Audit

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 Order Number:

Job Site Address:

Job Description:

Materials/Parts Used:

Electrical Worker # 1:

Electrical Worker # 2:

Electrical Worker # 3:

Electrical Worker # 4:

Additional Electrical Worker(s):

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's Signiture:
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 2002.
I certify that the cabling work provided, complies with the Australian Communications Industry Wiring Rules technical standard AS/ACIF S009:2001.
Worker's Signiture:

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 :
Photographic Information :
RISK. ASSESSMENT: 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 Envoirenment

Sun Exposure

Ultra-violet Radiation

Manual Handling

Vibration

Pinch Points

Sharp Edges

Cuts and Abrasions

Dust

Fumes

Gases

Liquids

Chemicals / Substances

Ceiling Space

RISK MATRIX:
Drawing:
Photographic:
RISK SCORE:

High : Moderate : Low

IMPLEMENT CONTROL MEASURES:

Isolate overhead lines:

Isolation:

Mechanical Locking Device:

Switchboard rescue kit

Safety Observer

Barricade / Fence

Rubber Matt / Barrier Matt

Insulating gloves

Safety Gloves

Helmet

Face Shield / Safety Glasses

Dust Mask

Other PPE

Fire Blanket

Fire Extinguishers

Mechanical Aid

Safety Equipment / Devices

Water

Solar Protection

Ventilation

Lighting

Scaffolding / Mobile Work Platform / EPV / Cherry Picker

Safety Harness

Signage / Signalling

Communications Equipment

Emergency Procedures

Work Procedures

Inductions / Briefings

Discussion with Supervising Adult / Person in Charge

Training

Work Out of Hours

WORK METHOD STATEMENT Working TO:

SWMS 1. Basic fault finding on 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 8. Conduit installation in ground

SWMS 9. Conduit installation in walls 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. Installation 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 and 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 or Railway

RECORD PROCEDURES:

Hazards:

Risk Score 1

Apply Control Measures / SWMS

Risk Score 2

IF RESIDUAL NOT LOW, RE DO 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

ELECTRICAL TEST. RESULTS:

#1 Circuit or Equipment Type:

Visual Inspection Complete ?

Circuit Number

Protection Size & Type ?

Neutral Number

Phase Type ?

Continuity Test : OHMs

Insulation Resistance : MEGOHMs

Polarity Test 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

Continuity Test : OHMs

Insulation Resistance : MEGOHMs

Polarity Test Equipment or Circuit

Fault. loop Impedance : OHMs

Operational Test

# 3 Circuit or Equipment Type:

Visual Inspection Complete ?

Circuit Number

Protection Size & Type ?

Neutral Number

Phase Type ?

Cable Size in MM:

Continuity Test : OHMs

Insulation Resistance : MEGOHMs

Polarity Test Equipment or Circuit

Fault. loop Impedance : OHMs

Operational Test

# 4 Circuit or Equipment Type:

Visual Inspection Complete ?

Circuit Number

Protection Size & Type ?

Neutral Number

Phase Type ?

Cable Size in MM:

Continuity Test : OHMs

Insulation Resistance : MEGOHMs

Polarity Test Equipment or Circuit

Fault. loop Impedance : OHMs

Operational Test

# 5 Circuit or Equipment Type:

Visual Inspection Complete ?

Circuit Number

Protection Size & Type ?

Neutral Number

Phase Type ?

Cable Size in MM:

Continuity Test : OHMs

Insulation Resistance : MEGOHMs

Polarity Test Equipment or Circuit

Fault. loop Impedance : OHMs

Operational Test

Tests carried out and signed off by:

This Document has been developed by and for the sole use of A&J Electrical Services and it's Staff. 18/1/2014
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.