Information
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
1. Administrative Procedures
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1.1 Is the Site Specific Safety Plan document on site ?
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1.2 Is Site Specific Safety Plan is revised on a regular basis
2. Compliance with the Site Specific Safety Plan
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2.1 Does the contractor have an adequate induction process for workers, contractors and visitors?
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2.2. Does the contractor have a register of training, licenses and skills
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2.3. Does the contractor have an adequate Safe Work Method Statements (SWMS) for high- risk work?
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2.4. Lack of, or inadequate system to review SWMS as needed?
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2.5. Review the contractors incident notification procedures?
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2.6. Lack of, or inadequate, routine inspections, monitoring, audits?
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2.7. Lack of/or inadequate consultative arrangements?
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2.8. Does the contractor have an adequate supervisory arrangements?
3. Plant and Equipment
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3.1. Unsafe or damaged plant/equipment? (including missing or damaged guards)
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3.2. Incorrect plant /equipment for job?
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3.3. Unsafe or incompatible attachments used with plant/equipment?
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3.4. licensing or proof competency of operators?
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3.5. Recorded procedures for cleaning, servicing and maintenance?
4. Lifting Equipment
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4.1 Are any loads lifted over persons, close proximity to obstacles incl. overhead power lines?
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4.2. Is the equipment maintained, is it tested and inspected on a regular basis
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4.3. Is SWL information displayed?
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4.4. Unsafe or damaged lifting equipment, including ropes, slings, chains, hooks?
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4.5. licensing or proof competency of operators?
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4.6. Recorded procedures for cleaning, servicing and maintenance?
5. Hazardous Manual Tasks
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5.1. Lack of identification hazardous manual tasks?
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5.2. Lack of assessment of hazardous manual tasks?
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5.3. Inadequate risk controls? (examples: no job rotation, lighter loads, trolleys, lifting equipment, etc)
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5.4. Lack of training in risk controls and safe lifting/ team lifting techniques?
6. Hazardous Chemical (including fuel and oil)
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6.1. Unsafe storage location? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)
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6.2. Incompatible chemicals stored near each other?
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6.3. Inadequate spill containment equipment?
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6.4. Safety Data Sheets not accessible on site?
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6.5. Lack of emergency procedures for injury/spills/fire etc?
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6.6. Excessive quantities stored on site or in vehicles?
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6.7. Insufficient ventilation?
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6.8. Insufficient, or incorrect, PPE?
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6.9. Unsuitable storage containers? (unlabeled or stored in food containers)
7. Emergency Response
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7.1. Lack of, or no emergency plans for site?
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9.2. Emergency procedures not displayed at site?
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9.3. Lack of training and rehearsal of emergency plans?
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9.4. Lack of, or inadequate first aid kits aid equipment for site?
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9.5. Insufficient access to formally trained First Aiders for all shifts?
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9.6. Unsuitable or inadequate communication equipment?
10. Traffic Management
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10.1. Lack of, or inadequate, Traffic Management Plan (TMP) in place?
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10.2. Lack of training in TMP for all persons on site? <br>(contractors and visitors)
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10.3. Inadequate controls for TMP? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)
11. Personal Protective Equipment (PPE)
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11.1. Lack of, or inadequate PPE (including sun protection)
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11.2. Lack of system to issue, inspect, replace and monitor PPE?
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11.3. Lack of training in safe use, clean-up and inspection of PPE?
12. Work Environment
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12.1. Lack of/or inadequate amenities? (toilets, wash areas, lunch rooms, etc)
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12.2. Insufficient lighting?
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12.3. Inadequate housekeeping?
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12.4. Lack of, or inadequate noise/ vibration control?
13. Electrical Hazards
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13.1. Unsafe electrical leads? (damaged, out of test date or untested)
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13.2. Lack of RCD protection?
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13.3. Contact with underground assets? DBYD Documents on site
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13.4. Contact with overhead electrical lines?
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13.5. Overloading outlets?
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13.6. Leads placed on ground or on metal structures?
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13.7. Electrical equipment near water?
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13.8. Electrical equipment near flammables?
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13.9. Electrical equipment near chemicals that could cause damage?
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13.10. Electrical leads that may be damaged from contact with moving machinery parts?
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13.11. Electrical leads on work surfaces?
Corrective Actions
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Enter any corrective actions that will be undertaken
Sign Off
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Gippsland Water Responsible Officer
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On site representative
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Auditor's signature
