Safety Checklist Form Template

Instantly Create Your Checklist, Just enter your details

CCTV Drain Survey Safety Checklist

Use our Checklist creator tool to create customised workplace safety documents. Learn more about CCTV Drain Survey Safety Checklist Template below
Safety Checklist Creator
Guest

Loading Safety Checklist Creator

Please wait while we prepare your workspace

Checklist Questions

Every question is included by default. Untick any you want to leave out, or delete the ones you don't need.

Click Add Question to add your own custom checks. Click a row to edit its wording, and drag to reorder.

The Yes / No / N/A tick-boxes and comments space are added automatically on the exported PDF or Word document.

No questions added yet — add your first one below.

Logo, Branding & Sign-off

Company brandingStandard+

Add your company logo and brand colours, and customise how your documents look. Available on our Standard and Pro plans.

Add my branding →

For the best result, upload a PNG with a transparent background — this lets your logo blend cleanly into headers and signature blocks across every generated document. JPG is also accepted but will appear with a white background.
Recommended size: at least 500×150px. Max file size: 5MB.

Choose the background colour for the header on shared documents. Select a colour that complements your logo and brand identity.

Select your brand colour for accents and borders that matches your company logo. Use HEX format (e.g., #E4B700 for yellow).

Colours are automatically synced with your Branding settings.

Sign to confirm you completed this checklist

Click to sign on behalf, or leave blank for on-paper approval.

Review & Export

Your checklist is ready. Register free to download your PDF — it opens in a new tab and signs you in here automatically, so don't refresh or leave this page.

Preview Document

See exactly how your checklist PDF will look before downloading.

Your checklist is ready

Ready to download

Register a free account to download your PDF. Your checklist stays right here.

Register to Download →

No card required · instant access

Save to Account

Not saved

Create a free account to save this checklist and re-export it any time.

Sign in to save

Export to Word

An editable Word (.doc) version with Yes / No / N/A tick-boxes and a comments space.

Export to Excel

A spreadsheet version for digital tracking and filtering.

Share & Sign

Not available for checklists — each checklist carries its own printed sign-off section instead.

Important: The documents produced by this tool are templates only. They must be reviewed and approved by a competent person or your HSEQ representative prior to publication or circulation, in accordance with our Terms & Conditions.

PDF Preview

100%

Creating preview

Building your PDF preview…

Still Using Paper Sign-Off Sheets?

Once you've generated and saved your document, create a secure share link to distribute across any platform. Collect encrypted digital signatures from your team and generate professional sign-off reports.

Generate
Save
Share
Sign
Report
Try It Free

Increased Limits Available

Risk Assessment Description:

This CCTV drain survey safety checklist template assists plumbers, heating engineers, Gas Safe registered engineers and supervisors to carry out a safe and compliant inspection of drainage systems using CCTV equipment.

It covers all essential checks including authorisation, competence, site conditions, equipment integrity, personal protective equipment, hazardous substances and emergency provisions. The checklist references the Confined Spaces Regulations 1997, the Control of Substances Hazardous to Health (COSHH) Regulations 2002 and the HSE Safe work in confined spaces guidance.

Use this checklist for:

  • Pre‑survey planning – confirming permits, risk assessments and competent personnel.
  • In‑process checks – verifying site conditions, equipment condition and PPE.
  • Post‑survey completion – ensuring waste disposal, equipment de‑contamination and record keeping.

Each item is answered Yes, No or N/A; any No response must be resolved before work continues. Record the response on the form, notify the supervisor and take corrective action before proceeding.

Fully editable and shareable – customise the questions to your site, download as a PDF and share with your team.

Use this checklist on site to verify each control before starting the survey, record responses on the worksheet and keep the completed form with the project health and safety file for audit and future reference.

Compliant with: Confined Spaces Regulations 1997; Control of Substances Hazardous to Health (COSHH) Regulations 2002; Safe work in confined spaces – HSE guidance.

Sample PDF Document Image:

Checks covered in this CCTV Drain Survey checklist

This CCTV Drain Survey safety checklist template covers 23 checks. Customise the questions to your workplace, then download a professional, print-ready PDF with Yes / No / N/A tick-boxes and a comments space.

#Checklist item
1Has a suitable risk assessment and method statement been completed for the CCTV drain survey?
2Is a confined‑space entry permit in place for the drain being surveyed?
3Are all operatives trained and competent to work in confined spaces and operate CCTV equipment?
4Is the operative Gas Safe registered where gas‑related work may be encountered?
5Is the work area adequately ventilated to prevent build‑up of hazardous gases?
6Is the access route to the drain clear of trip hazards and safe for equipment transport?
7Are lighting and visibility sufficient for safe camera insertion and retrieval?
8Has a COSHH assessment been carried out for any chemicals or cleaning agents used during the survey?
9Is appropriate PPE (water‑proof boots, gloves, eye protection and, where required, respiratory protection) being worn?
10Is the CCTV camera unit fully charged, waterproof and free of visible damage?
11Are all cables, connectors and battery packs inspected for cuts, fraying or corrosion?
12Is the probe cable correctly wound, without kinks, and is the reel brake functional?
13Is the camera housing sealed and are lenses clean for clear image capture?
14Are the control unit controls, buttons and emergency stop functioning correctly?
15Is a spill containment barrier or signage positioned to protect other workers from water or waste discharge?
16Is a calibrated gas detector in use for the specific drain environment?
17Are first‑aid facilities and trained responders readily available on site?
18Is a rescue plan documented and communicated for rapid extraction if a confined‑space incident occurs?
19After the survey, has all equipment been cleaned, de‑contaminated and stored safely?
20Has waste water, sludge or debris been disposed of in accordance with environmental regulations?
21Have the survey findings been recorded, reviewed and the required hand‑over documentation completed?
22Is the weather suitable for safe operation of the CCTV equipment and does rain not create slip or electrical hazards?
23Has the CCTV equipment been inspected for electrical safety, including earthing and insulation integrity?

Frequently asked questions

Are these safety checklist templates really free to download?

Yes — completely free. Customise any checklist to your workplace and download a professional, print-ready PDF in minutes. No paywall — a free account is all you need to download.

What format do the safety checklists download in?

Checklists download as a professional PDF, ready to print and complete on-site — each question has clear Yes / No / N/A tick-boxes and a comments space. You choose portrait or landscape at download. Word and spreadsheet formats are being added.

Can I customise the checklist questions to my workplace?

Yes — fully. Add your own questions, edit or remove any of the pre-written ones, and reorder them to suit your site, task or inspection before you download.

Are the safety checklists suitable for UK workplaces?

Yes. The checklists are written around UK health and safety good practice and HSE guidance, and are suitable for inspections, audits, toolbox checks and routine workplace monitoring.

Do I need an account to use the checklist templates?

You can build and preview a checklist without an account. To download the PDF you'll need a free account — it takes less than a minute, costs nothing, and also lets you save checklists to your dashboard and edit them later.

Can I add my company logo and branding to the checklist?

Yes — add your company logo, colours and details on Standard and Pro plans, so the exported checklist carries your own branding. Guests and Free downloads carry Health & Safety Zone branding.

How do I complete the checklist once it is downloaded?

The exported checklist is a blank, ready-to-use document: print it and tick Yes, No or N/A against each question and write any comments in the notes space, then sign and date it in the sign-off section.

What types of safety checklist can I create?

We are building specialist checklists across a wide range of subjects and industries — fire safety, workplace inspections, equipment and machinery checks, site inductions, vehicle checks, PPE, first aid and more. Browse by category to find the right one.

How often should safety checklists be completed?

It depends on the activity and your risk assessment — many checks are daily, weekly or monthly, while others are done before each task or shift. Completed, dated checklists provide a useful record of your monitoring.

Are the checklists a substitute for a risk assessment?

No. A checklist is a monitoring and inspection tool that complements your risk assessments and method statements — it helps confirm that controls are in place and working. Use them alongside your risk assessments.