Aqua Metro Services Leadership Conversation and Site Inspection checklist

• Project name / number

• Location
  Address

• Conducted on

  Date

• Leadership walk conducted by

• Personnel on site

• Take photo of SWMS / list of personnel on site

  Media

Safety and Culture Conversations

• Common point of interest discussed?

• Verbalise your appreciation for their level of commitment. Recognise the work they are doing and their contribution to the project.

• What has your experience on the project been like so far? How is the project different from other projects you have worked on?

• Negative aspects of working with AMS?

• Tell me about the works on site. <br>What hazards have the highest risk; those that could injure you or others, or worse?

  Comprehensive understanding of the tasks and hazards

  Understanding of specific tasks and hazards only

  Some understanding; works under direction only

  Low level of understanding

• What controls are you using to manage the hazards? If essential controls aren't in place, discuss why.

• Are all controls in place?

  Safe

  At Risk

  N/A

• Select to take photos of controlled or uncontrolled hazards

  Media

• What documentation do you have for working safely on site?

  Select SWMS Procedures Work Pack Melbourne Water Permit Other Safe Work Permits Daily Pre-Start risk assessment

  • SWMS
  • Procedures
  • Work Pack
  • Melbourne Water Permit
  • Other Safe Work Permits
  • Daily Pre-Start risk assessment

• Take photos etc of relevant documentation

  Media

• What is AMS' safety approach and beliefs?

  Proactive - reporting is encouraged

  Compliance only

  Innovative

  Rather not comment

• How do you find AMS' incident reporting culture? (10 = Great, 1 = Not good)

• What sort of incidents get reported?

  Select Hazards Near Misses First Aid injuries Medical Treatment Lost Time Injuries High Potential Incidents Environmental Incidents Plant/Property Security

  • Hazards
  • Near Misses
  • First Aid injuries
  • Medical Treatment
  • Lost Time Injuries
  • High Potential Incidents
  • Environmental Incidents
  • Plant/Property
  • Security

• How would you rate safety on this project - scale of 1 - 10? (10 = Great 1 = Not good)

• Any comments or observations you'd like to make?

Work Activities Conducted on Site

• What activities are happening on site?

  Select Excavation activities Confined space entry Earthworks / channel works Working on, over or near water Structural works Electrical commissioning Instrumentation systems Control systems design, monitoring, SCADA HV works / HV Switchboards Transformer Installation & works Mechanical commissioning Mechanical pipework fabrication, installations Fire service installation Sewer main works, structures, fittings Water main works, structures, fittings Other pipeline works Pump works Valve/Penstock works Hydro excavation Building works / refurbishment Welding activities Crane activities Road works / construction Traffic management Concrete structures Working at height Roofing works Tank works Environmental works Site inspection / audits

  • Excavation activities
  • Confined space entry
  • Earthworks / channel works
  • Working on, over or near water
  • Structural works
  • Electrical commissioning
  • Instrumentation systems
  • Control systems design, monitoring, SCADA
  • HV works / HV Switchboards
  • Transformer Installation & works
  • Mechanical commissioning
  • Mechanical pipework fabrication, installations
  • Fire service installation
  • Sewer main works, structures, fittings
  • Water main works, structures, fittings
  • Other pipeline works
  • Pump works
  • Valve/Penstock works
  • Hydro excavation
  • Building works / refurbishment
  • Welding activities
  • Crane activities
  • Road works / construction
  • Traffic management
  • Concrete structures
  • Working at height
  • Roofing works
  • Tank works
  • Environmental works
  • Site inspection / audits

• Other site activity not on the list:

• Select to take photos

  Media

Work Environment and Conditions

• Housekeeping and Layout:

  Safe

  At Risk

  N/A

• Security of equipment:

  Safe

  At Risk

  N/A

• Worksite delineation, barricades and signage:

  Safe

  At Risk

  N/A

• Environmental controls reviewed:

  Select Sedimentation controls; fences / bags / mats Noise / dust controls Flora and fauna controls Vibration controls Indigenous heritage requirements Cultural heritage requirements Waste management controls Stockpiling controls Soil disposal tracking Hazardous substances - used, stored correctly, SDS available

  • Sedimentation controls; fences / bags / mats
  • Noise / dust controls
  • Flora and fauna controls
  • Vibration controls
  • Indigenous heritage requirements
  • Cultural heritage requirements
  • Waste management controls
  • Stockpiling controls
  • Soil disposal tracking
  • Hazardous substances - used, stored correctly, SDS available

• Other controls not on the list:

• Environmental controls adequate ?

  Yes

  No

  N/A

• Select to take photos

  Media

Systems/Standards/Procedures

• Work Permits required/used on site:

  Select Melbourne Water Permit for works Trenching Permit Confined Space Entry Permit Hot work permit Working at height permit Isolation permit WorkSafe Excavation Notification Council Approvals EPA permit / notification

  • Melbourne Water Permit for works
  • Trenching Permit
  • Confined Space Entry Permit
  • Hot work permit
  • Working at height permit
  • Isolation permit
  • WorkSafe Excavation Notification
  • Council Approvals
  • EPA permit / notification

• Competence for task:

  Select Certificates of competency recorded Verification of competency undertaken Licences, tickets for equipment / machinery / task on site Licences, tickets not available

  • Certificates of competency recorded
  • Verification of competency undertaken
  • Licences, tickets for equipment / machinery / task on site
  • Licences, tickets not available

• Lock-out and Tag-out:

  LOTO system in place, used when needed

  LOTO system not in place

  N/A

• Other comment:

Safe Work Method Statements (SWMS) & Pre-Start Checks

• Pre-Start Records:

  Select Signed by employees, contractors, site visitors Records available Discussion covers daily activities Records not available No discussion about site hazards Not signed by everyone on site

  • Signed by employees, contractors, site visitors
  • Records available
  • Discussion covers daily activities
  • Records not available
  • No discussion about site hazards
  • Not signed by everyone on site

• SWMS Available:

  Yes

  No

  N/A

• SWMS Adequate:

  Yes

  No

  N/A

• SWMS Understood:

  Yes

  No

  N/A

• SWMS Followed:

  Yes

  No

  N/A

• Other comment:

• Select to take photos

  Media

Tools and Equipment

• Availability:

  Tools and equipment on site and adequate

  Tools and equipment not on site or not adequate

  N/A

• Condition?

  Safe

  At Risk

  N/A

• All measuring equipment such as gas monitors calibrated?

  Safe

  At Risk

  N/A

• All plant and equipment within servicing period eg forklifts, welding machines?

  Safe

  At Risk

  N/A

• Select to take photos

  Media

People and Behaviours

• Are employees ensuring they are not placing themselves in Line of Fire ?

  Yes

  No

  N/A

• Are employees selecting appropriate Tools and Equipment and wearing correct PPE ?

  Yes

  No

  N/A

• Are employees keeping Eyes on Hands whilst doing works which could result in injury ?

  Yes

  No

  N/A

• Are employees Looking Before Moving ?

  Yes

  No

  N/A

• Are employees Communicating their intent to others ?

  Yes

  No

  N/A

• Are employees using correct manual handling techniques to maintain correct Position and Effort ?

  Yes

  No

  N/A

• Are employees Assessing and Re-assessing the area ?

  Yes

  No

  N/A

• Are employees maintaining Eyes on Path whilst moving around the worksite ?

  Yes

  No

  N/A

Protection systems

• Is electrical equipment positioned appropriately, with test and tag in date?

  Safe

  At Risk

  N/A

• Are fire extinguishers positioned correctly with clear access, tested and tag in date?

  Safe

  At Risk

  N/A

• Are gas bottles / cannisters within date, as per compliance stamp?

  Safe

  At Risk

  N/A

• Harnesses, slings, lifting gear checked?

  Safe

  At Risk

  N/A

• Scaffold systems inspected and tagged?

  Safe

  At Risk

  N/A

• Select to take photos

  Media

High Risk Activities

• Are Confined Space Entries being carried out in accordance with AMS and MW procedural requirements?

  Yes

  No

  N/A

• Are Trenching activities being carried out in accordance with AMS and legislative requirements?

  Yes

  No

  N/A

• Are activities being carried out On, Over or Near Water being undertaken in a safe manner?

  Yes

  No

  N/A

• Are appropriate controls used for ascending and descending to and from work areas > 2 metres?

  Yes

  No

  N/A

• Are appropriate PPE and controls in place for welding, cutting or grinding activities?

  Yes

  No

  N/A

• Are required controls in place for LV and/or HV activities?

  Yes

  No

  N/A

• Are required controls in place for Crane/Lifting activities?

  Yes

  No

  N/A

• Select to take photos

  Media

Observations of Positives / Good Practice and Opportunities for Improvement / Concern

• Positives / Good Practice Consider - Leadership, employee engagement, machinery condition, PPE, LOTO, vehicle / pedestrian interface, manual handling

• Opportunities for improvement / Concern Consider - Leadership, employee engagement, machinery condition, PPE, LOTO, vehicle / pedestrian interface, manual handling

• Photos to support identified good practices / opportunities for improvement:

  Media

• Provide a sketch of the area to support findings (if applicable):

  Drawing

• Select to take additional photos

  Media

Comments

• Note other comments here:

Sign-off

• Signature of the person conducting audit / inspection:

  Sign