Chorus Health and Safety Week sites

• Techs name

• Address

• Service Provider

• CSA

• Date

  Date

• Completed by

General

• Personnel inducted and signed onto daily pre start / JSA?

  Yes

  No

  N/A

• Personnel wearing compliant PPE?

  Yes

  No

  N/A

• Hazards identified and controlled?

  Yes

  No

  N/A

• Comments

Organisational

• Appropriate register completed and on site? e.g. SDS plant/equipment/ladders

  Yes

  No

  N/A

• Documented SOP available and being followed? E.g SHEWMS

  Yes

  No

  N/A

• Does the tech have a sound understanding of their SOP? E.g what SHEWM number are they working to?

  Yes

  No

  N/A

• Comments

Process

• Are relevant permits in place e.g. excavation / drilling, working at height?

  Yes

  No

  N/A

• Traffic management plan available and current?

  Yes

  No

  N/A

Plant / Equipment / Vehicles

• Vehicles have current WOF and registration?

  Yes

  No

  N/A

• Site equipment in good condition?

  Yes

  No

  N/A

• Portable electrical equipment tested and tagged? e.g. generator

  Yes

  No

  N/A

• Ladders identified and tagged?

  Yes

  No

  N/A

• Safety equipment certified? e.g. harness

  Yes

  No

  N/A

• Compliant safety fences safe and secure?

  Yes

  No

  N/A

• Comments

Environment

• Worksite clean and tidy? - No trip hazards.

  Yes

  No

  N/A

• Comments

• Permits/consents of work not in place. e.g. working at heights, excavating/drilling, confined space work.

• Traffic management plan not in place.

• Breech of SOP (not following procedure )

• Unsafe behaviour where potential to injure a person

• Comments