Audit Title

  • Document No.

  • Customer Name & Job Number:

  • Worker ID:

  • Date:

Customer Information

A&J Electrical Services. E.C.N.- 9009

PO Box 6383, Upper Mt Gravatt, Qld, 4122

ABN- 28 474 378 319. ACN- 010 831 188.

Ph- 07 38495387. Fax- 07 38495484. Email- enquiries@aandjelectrical.com.au

  • Has the Risk Assessment Form been completed ?

  • Job Date:

  • Job Number:

  • Job Complete ?

  • Customer Name:

  • Customer Address:

  • Customer Phone Number & Email Address:

  • Customer Meter Numbers:

  • Customer Order Number:

  • Job Site Address

This Document has been developed by and for the sole use of A&J Electrical Services and it's Staff. 18/1/2014

Job Information

  • Job Description:

  • Materials/Parts Used:

  • Electrical Worker # 1:

  • Start

  • Finish

  • Electrical Worker # 2:

  • Start

  • Finish

  • Electrical Worker # 3:

  • Start

  • Finish

  • Electrical Worker # 4:

  • Start

  • Finish

  • Additional Electrical Worker(s):

  • Start

  • Finish

I agree that the electrical work was performed at the above address and accept responsibility for the payment of the work. I acknowledge that all parts remain the property of A&J Electrical Services until full payment has been completed. Settlement regarding purchase or transfer of these premises was prior to 1/9/2002. I understand that if this is not true, then I may be held liable for action to be taken.

  • Customer Signature

I certify that the electrical installation, to the extent it is affected by the electrical work, has been tested to ensure it is electrically safe and is in accordance with the requirements of the wiring rules and any other standard applying to the electrical installation under the Electrical Safety Regulation 2013.

I certify that the cabling work provided, complies with the Australian Communications Industry Wiring Rules technical standard AS/ACIF S009:2001.

  • Worker's Signature:

  • Have the Electrical Test Results been Recorded?

  • M.E.N checked and proof of testing noted on the switchboard??

  • Safety Switches Fitted & Tested?

Additional Information:

  • Sketch:

  • Photos:

Risk Assesment: Hazard Identification and Control Measures

Risk Assesment: Identify Hazards.....

  • Overhead Power lines

  • High Voltage

  • Electrical Contact

  • Fire/Explosion

  • Mechanical

  • Noise

  • Lighting

  • Plant/Vehicles

  • Roads/Traffic

  • Pedestrians/Children/Animals

  • Excavation

  • Trench Collapses

  • Confined Spaces

  • Access / Exits

  • Fatigue

  • Slip/Trip

  • Falling/Flying Objects

  • Heights/Falls

  • Weather Conditions

  • Hot Environment

  • Sun Exposure

  • Ultra-Violet Radiation

  • Manual Handling

  • Vibration

  • Pinch Points/Crushing

  • Sharp Edges

  • Cuts and Abrasions

  • Dust

  • Fumes

  • Gases

  • Liquids

  • Chemicals/Substances

  • Ceiling Space

RISK MATRIX:

  • Sketch:

  • Photos

RISK SCORE

  • High : Moderate : Low

IMPLEMENT CONTROL MEASURES:

  • Isolate Overhead Lines:

  • Isolation:

  • Mechanical Locking Device:

  • Switchboard Rescue Kit:

  • Safety Observer:

  • Barricade/Fence:

  • Rubber Mat/Barrier Mat:

  • Insulating Gloves:

  • Safety Gloves:

  • Helmet:

  • Face Shield/ Safety Eyewear

  • Dust Mask:

  • Other PPE:

  • Fire Blanket:

  • Fire Extinguishers:

  • Mechanical Aid:

  • Safety Equipment/Devices:

  • Water:

  • Solar Protection:

  • Ventilation:

  • Lighting:

  • Scaffolding / Mobile Work Platform / Cherry Picker:

  • Safety Harness:

  • Signage / Signalling:

  • Communications Equipment:

  • Emergency Procedures:

  • Work Procedures:

  • Inductions / Briefings:

  • Discussion with Supervising Adult/Person in Charge:

  • Training:

  • After Hours Work:

WORK METHOD STATEMENT Working To:

  • SWMS 1. Basic fault finding in LV MCC or similar panels

  • SWMS 2. Working in a trench or pit at a depth of 1.5m or more

  • SWMS 3. Working in a confined space

  • SWMS 4. Working with asbestos

  • SWMS 5. Live work

  • SWMS 6. Isolation and work on electrical equipment

  • SWMS 7. Conduit installation prior to pouring concrete

  • SWMS 9. Conduit installation in wall as and ceilings

  • SWMS 10. Cable and ladder tray installation

  • SWMS 11. Working in risers

  • SWMS 12. Using portable ladders

  • SWMS 13. Installing light fittings

  • SWMS 14. Installation of switchboards

  • SWMS 15. Installation of Pyrotenax (MIMS) cable

  • SWMS 16. Installation of lighting looms

  • SWMS 17. Installation of cable supports

  • SWMS 18. Installation of mains

  • SWMS 19. Installation of switchboard connections

  • SWMS 20. New work on existing switchboards

  • SWMS 21. Installation of sub-mains

  • SWMS 22. Installation of power and lighting cables

  • SWMS 23. Installations of power points

  • SWMS 24. Manual handling

  • SWMS 25. Working with elevated platforms

  • SWMS 27. Isolate, lockout and test.

  • SWMS 28. Working at heights

  • SWMS 29. Installing ceiling mounted lights and speakers

  • SWMS 30. Removal of PCB's

  • SWMS 32. Disconnecting an existing installation

  • SWMS 33. Installation of SELV cabling

  • SWMS 34. Demolition and dismantling

  • SWMS 35. Hazardous substances

  • SWMS 36. Plant

  • SWMS 37. Testing and tagging of electrical appliances and equipment

  • SWMS 38. Using mobile scaffolds

  • SWMS 39. Working on a road/driveway/railway

RECORD PROCEDURES:

  • Hazards:

  • Risk Score 1

  • Apply Control Measures/ SWMS

  • Risk Score 2

IF RESIDUAL RISK NOT LOW, REDO CONTROL MEASURES:

  • If residual risk low, commence work.....

  • Monitor and review effectiveness.......

RISK ASSESSMENT CARRIED OUT BY:

  • Name #1

  • Name #2

  • Name #3:

  • Name #4

ETR

ELECTRICAL TEST RESULTS:

  • #1 Circuit or Equipment Type:

  • Visual inspection complete?

  • Circuit Number

  • Protection size and type?

  • Neutral Number

  • Phase Type?

  • Cable size in MM

  • Earth continuity test: OHMS

  • Insulation Resistance: MEGOHMs

  • Polarity Test of Equipment or Circuit

  • Fault loop impedance: OHMS

  • Operational test

  • #2 Circuit or Equipment type:

  • Visual inspection complete?

  • Circuit Number

  • Protection size and type?

  • Neutral Number

  • Phase Type?

  • Cable size in MM

  • Earth continuity test: OHMS

  • Insulation Resistance: MEGOHMs

  • Polarity Test of Equipment or Circuit

  • Fault loop impedance: OHMS

  • Operational test

  • #3 Circuit or Equipment type:

  • Visual inspection complete?

  • Circuit Number

  • Protection size and type?

  • Neutral Number

  • Phase Type?

  • Cable size in MM

  • Earth continuity test: OHMS

  • Insulation Resistance: MEGOHMs

  • Polarity Test of Equipment or Circuit

  • Fault loop impedance: OHMS

  • Operational test

  • #4 Circuit or Equipment Type:

  • Visual inspection complete?

  • Circuit Number

  • Protection size and type?

  • Neutral Number

  • Phase Type?

  • Cable size in MM

  • Earth continuity test: OHMS

  • Insulation Resistance: MEGOHMs

  • Polarity Test of Equipment or Circuit

  • Fault loop impedance: OHMS

  • Operational test

  • #5 Circuit or Equipment Type:

  • Visual inspection complete?

  • Circuit Number

  • Protection size and type?

  • Neutral Number

  • Phase Type?

  • Cable size in MM

  • Earth continuity test: OHMS

  • Insulation Resistance: MEGOHMs

  • Polarity Test of Equipment or Circuit

  • Fault loop impedance: OHMS

  • Operational test

  • #6 Circuit or Equipment Type:

  • Visual inspection complete?

  • Circuit Number

  • Protection size and type?

  • Neutral Number

  • Phase Type?

  • Cable size in MM

  • Earth continuity test: OHMS

  • Insulation Resistance: MEGOHMs

  • Polarity Test of Equipment or Circuit

  • Fault loop impedance: OHMS

  • Operational test

  • #7 Circuit or Equipment Type:

  • Visual inspection complete?

  • Circuit Number

  • Protection size and type?

  • Neutral Number

  • Phase Type?

  • Cable size in MM

  • Earth continuity test: OHMS

  • Insulation Resistance: MEGOHMs

  • Polarity Test of Equipment or Circuit

  • Fault loop impedance: OHMS

  • Operational test

  • #8 Circuit or Equipment Type:

  • Visual inspection complete?

  • Circuit Number

  • Protection size and type?

  • Neutral Number

  • Phase Type?

  • Cable size in MM

  • Earth continuity test: OHMS

  • Insulation Resistance: MEGOHMs

  • Polarity Test of Equipment or Circuit

  • Fault loop impedance: OHMS

  • Operational test

  • #9 Circuit or Equipment Type:

  • Visual inspection complete?

  • Circuit Number

  • Protection size and type?

  • Neutral Number

  • Phase Type?

  • Cable size in MM

  • Earth continuity test: OHMS

  • Insulation Resistance: MEGOHMs

  • Polarity Test of Equipment or Circuit

  • Fault loop impedance: OHMS

  • Operational test

  • #10 Circuit or Equipment Type:

  • Visual inspection complete?

  • Circuit Number

  • Protection size and type?

  • Neutral Number

  • Phase Type?

  • Cable size in MM

  • Earth continuity test: OHMS

  • Insulation Resistance: MEGOHMs

  • Fault loop impedance: OHMS

  • Polarity Test of Equipment or Circuit

  • Operational test

  • Tests carried out and signed off by:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.