record
E4.01.1F2 Design Risk Assessment Record
E4.01.4S1 Risk Assessment Register
Risk Assessment File

E4.02 Safe Working Practices

E4.02 Safe Working Practice Record
E4.02.3i Safe Working Practices File

E4.03 Permits to Work

E4.03F1 General Permit to Work
E4.03F2 Permit to Work or Test for Non-Live Working (Electrical)
E4.03F3 Permit to Work or Test for Live Working (Electrical)

E4.04 Lone Workers

E4.04.1ii Lone Workers Site Procedure

E4.10 Control of Contractors

E4.10.2D1 Control of Contractor's Documentation
to include:

General Authorisation for Contractors (Appendix IA)
Authorisation for Contractors (Appendix I)
Certificate of Competence for Contractors, Employees and Sub-Contractors
E4.10F1 Contractor's Induction Form - printed form
Inspection of (Hired In)/Contractors Plant/Equipment (Appendix IV)
Contractors Safety Checklist (Appendix V)
Acknowledgement of Receipt for Contractors Summary Sheet
Signed Declaration of the Conditions of Contract and Safety Rules for Contractors
Contractors Health and Safety Policy (where applicable)
Copy of Contractors' Employers Liability Insurance
Copy of Contractors' Public Liability Insurance
Contractors' COSHH Assessments (where applicable)
Contractors'Noise Assessments (where applicable)
Risk Assessments and Method Statements
Health and Safety Plan (if project completed under CDM Regs)
E4.10F2 Competence and Resources of Designers
HSE Notification of Project(where applicable)

E4.11 Visitors

E4.11D1 Documentation for Signing In
Documentation for Signing In, to include:

Form I Visitors Pass
Form I A Visitors Log
Form II Contractors Log
Form III Drivers Log
Sheet I Essential Safety Rules for Visitors

E4.19 Safety Representatives and Safety Committees

E4.19 R1 Safety Committee Inspection Form - Manufacturing
E4.19 R2 Safety Committee Inspection Form - Administration
E4.19.2ii Minutes of Health and Safety Committee Meetings

E4.21 Management of Health and Safety at Work Regulations 1999

E4.21.1i Employer's Information for Shared Site (to be held in the Site Specific Procedures Manual)
E4.21.1iii Arrangements for Co-operation on Shared Sites (to be held in the Site Specific Procedures Manual)
E4.21.1v Relevant Employers Risk Assessments and COSHH Assessments (to be held in the relevant Files)
E4.21.2i Induction Training for Temporary (>6 months) Workers

E4.22 COSHH

E4.22D1 COSHH Assessment Record
E4.22.1iii Material Safety Data Sheets

E4.23 Noise

E4.23.1iii Noise Assessment Records
E4.23.3i Action Plan for the Ongoing Control of Noise

E4.24F1 Manual Handling Assessment Record
E4.24.2ii Action Plan for the Development of Mechanisation of Manual Handling Tasks

E4.25 Personal Protective Equipment

E4.25F1 PPE Record
E4.25G1 PPE Training Guide

E4.30 Confined Space Entry

E4.30F1 Confined Space Entry Checklist
E4.30F2 Emergency Action Checklist

E4.31 Dangerous Substances

E4.31F1 Dangerous Substances Notification

E4.50 Plant Maintenance

E4.50.1i Maintenance Schedule for Fixed Plant
E4.50.2i Maintenance Schedule for Mobile Plant
E4.50C1 - Operator Daily Inspection Sheet, Forklift Truck
E4.50C2 - Operator Daily Inspection Sheet, Telehandler
E4.50C3 - Operator Daily Inspection Sheet, MEWP - Boom & Scissor Type
E4.50C4 - Operator Daily Inspection Sheet, EMU
E4.50.3v Performance Targets for SIMRET testing

E4.51 Housekeeping

E4.51C1 Office Inspection Checklist
E4.51C2 Factory Inspection Checklist
F1.1.2C3 Supervisor's Weekly Inspection - Construction

E4.52 Lifting Equipment Inspections

E4.52.1i Schedule of Inspection Visits
E4.53 Pressure Systems

E4.53.1i Written Scheme of Examination for all Pressure Systems
E4.53.2ii Copies of Insurance Inspectors Reports and Actions

E4.54 Low and High Voltage Electrical Systems

E4.54R1 Inventory of Fixed Plant
E4.54R2 Inventory of Portable Equipment
E4.54F2 Portable Equipment Test and Repair History
E4.54F3 Fixed Plant Test and Repair History
E4.54F5 RCD Routine Periodic Test Results
E4.54.3i Copies of Inspection Records
E4.54.3iii Copies of Action Records

E4.55 Electrical Lock off

E4.55.1ii Procedure for Electrical Lock off (to be filed in the Site Specific Procedures Manual)

E5 Occupational Health

E5.1 Prospective Employee Health Assessment

E5.1F1 Pre-Employment Health Questionnaire
E5.1F2 Prospective Employee Health Assessment
E5.1F3a Consent Form-Access to Medical Records
E5.1F3b Employee Notes-Access to Medical Records

E5.2 Screening for Hand Arm Vibration Syndrome

E5.2C1 Hand-Arm Vibration Exposure Calculator
E5.2F1 Vibration Questionnaire

E5.3 Health Screening for Hearing Loss

E5.3F1 Noise Exposure Questionnaire
E5.3.1i Noise Monitoring Records
E5.3.1v (b) Record of Actions Taken in Employee’s Personnel File

E5.4 Health Screening for Isocyanate Users

E5.4.1ii (b) Record of Actions taken resulting from the Company Occupational Health Consultant’s Advice

E5.6 Procedure for Working with VDU’s