Title Page
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Document No.
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Job Reference
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Job Reference Number:
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Site Address:
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Select date
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Drivers Name:
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Drivers mate:
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Vehicle Reg:
Documentation/ Identification
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Work Order(s) for Job(s)
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Applicable RAMs
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Log book
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Vehicle Check/ Defect Sheet
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Current Driving Licence
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NRSWA Certification
Health and Safety
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Hi Vis being worn
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Safety boots being worn
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Hard Hats being worn (if required)
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Ear Protection being worn (if required)
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Eye Protection being worn (if required)
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Gloves being worn
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First Aid Kit available/ complete/ in date
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Fire Extinguisher available/ in date
Traffic Control (Chapter 8)
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Safety zone(s) set up correctly
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Photos of site set up
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Signage set up correctly (clean/undamaged)
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Signage correctly branded
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Barriers and cones set up properly
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Traffic lights set up correctly/ working properly
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Stop/ Go boards available (Where required)
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Pedestrian walkways/ ramps (Where required)
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Tools/ equipment/ spoils within safety zone(s)
Other
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Courtesy board on display/ clean/ correct info
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Crew smart and presentable/appropriate PPE worn
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Site/ operational area clean and tidy
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Crew courteous to clients/ customers/ general public
Equipment
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All plant/ equipment in good working order
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Entry equipment inspected
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Gas monitoring equipment calibrated
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Electrical tools/ Extension leads PAT tested in date
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Lifting equipment examined
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All equipment identified/ status tagged/ labelled
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All inspection/ test/ calibration records available
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Faulty equipment labelled/ prevention of use
Environmental
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Spill kits available/ complete
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Vehicle/ plant free of oil leaks
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Excessive exhaust/ other emmisions
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Excessive noise
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Excessive dust
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Unacceptable odour(s)
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Evidence of pollution/ contamination
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Photos of Evidence
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Pollution prevention measures in place
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Evidence of environmental damage
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Photos of Evidence
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Adverse effect on ecology (animals/plant life)
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Material data sheets available for chemicals
Vehicles
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Vehicle(s) parked in safe/ permitted location(s)
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Vehicle(s) clean/presentable (outside/inside)
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Hydrant licence(s) on view
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Pipes properly secured
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Visible damage to vehicle
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Photos of damage
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Accident procedure/ forms
Tool Check
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Ipad
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Hammer
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Crowbar
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Adjustable Spanner
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Lifters
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Screw Driver
Additional
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Duty of care paperwork done correctly
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Comments/ problems/ defects/ recommendations
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Action to take
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Auditors signature
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Auditors name:
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Drivers signature