Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

1. Administrative Procedures

  • 1.1 Is the Site Specific Safety Plan document on site ?

  • 1.2 Is Site Specific Safety Plan is revised on a regular basis

2. Compliance with the Site Specific Safety Plan

  • 2.1 Does the contractor have an adequate induction process for workers, contractors and visitors?

  • 2.2. Does the contractor have a register of training, licenses and skills

  • 2.3. Does the contractor have an adequate Safe Work Method Statements (SWMS) for high- risk work?

  • 2.4. Lack of, or inadequate system to review SWMS as needed?

  • 2.5. Review the contractors incident notification procedures?

  • 2.6. Lack of, or inadequate, routine inspections, monitoring, audits?

  • 2.7. Lack of/or inadequate consultative arrangements?

  • 2.8. Does the contractor have an adequate supervisory arrangements?

3. Plant and Equipment

  • 3.1. Unsafe or damaged plant/equipment? (including missing or damaged guards)

  • 3.2. Incorrect plant /equipment for job?

  • 3.3. Unsafe or incompatible attachments used with plant/equipment?

  • 3.4. licensing or proof competency of operators?

  • 3.5. Recorded procedures for cleaning, servicing and maintenance?

4. Lifting Equipment

  • 4.1 Are any loads lifted over persons, close proximity to obstacles incl. overhead power lines?

  • 4.2. Is the equipment maintained, is it tested and inspected on a regular basis

  • 4.3. Is SWL information displayed?

  • 4.4. Unsafe or damaged lifting equipment, including ropes, slings, chains, hooks?

  • 4.5. licensing or proof competency of operators?

  • 4.6. Recorded procedures for cleaning, servicing and maintenance?

5. Hazardous Manual Tasks

  • 5.1. Lack of identification hazardous manual tasks?

  • 5.2. Lack of assessment of hazardous manual tasks?

  • 5.3. Inadequate risk controls? (examples: no job rotation, lighter loads, trolleys, lifting equipment, etc)

  • 5.4. Lack of training in risk controls and safe lifting/ team lifting techniques?

6. Hazardous Chemical (including fuel and oil)

  • 6.1. Unsafe storage location? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)

  • 6.2. Incompatible chemicals stored near each other?

  • 6.3. Inadequate spill containment equipment?

  • 6.4. Safety Data Sheets not accessible on site?

  • 6.5. Lack of emergency procedures for injury/spills/fire etc?

  • 6.6. Excessive quantities stored on site or in vehicles?

  • 6.7. Insufficient ventilation?

  • 6.8. Insufficient, or incorrect, PPE?

  • 6.9. Unsuitable storage containers? (unlabeled or stored in food containers)

7. Emergency Response

  • 7.1. Lack of, or no emergency plans for site?

  • 9.2. Emergency procedures not displayed at site?

  • 9.3. Lack of training and rehearsal of emergency plans?

  • 9.4. Lack of, or inadequate first aid kits aid equipment for site?

  • 9.5. Insufficient access to formally trained First Aiders for all shifts?

  • 9.6. Unsuitable or inadequate communication equipment?

10. Traffic Management

  • 10.1. Lack of, or inadequate, Traffic Management Plan (TMP) in place?

  • 10.2. Lack of training in TMP for all persons on site? <br>(contractors and visitors)

  • 10.3. Inadequate controls for TMP? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)

11. Personal Protective Equipment (PPE)

  • 11.1. Lack of, or inadequate PPE (including sun protection)

  • 11.2. Lack of system to issue, inspect, replace and monitor PPE?

  • 11.3. Lack of training in safe use, clean-up and inspection of PPE?

12. Work Environment

  • 12.1. Lack of/or inadequate amenities? (toilets, wash areas, lunch rooms, etc)

  • 12.2. Insufficient lighting?

  • 12.3. Inadequate housekeeping?

  • 12.4. Lack of, or inadequate noise/ vibration control?

13. Electrical Hazards

  • 13.1. Unsafe electrical leads? (damaged, out of test date or untested)

  • 13.2. Lack of RCD protection?

  • 13.3. Contact with underground assets? DBYD Documents on site

  • 13.4. Contact with overhead electrical lines?

  • 13.5. Overloading outlets?

  • 13.6. Leads placed on ground or on metal structures?

  • 13.7. Electrical equipment near water?

  • 13.8. Electrical equipment near flammables?

  • 13.9. Electrical equipment near chemicals that could cause damage?

  • 13.10. Electrical leads that may be damaged from contact with moving machinery parts?

  • 13.11. Electrical leads on work surfaces?

Corrective Actions

  • Enter any corrective actions that will be undertaken

Sign Off

  • Gippsland Water Responsible Officer

  • On site representative

  • Auditor's signature

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