Safety Checklist Form Template

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Manhole and Chamber Construction Safety Checklist

Use our Checklist creator tool to create customised workplace safety documents. Learn more about Manhole and Chamber Construction Safety Checklist Template below
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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.

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Print-ready PDF with Yes / No / N/A tick-boxes and a comments space.

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

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A spreadsheet version for digital tracking and filtering.

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Risk Assessment Description:

This Manhole and Chamber Construction Safety Checklist from Health & Safety Zone helps construction supervisors and operatives ensure safe execution of groundworks involving manholes and chambers, which are classified as confined spaces. It guides you through planning, competence, site conditions, atmospheric testing, access, support, lifting of rings and covers, and post‑work verification.

It covers all essential safety dimensions, referencing the Confined Spaces Regulations 1997 and the Construction (Design and Management) Regulations 2015, as well as HSE guidance on confined spaces (INDG258). The checklist ensures risk assessments are in place, personnel are trained, atmospheric hazards are monitored, safe access and support systems are used, and emergency procedures are ready.

Use this checklist for:

  • Pre‑use checks – verify that the confined space is ready for entry before work begins.
  • During‑work monitoring – confirm ongoing safety controls while the manhole or chamber is being constructed.
  • Completion sign‑off – ensure the area is made safe and all documentation is completed after work.

Each item is answered Yes, No or N/A – any No answer must be resolved before proceeding or the work must be stopped.

The checklist follows HSE Approved Code of Practice L101 ‘Safe work in confined spaces’ and HSE guidance INDG258, ensuring compliance with the Confined Spaces Regulations 1997 and the Construction (Design and Management) Regulations 2015.

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

Compliant with: Confined Spaces Regulations 1997; Construction (Design and Management) Regulations 2015.

Sample PDF Document Image:

Checks covered in this Manhole and Chamber Construction (confined space work) checklist

This Manhole and Chamber Construction (confined space work) safety checklist template covers 27 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 for the manhole construction been completed and briefed to all operatives?
2Is the work authorised by a competent person under CDM 2015?
3Are all operatives trained and competent in confined space entry and rescue?
4Has a permit to work for confined space entry been issued and displayed?
5Is the ground around the manhole stable and free from hazards that could cause collapse?
6Are weather conditions suitable for safe excavation and entry (e.g., no heavy rain or high winds)?
7Is the access ladder or scaffold in good condition and securely positioned?
8Are guardrails, toe‑boards and edge protection installed where required?
9Has the atmospheric testing equipment been calibrated and is it functional?
10Is the oxygen level in the confined space between 19.5% and 23.5%?
11Are toxic gases (e.g., H2S, CO) below the action limit?
12Is the confined space continuously ventilated during work?
13Are gas detectors positioned correctly and monitored throughout the task?
14Is the lifting equipment (e.g., crane, hoist) inspected, certificated and suitable for the load of rings and covers?
15Are lifting plans prepared and communicated to the lift operator?
16Are rigging points and lifting attachments inspected for damage before use?
17Is the support system (e.g., shoring, trench boxes) in place and checked for stability?
18Is personal protective equipment (PPE) appropriate and worn, including hard hat, safety boots, gloves, high‑visibility vest and, if required, respiratory protection?
19Are collective safety measures such as exclusion zones, signage and barriers established around the work area?
20Is a trained rescue team on standby with appropriate rescue equipment?
21Are communication devices (e.g., radios, alarms) functional and within range of the confined space?
22Has the work area been cleared of unnecessary personnel and equipment before entry?
23Is a fire extinguisher suitable for the hazards present readily accessible?
24On completion, have all rings and covers been securely replaced and locked?
25Has the confined space been adequately ventilated and cleared of contaminants before sealing?
26Is the site left tidy, with waste removed and any temporary works dismantled?
27Are all permit and inspection records signed and filed as required by CDM 2015?

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, and no signup required for guests.

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?

No — guests can build and download a checklist for free without signing up. Register a free account if you want to 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.