Audit / Inspection Details
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Title of Compliance Audit
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Audited/Inspected by:
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Department / Client (PCBU)
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Department Line Manager
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Team Leader
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Worksite Supervisor
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Health and Safety Representative (HSR)
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Contact Name and Details (PCBU)
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Date and time of compliance inspection
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Location
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Yes - Compliant (Green) No - Not Compliant (Red) Not Yet Verified (Yellow) Not Applicable (Blue)
1. Worksite Access (Road and signs)
1. Worksite Access (Road access and signage)
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1. Is there sufficient signage in place advertising work in progress?<br>
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2. Are traffic controller ahead signs in place (Stop / Slow)?
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3. Are flashing hazard lights being used and working?
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4. Are sufficient traffic cones or bollards in use?
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5. Are all access and side tracks secured from unauthorised public entry?
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6. Other
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
2. Worksite Entry (Report site office etc)
2. Worksite Entry and Traffic Control (Vehicle and Pedestrian)
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1. Is signage in place for "No Unauthorised Entry"?<br>
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2. Are all persons must report to site office or site controller displayed?
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3. Is PPE required for site displayed?
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4. Worksite speed limit displayed?
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5. Site contact names and numbers displayed?
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6. Is the site secure from unauthorised entry of vehicles and/or traffic?
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7. Are spotters provided to control and direct pedestrian and vehicle traffic (where required)?
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8. Is a formal traffic management plan (TMP) available for the worksite (If required)?
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9. Other
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
3. Site Office / Crib Hut
3. Site Office / Crib Hut
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1. Are there designated parking areas for plant, workers and visitors?
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2. Is there a WHS notice board displayed?
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3. WHS policy displayed, signed by senior management and current?
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4. Is a site induction conducted?
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5. Are responsible persons names and titles displayed?<br>Site Manager<br>Superintendent<br>WHS Officer<br>Worker Safety Representative<br>Work Health and Safety Representative (HSR)<br><br><br>
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6. Other
Comments, Corrective Actions, and Person Responsible (Insert number and details i.e 1.1)
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Comments / Recommendations / Corrective Action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective Action
4. Visitor Controls
4. Visitor Controls
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1. Are visitors required to formally sign-in and out?
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2. Is the visitor to be escorted at all times while on site? (If yes, a basic induction is only required).
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3. Is a means of identifying visitors implemented?
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4. Are visitors advised of emergency procedures?
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5. Are areas where visitors are not permitted clearly identified / explained?<br><br><br>
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6. Is suitable PPE provided to visitors?
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Other issues
Comments, Corrective Actions, and Person Responsible (Insert number and details i.e 1.1)
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Comments / Recommendations / Corrective Action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective Action
5. Sub Contractors
5. Sub Contractors
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1. Are contractors made aware of company WHS policies and rules before commencing work<br>
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2. Do engaged contractors provide adequate insurances (Workers Compensation and Public Liability to 20 Million)?
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3. Are sub-contractors safety systems and consultation arrangements harmonised with the engaging PCBU?
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4. Are sub-contractors management systems provided to the principle PCBU?
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5. Are checks made of the contractors plant and equipment for compliance and safety?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
6. Emergency Procedures
6. Emergency Procedures
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1. Are emergency procedures displayed?
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2. Emergency services 000 and PCBU names and numbers?
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3. Site map available?
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4. Are training drills conducted periodically, verbally at toolbox talk and practically exercised (6 monthly)?
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5. Muster / Assembly point identified?
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6. Fire equipment available and tagged for currency?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
7. Communication
7. Communication
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1. Is communication available (Phone, radio, satellite)?
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2. Does the worksite have agreed radio contact numbers for various locations?
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3. Do all workers on-site know the radio numbers for locations?
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4. Do workers understand basic hand signals (i.e. Stop)?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
8. First Aid
8. First Aid - First Aid Code of Practice
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1. Qualified first aid names displayed (First aid level).
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2. Medical supplies checked for currency and expiry date?
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3. First aid kits for workers on-site within easy access?
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4. Medical supplies and facilities are adequate for the nature, location and composition of workers on site?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
9. Workplace Amenities
9. Workplace Amenities
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1. Toilets available on site?
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2. Are toilets provided for each gender?
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3. Washing facilities provided?
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4. Are toilets and shower areas cleaned regularly?
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5. Are sufficient consumables made available in washrooms and toilets?
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6. Are sufficient tables and chairs provided?
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7. Are lunchroom, kitchen facilities clean and hygienic?
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8. Is clean drinking water provided?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
10. Consultation (Pre-start briefs, toolbox talks)
10. Consultation (Pre-start briefs, toolbox talks)
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1. Is there a WHS project or site specific plan in place?
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2. Do all workers have their General Construction Card on-site?
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3. Are pre-start shift meetings conducted?
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4. Are toolbox talks conducted periodically to discuss safety issues between worker and management?
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5. Are there worker safety representatives I.e. HSR
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6. Do workers understand the PCBUs legal responsibilities for consultation?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
11. Personal Protective Equipment (PPE)
11. Personal Protective Equipment (PPE)
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1. PPE allocated to workers specific to activities (Australian Standard)?
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2. Workers wearing PPE required by company policy?<br>
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3. High visibility clothing?
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4. Hard hat and wide brim hat?
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5. Fully enclosed footwear?
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6. Are signs displayed where specified PPE must be worn?
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7. Is PPE fitted correctly, serviceable and in good condition?
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8. Do workers wear PPE when mandated in SWMS?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
12. Manual Handling
12. Manual Handling (Hazardous Manual Tasks Code of Practice)
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1. Is a risk assessment conducted for manual tasks (heavy lifting or strenuous work)?
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2. Are workers trained in lifting practices?
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3. Do workers request assistance for heavy or awkward lifting tasks?
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4. Do workers warm before heavy lifting to avoid strain injuries?
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5. Are adequate rest breaks allocated to allow workers time to recover?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
13. Safety Issue, Hazard Reporting and Controls
13. Safety Issue, Hazard Reporting and Controls (Hierarchy of control)
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1. Are safety issue / hazard and near miss reporting forms available on-site
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2. Do workers understand the procedure for reporting safety concerns (Stop work, apply control or report to supervisor)?
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3. Are risk assessments conducted to identify site hazards with controls implemented?
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4. Do workers know and refer to the hierarchy of control?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
14. Incident Reporting and Investigation
14. Incident Reporting and Investigation
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1. Are incident / injury forms available on site?
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2. Do workers report all incidents ASAP?
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3. Are all incidents fully investigated and effective remedial action implemented?
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4. Are WorkCover NSW "Notifiable Incidents and Preservation Site", regulations clearly understood by the PCBU?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
15. Safe Work Method Statements (SWMS)
15. Safe Work Method Statements (SWMS) - Code of Practice for Construction Work
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1. Have workers been inducted and consulted, in the development of SWMS?
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2. Are SWMS systematic with steps, hazards and controls?
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3. Are SWMS specific to the activity and easy for workers to understand?
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4. Do all workers understand SWMS and are they signed off?
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5 Are SWMS monitored and reviewed for effectiveness?
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6. Are SWMS provided to the principle contractor?
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7. Do SWMS meet the minimum standards required by applicable Codes of Practice?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
16. Plant (General)
16. Plant (General) - (Evidence required i.e. documentation)
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1. Has plant been assessed as safe to use and complaint to Australian standards?
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2. Are operators trained and Verified as Competent (VOC); is evidence available?
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3. Are daily pre-start checklist completed and faults reported?
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4. Are repairs and maintenance conducted in a timely manner (Risk rated)?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
17. Safe Operating Procedures (SOP)
17. Safe Operating Procedures (SOP)
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1. Are worker safe operating procedures (SOP)in place specific to plant?
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2. Are operators provided with periodic checks on SOPs?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
18. Plant used to Lift Loads
18. Plant used to Lift Loads
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1. Loads requiring calculation must be slung by a competent person i.e a licensed dogman?
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2. Are all ropes, slings, chains and lifting attachments inspected daily before use?
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3. Are loads properly calculated before lifting commences?
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4. Does the Crane operator and Dogman communicate effectively?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
19. Isolation: Tag-out, Lockout
19. Tag-out, Lockout Procedure (SWMS)
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1. Do operators understand the initial tag-out procedure?
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2. Are tags available in the machine or location?
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3. Do mechanics apply their own locks when working on machinery?
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4. Are all locks issued to a person keyed identically?
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5. Are operators notified of return to service?
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6. Are there procedures or SWMS for Isolation, tag-out and lock-out.
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
20. Environmental Controls
20. Environmental Controls
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1. Is there an environmental plan in place?
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2. Are work practices designed to reduce impacts to the environment?
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3. Are sediment barriers used around perimeters of earthworks and waterways?
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4. Is dust suppression available (E.g. Water carts)?
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5. Are vehicles and plant purchased and maintained to reduce emission levels?
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6. Are procedures available for the disposal of waste and used hazardous substances E.g. Safety Data Sheets?
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7. Does the company have a recycling policy?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
21. Plant Exclusion Zones
21. Plant Exclusion Zones
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1. Permit completed?
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2. Signs in place to identify exclusion zone?
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3. Exclusion zones secured?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
22. Storm Water Run-off
22. Storm Water Run-off
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1. Weather monitored to implement controls to minimise soil erosion?
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2. Silt control fences in place or other?
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3. Waterway traps inserted to contain and remove contaminants?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
23. Occupational Noise
23. Occupational Noise
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1. Have all areas been assessed for the presence of harmful noise levels?
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2. Are all workers in the presence of harmful noise levels wearing hearing protection?
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3. Are noise hazard locations identified by safety signs or stickers?
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4. Are workers wearing hearing protection provided with hearing tests (Every 2 years if wearing hearing protection)?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
24. Site Rehabilitation
24. Site Rehabilitation
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1. Are work plans available to include procedures for re-instatement of work sites?
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2. Are all locations rehabilitated to meet EPA standard?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
25. Hazardous Substances (Chemicals)
25. Hazardous Substances (Chemicals) - Code of Practice for Hazardous Substances
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1. Are hazardous materials identified and control measures implemented?
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2. Are Safety Data Sheets available for all substances used in the workplace?
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3. Are all safety data sheets current (not over 5 years old)?
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4. Have risk assessments been conducted to eliminate or minimise the type of chemicals used?
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5. Are workers trained in the safe handling and application of hazardous chemicals?
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6. Do workers follow SDS procedures when handling chemicals?
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7. Are chemicals stored properly ( E.g. 110% bunded and in-compatible separation)?
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8. Are all containers used for handling chemicals labeled correctly?
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9. Is the product identified correctly?<br>- Australian address, business telephone number and manufacturer / import identified?<br>- hazardous chemical pictograms consistent with correct classification?<br>
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10. Are first aid treatment and emergency procedures available relevant to the chemical?
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11. Do workers using hazardous chemicals require health monitoring (Refer chemical)?
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12. Are workers wearing PPE as prescribed by the safety data sheet (SDS) for chemical used?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
26. Electrical and Power Tools
26. Electrical and Power Tools
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1. Is electrical equipment tagged and tested for currency?
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2. Is the site shed protected by Residual Current Device (RCD) Electrical circuit breaker?
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3. Are power boards used (no double adaptors or piggy backs)?
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4. Do portable power tools have RCDs?
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5. Are leads inspected daily for damage (Hostile environment)?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
27. Portable Power Tools
27. Portable Power Tools?
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1. Are power tools in good condition?
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2. Are adequate storage facilities provided?
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3. Are all guards in place?
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4. Is hearing protection worn if over 85dB?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
28. Hotwork
28. Hotwork
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1. Permit to conduct hot work (Usually encompasses a risk assessment)?
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2. Have risk assessments been conducted where hot work presents a risk?
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3. Is fire fighting equipment available for fire prone locations?
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4. Are flammables or explosive substances removed from location prior to hot work?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
29. Gas Cylinders
29. Gas Cylinders (Oxy and Acetylene etc)
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1. Are gas cylinder properly stored (chained and secured)?
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2. Gas cylinders properly turned off and hoses wound up?
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3. PPE available and used for welding or oxy cutting?
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4. LPG - Is the LPG cylinder stamped as current (Within 5 years) and in serviceable condition?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
30. Working at Heights
30. Working at Height (Generic)
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1. Risk assessment conducted?
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2. Are workers trained in working at heights?<br> - Evidence provide e.g. tickets?
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3. Height of work and regulations checked?
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4. Is there electricity power cables in close proximity to the work?<br>- Have effective controls been implemented?<br>- Essential energy notified 13 20 80 to conduct preliminary risk assessment if required?
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5. Correct edge protection in place and to a structural strength?<br>AS/NZS 1576 Scaffold Series?
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6. Fall protection device includes AS/NZS 1891.1<br>- a secure fence<br>- edge protection<br>- working platforms and;<br>- covers
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7. Surfaces are structurally capable of supporting all persons and things that may be located or placed on it?
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8. Surface materials not brittle?<br>- skylights identified?<br>
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9. Pitch of roof assessed?<br>- less than 15 degrees?<br>- worker no closer than 3 metre from edge?<br>- how is this controlled?
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10. If no edge protection and the roof is flat and is less than 15 degrees the following applies:<br>1. Conduct a risk assessment?<br>2. Floor sound and not slippery?<br>3. No person is to be within 3 metres of the edge?<br>4. Optional - 3 metre line is identified with a barrier or adequate controls that ensures a person cannot cross?
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11. Loose objects secured from falling?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
31. Portable Ladders
31. Portable Ladders
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1. AS/NZS 1892 Portable Ladder?
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2. Load rating of 120kg?
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3. Ladder placed at 1:4 or no more than 1:6 slope?
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4. Is the ladder secure at top and bottom?
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5. Does ladder extend 900mm to 1 metre above the landing platform?
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6. Fall protection at stepping of point?
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7. Are temporary ladders not > 6 metres between successive ladder landings?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
32. Elevated Platform
32. Elevated Platforms
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1. Are workers trained and competent in the safe operation of plant?
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2. Manufacturers or suppliers instructions are consulted on safe operation of plant?
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3. Platforms are used as a working platform and not as a means of entering and exiting the work area?<br>Unless the conditions set out in AS 2550.10 Cranes, hoists and winches - Safe use - Mobile elevated platforms are met.
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4. Unless designed for rough terrain, the platforms are used only on solid level surface?
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5. Workers are licensed (HRWL) when operating boom type elevating work platforms with a boom length of 11 metres or more?
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6. Are persons in travel towers, boom lifts, or cherry pickers wearing a properly anchored safety harness?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
33. Scaffolding - Documentation
33. Scaffold - Documentation
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1. Handover certificate on-site E.g. Scaff tag?
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2. Has steel wire mesh/shade cloth or containment sheeting been erected to protect members of the public or workers from falling objects?
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3. Where the working platform is less than 4 metres, was it erected by a competent person? Are procedures in place to inspect scaffolding every 30 days?
-
4. System in place in place to inspect after trades have used scaffolding e.g. Form workers, concreters, brick layers, tillers etc?
-
5. Is a work method statement or appropriate documentation available for management on-site once erected?
-
6. Is there a system in placed to prevent damage to the scaffolding from loads suspended from a crane and is it recorded in SWMS?
-
7. Have trades been inducted on the safe use of the scaffolding?
-
8. Is metallic scaffold a minimum of 4 metres from overhead powerlines?
-
9. Where overhead powerlines (up to and including 1000 volts) cannot be de-energised and isolated, are tiger tails installed by the network operator for the full length of the scaffold plus a minimum distance beyond each end of the scaffold of 5 metres?
-
10. Has the network operator e.g. Essential Energy, been contacted to conduct a risk assessment where uncertainty exists or scaffold is within 4 metres or above 1000 volts of powerlines?
-
Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
34. Scaff-Supporting Structure
34. Scaffold - Supporting Structure and Foundation
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1. Is supporting structure in good condition and adequate strength?<br>Has it been assessed by a competent person / engineers certificate?
-
2. Is there a risk of the supporting structure being overloaded from other sources adequately controlled?
-
3. Is there a system in place to prevent scaffolding being struck by vehicles and or plant e.g. Concrete blocks, guards, fenders, traffic management?
-
Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
35. Scaff-Foundation
35. Scaffold - Foundation
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1. Scaffolding erected on suitable foundation/footing e.g. Not adjacent to excavations, trenches, underground services or soft ground?
-
2. Base plates used are a minimum 100mm x 100mm and 6mm thick?
-
3. If on soft ground are sole boards being used to distribute the weight evenly e.g. Unstable ground, gaps?
-
4. Are the sole boards continuous and where ever possible support two standards?
-
5. Are the sole boards a minimum 220mm wide?
-
6. Is packing used under sole boards e.g. Hardwood?
-
7. Screw jacks not extended more than 600mm or a a manufacturers requirements?
-
Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
36. Scaff-Mesh Shade Cloth/Sheeting/Signage
36. Scaffold - Steel wire mesh/ shade cloth/ containment sheeting/ signage
-
1. Has scaffold been designed for wind loading where signage is being tied to the scaffolding?
-
2. Are the sheets adequately fixed/tied?
-
3. Are there tears or gaps in the sheeting?
-
4. Is the an engineering ticket for ties?
-
5. Is there a minimum 50mm overlap?
-
6. Signs on scaffolding - any engineering calculations - wind design?
-
Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
37. Scaff-Overhead Powerlines
37. Scaffold - Overhead power lines (OHPL)
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1. Is the scaffold erected close to OHPL within 4 metres?
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2. Has the service provider been contacted to conduct a risk assessment for controls e.g. Disconnect service lines, erect tiger tales?
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3. If the OPHL have not been de-energised is there a system of work to ensure the scaffold complies with local requirements during erection, altering, use and dismantling?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
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Corrective action completed details
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Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
38. Scaff-Ties and Mixed Components
38. Scaffold - Ties and mixed components?
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1. Are mixed components being used?
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2. Are they compatible?
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3. Engineers certificate available if required?
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Other issues
Scaffold Ties
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4. Have ties been installed as per manufacturers/suppliers instructions/information and AS/NZS 1576?
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5. System in place to monitor ties as other trades progress e.g. Form workers, brick laying, tilers etc?
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6. System in place to monitor ties as the structure is dismantled?
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7. Do the ties pick-up two standards or legs?
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8. Are single leg ties used - is relevant documentation available?
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9. Have 90 degree fittings been used (Swivel fittings not to be used)?
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10. Are ties provided every 4 metres (Vertically) in height?
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11. Are ties provided as per AS/NZS 1576 - Vertical = 4 metres?
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12. Height of scaffolding < 15 metres (horizontal ties required)<br>- Between ground and 15 metres = Every 3rd standard<br>- Between 15m and 30m = zero<br>- Between 30m and 45m = zero
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13. Height of scaffolding 15 metres and 30 metres (horizontal ties required)<br>- Between ground and 15 metres = Every 2nd standard<br>- Between 15m and 30m = Every 3rd standard<br>- Between 30m and 45m = zero
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14. Height of scaffolding > 30 metres (horizontal ties required)<br>- Between ground and 15 metres = Every standard<br>- Between 15 and 30 metres = Every 2nd standard<br>- Between 30m and 45m = Every 3rd standard
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15. Where drilled-in anchors are being used; are engineering drawings/calculations etc available on site?
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16. Do the ties obstruct access along the full length of the working and access platforms?
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
39. Scaff Platforms (General)
39. Scaff-Platforms (General)
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1. Are platforms free from obstruction?
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2. Are planks in good condition and a minimum of 220mm wide?
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3. Do planks overhang supports by 150mm - 300mm?
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4. Are planks adequately secured where they overlap?
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Other issues
Site Address
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5. Are loads on any given platform evenly distributed?
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6. Are standards correctly positioned i.e. Staggered?
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7. Is the duty of the scaffolding suitable for the task i.e. Heavy, medium or light?
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8. Is the scaffold width appropriate for the duty e.g. Heavy duty 5 planks?
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9. Are signs erected on the bays indicating duty of the bay(s)?
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10. Are any of the platform bays being used to stack/store materials e.g. Bricks, formwork?
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11. Does the weight of these materials exceed the rated WLL per platform bay?
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12. Is there any material etc. being stacked/stored above the height of the guardrail?
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13. Is there any signage indicating scaffolding incomplete where required?
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14. Are openings at working platform level covered and secured e.g. Plywood (17mm), planks?
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
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Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
40. Scaff Temporary Stairways
40. Scaffold Temporary Stairways
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1. Has separate stairway access been provided to access scaffold?
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2. Is the stairway a minimum of 500mm wide?
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3. Is the access landing a minimum 500mm x 450mm?
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4. Is a handrail provided on each side of the stairway?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
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Comments / Recommendations / Corrective action
41. Scaff Bracing
41. Scaffold - Bracing
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1. Has face bracing been provided i.e. Longitudinal at no more than 3 bays apart, unless otherwise specified?
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2. Has bracing been provided at the end of scaffolding i.e. Transverse bracing
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3. Does the bracing extend the full height of the scaffold?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
42. Scaff Access and Hop-up Brackets
42. Scaffold - Access and Hop-up Brackets
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1. If hop up brackets are 500mm above or below the working platform, has adequate fall prevention been provided?
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Other issues
Access
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2. Is the access along the working platform - 450mm wide for persons and tools only 2 planks?
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3. Is the access along the working platform - minimum 675mm wide for persons and materials (3planks)?
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4. Are incomplete scaffolding platforms etc. blocked off and/or signs used?
-
5. Is there suitable access to and from the working platform e.g. From the building to the platform?
-
6. Is there safe access between working platform during use , erection and dismantling?
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
43. Scaff Edge Protection
43. Scaffold - Edge Protection
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1. Is edge protection provided where a person or object could fall (2m or) more?
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2. Handrail, mid rail and toe board or brick guard provided?
-
3. Where guard rails and toe boards (150mm) only are being used, is a suitable infill such as brick guards or infill panels being used?
-
4. Are guard rails being erected, between 900mm and 1100mm above the platform?
-
5. Where brick guards are being used, is the mesh aperture no > 50mm x 50mm?
-
6. Where the gap between scaffolding and supporting structure is > 225mm, has edge protection been provided?
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Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
44. Scaff Trades Using
44. Scaffold - Trades using scaffold
-
1. Do the trades on site using scaffolding alter the scaffolding themselves?
-
2. Are trades on site that are using the scaffolding aware that any alterations to the scaffold is to be done by the scaffolder?
-
Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
45. Fall Arrest System
45. Fall Arrest System
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1. Do restraint systems conform to AS/NZS 1891 industrial fall arrest systems and devices?
-
2. Does each anchorage point conform to AS/NZS 1891.4 industrial fall arrest systems devices - selection, use and maintenance?
-
3. Are fall arrest systems and devices inspected by a competent person at regular intervals to manufacturers specifications?
-
4. Is there a minimum of two persons on site to activate an emergency rescue in the event of a person falling?
-
5. Are the fall arrest systems adequate for the type of working at height activity?
-
6. Are workers trained in working at height? Provide evidence?<br>Competence person providing full supervision for untrained workers?<br>
-
7. Is a safe work method statement available for the activity of high risk construction work?<br>Excluding minor work exemptions and those definitions?
-
8. Do persons in charge have access to the Code of practice for Falls<br>Are they aware of the Code of Practice for Falls?
-
Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
46. Scaffold-Mobile
46. Mobile Scaffold
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1. Are details available for scaffold WLL and/or a compliance plate?
-
2. No unauthorised alterations prevalent?
-
3. Kickboards or toe boards in place to prevent falling objects?
-
4. Scaffold level and plumb at all times?
-
5. Kept well clear of powerlines, open floor edges and penetrations?
-
6. Is not accessed until castors are locked to prevent movement?
-
7. Is never moved while anyone is on it?
-
8. Is only accessed using external ladders?
-
9. Has a trap door for a hazard free platform?
-
Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
47. Confined Spaces
47. Confined Space
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1. Code of Practice for Confined Space available on-site?<br>SWMS states COP to be made available on entry sites.
-
2. SWMS available on-site, signed by all workers?
-
3. Emergency rescue plan discussed and adequate?
-
4. Emergency rescue equipment/trailer and medical supplies available on-site?
-
5. Communication system in place?
-
6. Entry permit available and progressively completed as required for activity?
-
7. Risk assessment completed and necessary controls are in place e.g. Ventilation, gas monitoring, barriers in place etc?
-
8. Workers are nominated for positions e.g. Worker entering space, competent worker in charge and 3rd worker to assist with spotting or activating emergency response plan?
-
9. Access and egress are clear as is reasonable practicable?
-
10. Permit completed and all equipment removed?
-
Other issues
Comments, Corrective Actions and Person Responsible (Insert number and details i.e. 1.1)
-
Comments / Recommendations / Corrective action
-
Corrective action completed details
-
Name and signature of person responsible for implementing corrective action
-
Comments / Recommendations / Corrective action
48. Asbestos
48. Asbestos
-
1. Asbestos removalist has applicable license (Class A Friable or Class B Non-Friable less than 10 Square metres)?
-
2. Asbestos management plan available at the worksite (SWMS acceptable provided compliant)?
-
3. Is a licensed asbestos removalist on location?
-
4. Are workers wearing the correct PPE when handling asbestos?
-
5. Are all workers trained in the handling and removal work (Provide evidence)?
-
6. Are suitable suppression of asbestos equipment of processes being used?
-
7. Is adequate signage and fencing in place for asbestos contaminated locations?
-
8. Are there adequate decontamination facilities for workers?
-
Other issues
Comments, Corrective Actions and Persons Responsible
-
Comments / Recommendations / Corrective Action
-
Corrective action completed details
-
Name, signature and person responsible for implementing corrective action
-
Comments / Recommendations / Corrective Action
Compliance Officer Summary Comments and Officer Details
Compliance WHS Officer(s) (Comments)
-
1. Name, title and signature of person conducting compliance audit
-
Comments
-
2. Name, title and signature of person conducting compliance audit
-
Comments
Site Supervisor (Person in charge) Details
Site Supervisor (Person in charge) Details
-
Name, title and signature of person in charge (Supervisor)
-
Comments
-
Name, title and signature of person in charge (Team Leader)
-
Comments
Worker Names, Titles and Signature
Workers On-site, Names, Titles and Signature
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
-
Name of worker and signature (Add title if required)
Sketch Details
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Details:
-
Select date
-
Add location
-
Add drawing
-
Add media
-
Add drawing
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Add media
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Add drawing