CJH Worksite Observations V1.0

• Document Reference:

• Inspection conducted:

  Date

• Working Environment:

  Scheduled Closedown (i.e. Major Possession)

  Routine Maintenance

  Construction Work (Outside of Closedown)

• Closedown Job Number (if applicable)

• Activity being undertaken:

• Observations and Report generated by:

Site information

• Date:

  Date
• Location:
  Address

• Location/ Section:

• KM from:

• KM to:

• Type of work:

• Centrogen Site Supervisor:

• Protection Officer:

• PO Level:

• R.I.W. Card #:

Pre Start/ Pre Work Brief/ PO Brief

• Scope, date and location of works?

  Yes

  No

• Weather Conditions?

  Yes

  No

• Name and Signature of Responsible Person conducting the briefing?

  Yes

  No

• Location and Time of Briefing?

  Yes

  No

• Whether the Qualified Safe Worker has provided a briefing or not?

  Yes

  No

• First aider's Name and Location of First Aid kit/s?

  Yes

  No

• What form the Warning Alarm will be?

  Yes

  No

• Network Controllers Emergency Number?

  Yes

  No

• Asked whether free of effects of Drugs, Alcohol and Fatigue?

  Yes

  No

• Has the Pre Work Brief been Communicated clearly and easily understood?

  Yes

  No

• Comments (optional):

• Have relevant Worksite Hazards been identified?

  Yes

  No

• Comments (optional):

• Has the PO Brief included appropriate Hazards and Controls?

  Yes

  No

• Comments (optional):

• Has the PO Diary been completed with Safety critical information?

  Yes

  No

• Comments (optional):

• Type of Worksite Protection?

  Select LPA TWA TOA CSB LOW WIC

  • LPA
  • TWA
  • TOA
  • CSB
  • LOW
  • WIC

• Has TRAB been completed?

  Yes

  No

  N/A

• Is Worksite Protection deemed appropriate for task being performed?

  Yes

  No

• Comments (optional):

• If "NO" to above - Stop Work! Risk Assessment Required!

• Comments (optional):

Detonators (Safeworking Protection)

• Are Detonators stored correctly and within expiry date?

  Yes

  No

  N/A

• Comments (optional)

• Has the Detonator Register been filled out?

  Yes

  No

  N/A

Protection Officer - Worksite Protection Plan

• Has Worksite Protection Plan been completed correctly as per Worksite Protection Plan NO-WI-02-010?<br>* 5 Mandatory Safety Critical items needed:<br> - Reference to Capital City in top left hand corner<br><br> - An easily reached Safe Place<br><br> - Name of the track/s<br><br> - Worksite location defined whether in or not Danger Zone by KM or Crossover No. or Points No. or Signal No.<br><br> - The name of the stations either side of the worksite.

  Yes

  No

• If "NO", additional detail or clarification required:

• Do relevant Controls listed in Pre Work Brief appear on the Worksite Protection Plan?

  Yes

  No

  N/A

• If "NO", education required. Comments (optional):

• Does Protection Officer have access to Network Rules and Procedures?

  Yes

  No

• PO must have access to these Documents. Available via www.artc.com.au

• Photo of PO Brief:

  Media

• Photo of Worksite Protection Plan:

  Media

• Photo of PO Diary:

  Media

Workers Observations

• Have all site personnel completed a Worksite Induction?

  Yes

  No

• Have ALL relevant personnel signed the PO Brief?

  Yes

  No

• Number of Personnel:

• Have ALL relevant personnel signed the Pre Start?

  Yes

  No

• Number of Personnel:

• Does this number match the number of workers signed onto the PO Brief?

  Yes

  No

• If "NO", Non-Conformance and Action required.

• Comments (optional):

• Have Work Method Statements been signed by relevant personnel for tasks being undertaken?

  Yes

  No

• Comments:

• Can Workers demonstrate knowledge of Work Method Statements?

  Yes

  No

• Comments:

• Can Workers demonstrate knowledge of Worksite Protection Plan?<br>Network Control Emergency Phone Number etc.

  Yes

  No

• Comments:

• Can Worker name one or more Hazards on the PO Brief and the Controls?

  Yes

  No

• Comments:

• Do the Workers know who the First Aid Officer is?

  Yes

  No

• Comments:

• Is there a First Aid Kit on site?

  Yes

  No

• Location:

• Are all personnel on site wearing appropriate PPE as required for the task?

  Yes

  No

• Comments:

• Is lighting adequate for the activity/ works?

  Yes

  No

• Is perimeter of worksite secure/ gates locked?

  Yes

  No

  N/A

• Comments:

• Comments:

General Summary

• Are the following documents available on-site?

• Site Specific Safety Management Plan

  Yes

  No

  N/A

• Safe Work Method Statement/s relevant to task being performed.

  Yes

  No

• Construction Environmental Management Plan

  Yes

  No

  N/A

• Are there Hot Works being conducted on the Worksite?

  Yes

  No

• Is there a Hot Works Permit in place?

  Yes

  No

  N/A

Water/ Land Contamination

• Is it required on this site to include topics on environmental management and site environmental issues?

  Yes

  No

• Comments:

• Can workers demonstrate knowledge of environmental requirements and specific site sensitive areas?

  Yes

  No

  N/A

• Comments:

• Are regular environmental site inspections carried out and documented by the contractor?

  Yes

  No

  N/A

• Comments:

• Are all oils /fuels/ chemicals stored as documented in the CEMP (Construction Environmental Management Plan)

  Yes

  No

  N/A

• Are Spill Kits readily available and easily identified on-site including at work locations?

  Yes

  No

  N/A

• Comments:

• Are controls in place to ensure mud is not being tracked onto public roads or private property?

  Yes

  No

  N/A

• Comments:

• Are Construction Hours restricted to 7am to 6pm Monday to Friday and 8am to 1pm Saturday? As per EPL (Environmental Protection License 3142) where work is occurring outside these work hours, has approval been sought and residents notified?

  Yes

  No

• If different, please specify.

No Go Zones

• Have required no-go zones been established and demarcated?

• Heritage listed areas

  Yes

  No

  N/A

• Aboriginal and European protected areas

  Yes

  No

  N/A

• Endangered species

  Yes

  No

  N/A

• Flora and Fauna

  Yes

  No

  N/A

• Are they being adhered to?

  Yes

  No

  N/A

Additional Comments / Site Photos

• Comments

• Site Photo 1

  Media

• Site Photo 2

  Media

• Site Photo 3

  Media

• Site Photo 4

  Media