BFM Site Safety Inspection Report

• Document No.

• Job title

• CRC reference number/file/job number

• CRC Client for Site (Officers name & contact number)

• Conducted on

  Date

• Prepared by

• Location
  Address

• Contractor Company Name

• Contractor Representatives Name

• Contractor Representatives Tel. Number

• Contractor Representatives Email

• Note: if follow up action is required, use the "+" button every time you answer a logic question

Administration

Works Order / Instruction

• Has the work request & OHS requirements been completed and followed?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Is a Construction Safety Plan in place? (requirement for all works projects of $250,000)

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Is the Construction Safety Plan being followed by construction crews?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Safe Work Method Statements (SWMS)

• Are SWMS in place and available?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are the SWMS dated, signed and being followed?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Traffic Management

• Is a Traffic Management Plan or Traffic Management Scheme in place which has been provided by a suitably qualified practitioner ?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Is the TMP/TMS readily available on site in hard copy?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Stormwater management and Erosion & sediment control

• Is there an approved plan for the works ?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Site Induction

• Are induction records in place, signed and understood?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Do all persons have available White/Blue card, and other relevant High Risk Work Licenses? (Scaffold, dogger, rigger)

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are appropriate work permits in place? (Confined Space/Hot Work/Isolation Lock Out)

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Hazardous Substances

• Is a Hazmat register (folder), MSDS & Risk Assessments in place and within 5 years of age?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

On the job site ........

Signage and Barriers

• Is the applicable signage or guarding in place according to any approved plans? (Construction site, No unauthorised entry, safety fencing, etc.)

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are blue PPE advisory signs in place, legible and relevant for site?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Dangerous goods placarding in place and relevant to site?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are the public reasonably aware of the activity taking places and if applicable, is there a safe and easily understood way around the jobsite

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Common Plant, Rescue and Lifting Equipment

• Is scaffolding approved for use and displaying a scaf tag or similar?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are tri-pods, winches and lifting equipment in good condition and tagged?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are harnesses, lanyards or slings in good condition and been tested, tagged and current?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are ladders in good condition, been inspected by a competent person and appropriate for task?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are harnesses, lanyards or slings in good condition and been tested, tagged and current?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Electrical

• Are electrical leads and power tools in test date (3 monthly for construction)?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are RCD's in place and tested ?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are electrical leads and power boxes cleared away so they do not form trip hazards?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are any temporary supply distribution boards, generators etc. properly guarded and secured ?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Emergency Management & First Aid

• Is a first aid kit in place and in order?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are emergency procedures in place and all relevant emergency routes known and defined?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Depending on the nature of the work being performed, the contractor maybe required to provide appropriate fire fighting equipment within the work area. However, it is often the asset owner who will be responsible for ensuring that there are adequate fire fighting appliances within a building facility for example. If this is not the case, answer "NO" here..

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Equipment - Small plant eg: whacker packer, generator etc

• Is small plant in good condition and fit for use?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are safety labels attached to plant and legible?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are operating manuals available for relevant plant?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Is there evidence of regular maintenance of plant I.e. Test tags etc. and if so, is it in date ?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Special Safety Issues - Trenches, working over water, working near roads and rail tracks etc.

• Are there any safety issues related to special safety protocols such as working in trenches etc ?

  YES

  No

  N/a

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

People and Behaviours

Safety culture

• Are employees wearing appropriate PPE ?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are employees using appropriate tools for the job ?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are employees using correct manual handling techniques?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are employees following signs, TMP's etc. ?

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

• Are employees acting appropriately and with due diligence in respect to the work they are conducting and the way they are conducting it? I.e. Are they sensible or larking about etc..

  Yes

  No

  N/A

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Other issues

• Are there other issues or concerns that require comment or rectification ?

  YES

  No

  N/a

🔧🔧🔧🔧🔧Rectification Required🔧🔧🔧🔧🔧🔧

• Brief summary of rectification required

• Add photo if nec.

  Media

• Contractor sign off and date of completion of recommended Rectifications/controls

  Sign

• CRC Inspecting officer sign off and date of completion of recommended Rectifications/controls

  Sign

Audit sign off & date

• Auditor

  Sign

• Contractor

  Sign

• Is a STOP WORK notice or Work Improvement Notice required?

  YES

  No

  N/a

• Provide details or external references to notice/letter/email etc.

• Agreed date for follow up inspection

  Date

• A copy of this report must be made available to the contractors representative.
  
  The council officer will also need to retain a copy of this report and program a follow up inspection if required.
  
  If required under Departmental protocols, a copy should also be sent to the manager of the Council staff member who inspected the works.
  
  The Council officer must profile a copy of this report into dm5 and relate any follow up inspections