SEW - BRANCH SEWER RENEWALS SAFETY AUDIT

• Document No.

• Audit Title

• Project/Package Name

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

SYSTEM / STANDARDS / PROCEDURES

• SWMS are being filled in each day and all staff are signing on? <br>

  Yes

  No

  N/A

• OH & S Forms available to report near misses, issues, incidents and hazards?

  Yes

  No

  N/A

• Regular " TOOL BOX " Meetings are being held and minutes and attendances are recorded and available to staff on site?<br>Are all relevant components of task discussed?

  Yes

  No

  N/A

• Confined Space Permit filled in prior to entry?

  Yes

  No

  N/A

INSPECTION OF WORK ENVIRONMENT

• Barricades, Signage and Fencing around Confined Space Work Area is in place and secure?

  Yes

  No

  N/A

• Are ROAD PLATES securely pinned in place on the Road Surface?

  Yes

  No

  N/A

• Correct equipment/procedure is being used when working in confined space?

  Yes

  No

  N/A

• Spotters / Dogmen are part of work crew when required?

  Yes

  No

  N/A

• Traffic Management is being utilised correctly and appropriately?

  Yes

  No

  N/A

• Are Plugging Points in accordance with submitted Flow Management Plan ?

  Yes

  No

  N/A

• Night Works: Is Work Site sufficiently lit up?

  Yes

  No

  N/A

TOOLS AND EQUIPMENT

• PLANT and EQUIPMENT are in good working condition and log books are being filled in as required?

  Yes

  No

  N/A

• SPILL KIT on site and accessible to all staff?

  Yes

  No

  N/A

• FIRE SAFETY EQUIPMENT on site and within regular service date?

  Yes

  No

  N/A

• FIRST AID KIT is on site and accessible to all staff?

  Yes

  No

  N/A

• FLASH LIGHTS are in good working condition and installed in appropriate locations on site if required?

  Yes

  No

  N/A

PEOPLE / BEHAVIOUR

• All staff have been INDUCTED on site and listed on Site register, before commencing work?

  Yes

  No

  N/A

• Correct PPE is being worn/used and is available to all staff?

  Yes

  No

  N/A

• Staff have relevant cards/tickets for the works being undertaken?

  Yes

  No

  N/A

• QUALIFIED FIRST AID Staff member available on site?

  Yes

  No

  N/A

• Have customers/residents been notified prior to commencement of works?

  Yes

  No

  N/A

• SEW Representative

  Sign

• Contractor Representative

  Sign