Information
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Company
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Date
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Prepared by
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Location
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Personnel
1.0 Work Environment
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1.1. Adequate wash areas for workers?
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1.2. Adequate number of toilets (1:20 for males)?
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1.3. Adequate amount of lunch rooms provided for number of workers on site?
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1.4 Toilets and lunch rooms are clean?
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1.5 lighting adequate?
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1.6 Inadequate housekeeping? (site has clear pathways and rubbish managed).
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1.7 Bins provided for food scraps and regularly cleaned?
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1.8 Other
2.0 Plant and Equipment
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2.1 Plant/equipment is safe / undamaged? (i.e. missing or damaged guards)
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2.2. Plant /equipment correct for job? (e.g. grinding discs for cutting)
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2.4. High Risk Work Licences for relevant workers?
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2.5. Pre-operational inspection performed by operator.
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2.7 Other
3.0 Working at Heights
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3.1 Work at heights (including voids, pits, and trenches) are fenced or secured with scaffold or handrail protection?
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3.2 Safe access is maintained to different levels?
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3.3 Penetrations are covered, secured (bolted) and labelled (penetration below)
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3.4 Edge protection is secured adequately with top and mid rail?
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3.5 Other?
4.0 Lifting Equipment (cranes & hoists)
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4.1. Crane or hoist is safe for use?
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4.2. Loads lifted are safe (i.e. not over persons, or in close proximity to obstacles incl. overhead power lines)?
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4.3. Maintenance, testing and inspection is undertaken?
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4.4. SWL information displayed?
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4.5. Lifting equipment, including ropes, slings, chains, hooks is safe for use?
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4.6. Lifting equipment labelled, meet Australian Standards, has SWL displayed?
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4.7 Other
5.0 Excavations
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5.1. Service drawing attached and readable (DBYD)
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5.2. Barricade & signage erected at least 1m from edge of excavation. Correct type selected and maintained.
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5.3. Excavation/s correctly benched/battered/shored where excavation is 1.5m or more in depth
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5.4. Adequate access/egress provided. Ladders secured where applicable
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5.5. Spoil kept from edge of excavation (zone of influence depending on depth)
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5.6. Plant & equipment kept safe distance from excavation edge (consider zone of influence)
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5.7 Other
6.0 Ladders
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6.1. Ladders are undamaged?
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6.2. Positioning of step ladder safe and stable?
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6.3. Ladder properly secured?
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6.4 Ladder complies with AS (has sticker on ladder)
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6.5 Ladder unsuitable for job? (e.g. metal ladder used for electrical work) and being use properly (3 points of contact).
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6.6 Other?
7.0 Hazardous Manual Tasks
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7.1. Hazardous manual tasks are risk assessed?
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7.2 Adequate risk controls? (examples: no job rotation, lighter loads, trolleys, lifting equipment, etc)
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7.3 Other details
8.0 Hazardous Chemical (including fuel and oil)
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8.1. Fuels and chemicals are stored to prevent risk of spillage.
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8.2. Incompatible chemicals not stored near each other?
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8.3. Adequate spill containment equipment?
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8.4. Safety Data Sheets accessible on site?
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8.5 Emergency procedures for injury/spills/fire etc?
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8.6 Correct PPE being used?
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8.7 Other?
9.0 Emergency Response
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9.1. Emergency plans prepared for site?
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9.2. Emergency procedures displayed at site?
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9.3. Evacuation drills conducted yearly?
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9.4 Adequate first aid equipment on site?
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9.5 First Aiders are available and trained for all shifts?
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9.6. Fire extinguishers are provided and maintained (i.e. adequate numbers, correct type, tested, tagged & unobstructed)?
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9.7 Other?
10.0 Traffic Management
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10.1 Traffic Management Plan (TMP) are in place?
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10.2. Traffic controllers trained?
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10.3 Adequate controls for TMP? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)
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10.4 Other?
11.0 Personal Protective Equipment (PPE)
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11.1. Mandatory Site PPE being worn (safety helmet, steel cap footwear and hi-vis)?
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11.2 Task specific PPE being worn (glasses, gloves, face shields, hearing protection)?
12.0 Electrical Hazards
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12.1 Electrical leads and equipment safe for use? (damaged, out of test date or untested)
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12.2 RCD protection provided?
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12.3 Temporary supply is adequate ( i.e. SWB on each level, leads not required to run 30m, number of SWB and GPO is suitable for contractors numbers)?
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12.4 Work near overhead electrical lines maintains safe distances or is isolated?
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12.5 Switchboards are installed correctly ( i.e. separate isolations switch, locked cover over RCD, no gaps & space for leads at base).
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12.6 Leads are protected against mechanical damage (i.e. off the ground or on insulated hooks or stands)?
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12.7 Electrical equipment are not in damp operating conditions.
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12.8 Temp. power boards (SWB) unobstructed and secured upright.
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12.9 Other?
13.0 Scaffolding
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13.1. Licensed persons erecting scaffold above 4m?
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13.2. Scaffold components are in good condition?
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13.3. Scaffolders Hand over certificate provided.
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13.4. Scaffold complies with AS1576 i.e. not overloaded, hand rails, stairs/ladder access, fully decked, gaps less than 230mm from working edges
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13.5. Scaffold over 4m high is inspected very 30 days
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13.6 Other?
14.0 Environmental Hazards
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14.1 Systems to prevent contaminants entering stormwater drains are implemented ?
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14.2. Adequate dust suppression systems (water)
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14.3. Silt control fencing adequately installed
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14.4 Other
15.0 Administrative Procedures
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15.1. Site specific Site Safety Plan on site?
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15.2. Permits (Council, EPA, Cranes, Hot Works, Confined Space) are on site?
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15.3. Induction for workers, contractors, visitors undertaken?
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15.4. Supervisory arrangements suitable for project?
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15.5 Safe Work Method Statements (SWSM) for high- risk work are on site?
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15.6 Review SWMS undertaken to to start work.
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15.7 Routine safety inspections, monitoring, audits undertaken on site by project staff?
16.0 Other Issues
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16.1 Other Issues
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16.2 Other Issues
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16.3 Other Issues
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16.4 Other Issues
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16.5 Other Issues
Sign Off
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On site representative
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Auditor's signature
