Information
-
Audit Title
-
Document No.
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
-
Water Authority Validation Officer present?
Tap to enter information
-
Personnel
Site overview
-
Inspection carried out the following time
-
Select date
-
Principal Contractor
-
Watermain Contractor
-
Weather
-
Site conditions
-
Additional site conditions:
-
All actions from previous inspection report completed
Watermains Construction
-
Correct pipe class/in date
-
Bedding material complies and is sufficient depth
-
Bedding material documentation recorded - Supplier, Receipt, Number & Quantity
-
Watermains have sufficient clearances from other services
-
No connections on curved mains
-
Is plastic wrapping in place
-
Watermain depths accord with plans
-
Have the anchor blocks been poured to conform with the specifications
-
Kerb markings are correct
Watermains Management
-
Contractor has Project Management Plan onsite and up to date
-
Contractor has Safe Work Method Statement (SWMS) on site and up to date
-
Contractor has Inspection Test Plan on site and up to date
-
Contractor has Tool Box meeting minutes on site and up to date
-
Contractor has Site Induction requirements and documentation on site and up to date
-
Contractor has Approved up to date construction plan on site
-
Contractor has One call documentation on site and up to date
-
Nominated supervisor on site
O.H.S Checks
-
Red card
-
Traffic
-
Correct PPE Hats, Vests
-
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
-
Is VicRoads approval required/received
-
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 Managers" certificate holder on site
-
Is spoil away from edge of 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
-
Are log books up to date
Environment
-
Runoff Controlled
-
Dust Controlled
-
Noise Acceptable
-
Tree Protection Zones in Test
Summary
-
Safety Advisors Comments
-
Photo Records:
-
Safety Advisor
-
Site Representative
-
I confirm that all actions highlighted within this report have been completed