Boden Permits to Work Audit

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Executive Summary

• undefined

Introduction

Scope of Work

• undefined

Method of Assessment

• Face to Face

  Teams

  Documents submitted review

undefined

• Client/s

• Building/s

• Contract Type

• Contractor

• Date and Time

  Date

• Auditee Name

• Auditee Job Title

• Assessor Name

• Asser Job Title

Roles & Responsibilities

• AP Appointed Person In Place?

• RP Responsible Person Identified and appointed?

• DRP Deputy Responsible person identified and appointed?

• CP Competent Persons Identified

• Skilled Persons Register available and up to date?

  Date

Work Permit General

Do you want to answer these questions?

• Was the scope of the work correctly described indicating location, risks, equipment to be used?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was /Were the correct permit(s) specified?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Were hazardous materials or equipment identified

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Are the team aware of any hazardous materials or situations which they may be exposed to?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the correct PPE specified?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the correct PPE worn?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Did the area of work require barriers putting place?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the work area segregated with suitable barriers/fencing?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was consideration given to surrounding equipment/operations for potential impacts to the task?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Were the appropriate gas tests specified

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Were the appropriate gas tests performed and results entered on permit or gas related certificate?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the gas monitor within calibration date

  Date

• Was the correct types of tools specified? (nonsparking intrinsically safe, pneumatic, etc.)?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Were the correct types of tools being used?

  Yes

  No

  N/A

• Were the tools used in good safe condition?

  Good

  Fair

  Poor

  N/A

• Was contractor training verified?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Were the appropriate authorisation or approval signatures in place?

• Was the completed permit completed by a competent/authorised person?

  Yes

  No

  N/A

• Was the permit correctly signed off by the issuer?

• Was the permit correctly closed off by the issuing department?

  Yes

  No

  N/A

Lockout/Tagout Electrical

Do you want to answer these questions?

• Yes

  No

  N/A

• Was the AP Electrical in possession of a current authorised persons certificate of appointment?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the certificate of appointment appropriate for the equipment being worked on?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Were area specific safety procedures identified prior to works and communicated to the workforce?

  Yes

  No

  N/A

• Was a safety plan in place for the works?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the lock out tag out procedure followed?

  Yes

  No

  N/A

• Was the location of the lock out tagout equipment known and readily available?

• Were the correct isolation points identified?

  Yes

  No

  N/A

• Have Lockout Tag off processes involved more than one person

  Yes

  No

  N/A

• if yes has the lock off been completed so the neither can activate without the others padlock being removed

  Yes

  No

  N/A

• Was isolated points clearly tagged out with ownership of system/circuits identified by person?

  Yes

  No

  N/A

• Were the keys for anyone working on the system on their person / or securely stored if long term is location in place

  Yes

  No

  N/A

Work At Height permit?

Do you want to answer these questions?

• Contractor Inducted?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Have there been clear details of the activity recorded?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Have the work team reviewed and signed off the RAMs for the task?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Are relevant training records present?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Has the location of works been clearly identified?

  Yes

  No

  N/A

• Is all equipment within inspection date?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Have any special safety conditions been identified?

  Yes

  No

  N/A

• Is there a working at heights register or restricted high places register available?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Rescue plan in place?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Rescue plan suitable and sufficient?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• All parties involved in rescue plan understand what to do and how to respond to complete the approved safety plan

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Permit signed off as applicable?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Safety Checklist completed in line with task?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

Confined Space Entry

Do you want to answer these questions?

• Yes

  No

  N/A

• Contractor Inducted?

  Yes

  No

  N/A

• Have there been clear details of the activity been recorded?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Have the work team reviewed and signed off the RAMs for the task?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the type of hazard identified for making the area a confined space?

  Yes

  No

  N/A

• provide details of hazard?

• Are relevant training records present?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Is a rescue plan in place

  Yes

  No

  N/A

• Did the gas monitor pass a functional field or bump test at the time of the audit?

  Yes

  No

  N/A

• Have the persons using the monitors been shown how to use them?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Have prestart checks such as gas checks been completed and recorded before commencing the entry

  Yes

  No

  N/A

• What pre-start checks are carried out?

• Were followup or continuous monitoring requirements met and documented?

• Was the correct type of ventilation equipment specified?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the specified ventilation equipment installed correctly?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Are special tools required such as Intrinsically safe electrical equipment

  Yes

  No

  N/A

• What tools?

• Were all confined space entrants’ names listed on the entry permit?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the confined space attendant’s name listed on the entry permit?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Were confined space entrants wearing the required retrieval equipment?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Why was there no retrieval equipment worn?

• Who made the decision the retrieval equipment was not worn/required?

• Was the decision not to wear retrieval equipment documented formally on the confined spaces permit or method statement and associated risk assessment?

• Could the confined space 2nd person describe how to call for help?

• Could rescue team describe/demonstrate the rescue plans?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the permit opened and closed correctly and signed off by the same personnel?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

Hot Works Permit

Do you want to answer these questions?

• Yes

  No

  N/A

• Were the correct fire precautions specified?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was there a need to cover or protect any combustibles?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the correct fire extinguisher(s) specified?

  Yes

  No

  N/A

• Have operatives been fire trained?

  Yes

  No

  N/A

• Was the correct fire extinguisher(s) readily available?

  Yes

  No

  N/A

• Was a fire watch identified?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the fire watch present?

• Could the fire watch accurately describe his/her duties?

• Was the fire watch aware of the specified fire watch time to have the area monitored?

  Select 30 minutes 1 hour 2 hours Alternate if evidenced by site specific process

  • 30 minutes
  • 1 hour
  • 2 hours
  • Alternate if evidenced by site specific process

• Was the fire watch trained in the use of fire extinguishers?

  Yes

  No

  N/A

• Has operative ever been trained?

• Was the fire alarm system identified as needing Isolation of the task?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the fire alarm system detector heads protected from unwanted activations?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was it clearly identified who the fire responsible person was and that the point of works had the necessary isolations?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

Permit to Excavate/Dig

Do you want to answer these questions?

• Contractor inducted?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Operatives named on permit

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Supervisor named on permit

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• site utility plans available and in date?

• Are there drawings on site which show underground utilities

  Yes

  No

  N/A

• What assurance is there that there was/are no services as per original build in order for works to commence?

• If a CAT and Genny was to be used was the calibration details recorded?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was the competent person identified to complete a survey of buried utilities?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Were all buried utilities identified and marked?

  Yes

  No

  N/A

• What further actions were carried out?

• Was the safe place to break ground identified?

  Yes

  No

  N/A

• How was the safe break ground point decided and by who?

• Was the work areas securely barriered off before breaking ground

  Yes

  No

  N/A

• Was there a valid risk and method statement in place?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Had the risk and method statement been briefed to the workforce and signed off by all parties?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Did RAMs state flame retardant PPE and long sleeves?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Did the method of work consider environmental impacts and that it did not pose any significant concerns?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Were suitable controls put in place to prevent impacts on the environment and the workforce briefed on these?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Were all hand tools in good condition and insulated?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Where mechanical plant was used was the operator trained in the use of the plant and familiar with safe excavation practices?

• Was the depth of intended excavation known?

  Yes

  No

  N/A

• Had the ground conditions been considered and prevention of land slip considered with shoring up for excavations beyond 1.2 meters in depth?

• Any temporary works Benching/Battering back identified and carried out?

  Yes

  No

  N/A

• What was required?

• What depth was the excavation?

• Any additional designs or calculations required identified and records within works package?

  Yes

  No

  N/A

• Permit opened and signed off by Supervisor?

  Yes

  No

  N/A

• Permit opened and signed off by Appointed Person?

  Yes

  No

  N/A

• PTW issuer have valid certification

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• PTW receiver have valid certification

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Joint site inspection conducted

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• PTW heading completed fully

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Tools & Equipment to be used complete

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Additional Precautions complete

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Gas testing information complete and proper where appropriate

  Yes

  No

  N/A

• Gas testing conducted prior to and during the work

  Yes

  No

  N/A

• Why was this not carried out?

• Issuer and Receiver signatures present?

  Yes

  No

  N/A

• If PTW is extended, are/were signatures and extension details correct?

• PTW properly closed out at end of job?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• PTW available at site

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Receiver/delegate available at site

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Work scope defined properly

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Equipment properly identified

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was equipment defined correctly within RAMs and were they suitably reviewed?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Hazard properly identified

  Yes

  No

  N/A

• What actions were carried out to identify these?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Receiver following PTW instructions

  Select Point of work reviewed Office review Unable to verify Evidence of supervisor management

  • Point of work reviewed
  • Office review
  • Unable to verify
  • Evidence of supervisor management

• Barricade/warning signs adequate

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• PPE adequate

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Rescue man available

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Was rescue person able to demonstrate how to raise the alarm and instigate the rescue plan?

  Select Demonstrated on site Talked through via desk exercise Unable to demonstrate Unaware of rescue plan and the need for one N/A

  • Demonstrated on site
  • Talked through via desk exercise
  • Unable to demonstrate
  • Unaware of rescue plan and the need for one
  • N/A

• Tools in acceptable condition

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

• Are periodic PUWER inspections carried out?

  Yes

  No

  N/A

• Date of last PUWER inspection if there has ever been one?

• Arrange for inspections to be completed

• Overall acceptable excavation procedures in place?

  Select Appropriate documented procedures are in place Appropriate evidence was provided for inspection Documented procedures are in place but require improvement The evidence provided requires improvement Work in Progress No Evidence was provided for inspection Nothing in place for this item N/A

  • Appropriate documented procedures are in place
  • Appropriate evidence was provided for inspection
  • Documented procedures are in place but require improvement
  • The evidence provided requires improvement
  • Work in Progress
  • No Evidence was provided for inspection
  • Nothing in place for this item
  • N/A

Summary of findings

• undefined

Learning and ongoing actions

• undefined

Auditor Signature

• Add signature

  Sign