Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Council representative onsite?

  • Tap to enter information
  • Personnel

Site overview

  • Inspection carried out the following time

  • Select date

  • Site overview

  • Principal Contractor

  • Number of workers on site

  • Weather

  • Site conditions

  • Additional site conditions:

  • All actions from previous inspection report completed

Site documentation

  • Site JSA

  • Method Statments

  • All operatives inducted by Principal Contractor

Emergency Arrangements

  • All accidents, incidents and near misses reported and investigated since last visit.

O.H.S Checks

  • Red card

  • Traffic

  • Correct PPE Hats, Vests

  • Isolation of live sewer

  • Barricading

  • First aid

  • Power

  • Water

  • Toilets

  • General safety

Traffic control

  • Is traffic control required

  • Tap to enter information
  • Workmen ahead signage

  • Detour ahead signage

  • Arrow boards

  • Road closed signage

  • Is traffic management plan in place

  • Are bollards being used in a reasonable manner

  • Is pedestrian access in place

Excavations / Trenching

  • Are there any excavation works

  • Tap to enter information
  • Is trenching/excavation > 1.5m deep

  • Edge protection & ladder access in place

  • Are shields being used

  • Is benching being used

  • Are road plates required and available

  • Are road plates in use

  • Is there a "Mine Mangers" certificate holder on site

  • Is spoil away from edge of trench

  • Is there access into and out of the trench

  • Are the trenches backfilled if no more work is required

  • Is barricading suitable

  • Has allowance for underground services and protection been made

Confined Spaces

  • Is confined space entry required

  • Tap to enter information
  • Has permit to work been obtained

  • Is entry to a confined space required

  • Is signage in place

  • Do personnel have confined space entry ticket

  • Is breathing apparatus in use

  • Pits > 1.5 required for assessment

  • Is the SWIFT Form Q current for Sewer applications

Materials

  • Delivery / Handling / Storage

Temporary bench marks

  • Marked and maintained

Machinery

  • Is machinery in use

  • Tap to enter information
  • Does plant have flashing lights that are working and being used

  • Does plant have reversing beepers

  • Does plant have roll over cages / protection where required

  • Has provision for O/H services been allowed for

Environment

  • Runoff controlled (silt fence, hay bales ect)

  • Dust controlled

  • Noise acceptable

  • Tree protection zones in place

Summary

  • Safety Advisors Comments

  • Photo Records:

  • Safety Advisor

  • Site Representative

  • I confirm that all actions highlighted within this report have been completed

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.