Title Page

  • Site Address
  • ROW, SDU, MDU or Other

  • What type of work was completed?

  • Prepared by

  • Conducted on

  • Pass or Fail

  • Lead Tech

  • Assistant Tech

  • Type of Audit

  • Were you (the auditor) inducted properly before entering the site in the following information?<br>1. Tasks to be performed, the risks associated & the controls in place.<br>2. Checked your PPE if complete<br>3. First aiders on site, first aid kit and fire extinguisher location (rego if in vehicle).<br>4. Exact location of evacuation point, nearest emergency center address.

  • Provide details of the coaching onsite and/or additional training required.

  • Do you believe the crew can perform their tasks for this job and have all appropriate training.

  • Provide details of the coaching onsite and/or additional training required.

  • Has the site management and setup been observed to be... <br>Consider the following: <br>1. Work Isolation <br>2. Traffic and pedestrian management <br>3. Safe and efficient site layout

  • Provide Details of the risk, coaching on site and additional training required.

  • Provide Details of the risk, coaching on site and additional training required.

  • Stop works and ensure site is made safe! Provide Details of the risk, coaching on site and additional training required.

  • Have the crew reviewed/signed the JSA, relating to their work, and are the appropriate risk control methods being put in place?

  • Provide details of the coaching onsite and additional training required.

  • Has the Site Risk Assessment document (Site Plan) been correctly completed relative to the specific job?

  • Provide details of the coaching onsite and additional training required.

  • Is the crew compliant with current Health, Safety & Environmental procedures & policies?

  • Provide details of the coaching onsite and additional training required.

  • Is all required PPE available, in good condition and being used correctly.

  • Provide details of the coaching onsite and additional training required.

  • Do the crew have all the tools and equipment they need to perform their task safely.

  • Provide details of the coaching onsite and additional training required.

  • Observe the vehicles on site for the following: 1. Safe to operate including WOF/COF and Rego 2. Presentable and Tidy 3. Equipment is secure and secured properly 4. Parked appropriate and safely

  • Provide details of the coaching onsite and additional training required.

  • Have you observed exceptional behavior that warrants recognition? (Please note the behavior)

Are there any High Risk activities taking place onsite?

  • Concrete Saw Cutting.

  • Is Concrete Cutting activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Terrasaw Cutting

  • Is Terrasaw Cutting activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Mechanical Trenching

  • Is Mechanical Trenching activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Digger Operation

  • Is Digger Operation activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Working in the vicinity of services while trenching Manually or Mechanically

  • Is the Working in the vicinity of services while trenching activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Location of Services (Cat/Genny)

  • Is the Location of Services (Cat/Genny) activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Use of Compactor

  • Is Compacting activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Use of Drill

  • Is Drilling activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Fibre Blowing and/or use of compressor

  • Is Fibre Blowing and/or use of compressor activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Working at height

  • Is Working at height activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Working with suspected Asbestos

  • Is Working with suspected Asbestos activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Working in a confined/restricted space

  • Is Working in a confined/restricted space activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Working in High Traffic areas

  • Is Working in High Traffic areas activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Working on a sloping site

  • Is Working on a sloping site activity:

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Any other potentially high risk activities

  • Activity
  • What is the activity?

  • Is the Activity

  • Provide details of the coaching onsite and additional training and/or remedial action required.

  • Provide Photos of at risk or significant at risk activity.

  • Would you like to complete a live Quality Assessment?

Audit Type

  • What part of the work is the Audit completed for?

Inside Boundary Civil

  • Please select all methods completed

  • Soft Trench Depth to Standard?

  • Soft Surface Reinstatement to Standard? (Grass seed and Topsoil)

  • Is there evidence of Service Location?

  • Have the site been left in a clean and tidy manor?

  • Hard Trench Depth to Standard?

  • Hard Trench Cut Straight?

  • Hard Trench Temp Reinstatement?

  • Hard Trench Permanent Reinstatement Completed?

  • Hard Trench Permanent Reinstatement To Standard?

  • Is there evidence of Service Location?

  • Is the Slot Trench to Standard?

  • Is the Slot Trench Straight?

  • Slot Trench Depth to Standard?

  • Is the Slot Trench Reinstatement to Standard? (If not reinstated please Fail)

  • Has the Fenceline been installed to Standard?

  • Is Fenceline at correct height?

  • Correct spacing between P-Clips? (300mm)

  • Has stainless steel screws been used?

  • Is the transition completed to standard?

  • Have the use of conduit been approved?

  • Is the conduit on fence installed to Standard?

  • Correct spacing between saddles? (600mm)

  • Stainless Steel Saddles and Screws used?

  • All connections on ISB conduit properly connected?

  • Is the Thrust at correct depth? (450mm)

  • Is the reinstatement for entry and exit holes to Standard?

  • Is the Undermine completed to standard?

  • Is the Undermine at correct depth?

  • Is the Ped installed to standard

  • Have the Ped been labeled?

  • Are the drop offs' installed to standard?

Outside Boundary Civil

  • Please select all methods completed

  • Is there evidence of Service Location?

  • Hard Trench Depth to Standard?

  • Hard Trench Cut Straight?

  • Hard Trench Temp Reinstatement?

  • Hard Trench Permanent Reinstatement Completed?

  • Hard Trench Permanent Reinstatement To Standard?

  • Is the Marker Post/ Pave-stone left to Standard?

  • Is there evidence of Service Location?

  • Soft Trench Depth to Standard?

  • Soft Surface Reinstatement to Standard? (Grass seed and Topsoil)

  • Is the Marker Post/ Pave-stone left to Standard?

  • Has the Fenceline been installed to Standard?

  • Is the transition completed to standard?

  • Is the Marker Post left to Standard?

  • Is the Undermine completed to standard?

  • Is the Undermine at correct depth?

  • Have the use of conduit been approved?

  • Is the conduit on retaining wall installed to Standard?

  • Correct spacing between saddles? (600mm)

  • Stainless Steel Saddles and Screws used?

  • All connections OSB conduit properly connected?

Reinstatement

  • Has the permanent Reinstatement been completed to Standard?

  • Has council Standards been adhered to?

  • All cones removed from site

  • Is the marker post/ pave-stone been left to standard?

Fibre Blowing

  • Have fibre blowing standards been followed?

  • Is the slack managed and sufficient?

  • Gas block installation?

  • ETP Installation and secure on house side?

External Building Cabling

  • Please select all methods completed

  • Is ETP Installation Completed to standard?

  • It the ETP secured appropriately

  • Is fibre Management as per standard?

  • Are all screws present and fitted?

  • Have all penetrations into property been completed to standards?

  • Have the site been left in a clean and tidy manor?

  • Is the conduit on building installed to standard?

  • Correct spacing for saddles used on building? (600mm)

  • Stainless Steel Saddles and Screws used?

  • All connections on External conduit properly connected?

  • Have all penetrations into property been completed to standards?

  • Is the External Exposed Cable installed to standard?

  • Has the exposed cable P-clip spacing been adhered to?

  • Has stainless steel screws been used?

  • Have all penetrations into property been completed to standards?

Internal Building Cabling

  • Please select all methods completed

  • Has the installation Standards been adhered to?

  • s the cable covered according to standard?

  • Has the penetration been sealed appropriately?

  • Is the capping installed to standard?

  • Is the capping secured securely?

  • Are all bends/corners and ends capped with covers?

  • Is the capping cover securely fitted?

  • Is the capping clean and tidy?

  • Has the penetration been sealed appropriately?

  • Is the cable run in the underfloor per standard?

  • Is the cable securely fastened and not hanging on the floor?

  • Is securing clips installed max 600mm apart?

  • Has the penetration been sealed appropriately?

  • Is the cable run in the ceiling per standard?

  • Is the cable securely fastened and not hanging loose?

  • Is securing clips installed max 600mm apart?

  • Has the penetration been sealed appropriately?

  • Has the internal conduit run been approved?

  • Is the internal conduit installed to standard?

  • Correct spacing of the saddles on internal conduit? (600mm)

  • All connections on Internal conduit properly connected?

  • Has the penetration been sealed appropriately?

Fibre Splicing and Management

  • Please select all methods completed

  • Is cable routing standard in Ericsson cabinet followed?

  • Is the splice to standard with pigtail in Ericsson cabinet?

  • s the management of the fibre in the tray in the Ericsson cabinet to standard?

  • Is All areas clear of fibre waste?

  • Is cable routing standard in Shape cabinet followed?

  • Is the splice to standard in Shape cabinet?

  • Is the correct tray used in Shape cabinet?

  • Is the management of the fibre in the tray in the Shape cabinet to standard?

  • Is All areas clear of fibre waste?

  • Is the Ped lid secured?

  • Is the tube for the fibre installed in the correct position?

  • Is cable routing standard in Ped been followed?

  • Have the correct Tray been used in Ped?

  • Is the splicing standard in Ped adhered to?

  • Is the management of the fibre in the Ped tray to standard?

  • Is All areas clear of fibre waste?

  • Is the cable routing standard in CDP followed?

  • Is the fibre management standard for the CDP followed?

  • Is the splicing in CDP standard adhered to?

  • Is All areas clear of fibre waste?

  • Is the fibre management standard for the ETP followed?

  • Is the splicing in ETP standard adhered to?

  • Is a gas block installed?

  • Is All areas clear of fibre waste?

  • Is the fibre management standard for the ITP followed?

  • Is the splicing in ITP standard adhered to?

  • Is connector installed in the ITP to standard?

  • Is All areas clear of fibre waste?

  • Is the fibre management standard for the back plate followed?

  • Is the splicing in back plate standard adhered to?

  • Is All areas clear of fibre waste?

Fibre Splicing and Management

  • Is the Customer or End user present?

  • Is the ONT installed to standard?

  • Is the Connection standing up and working correctly?

  • Did the tech complete all the correct documentation?

  • All photos uploaded to simPRO?

  • Is the phone integration completed as per standard?

  • Have the site been left in a clean and tidy manner?

  • In General the site Health and Safety, and actions/behaviors were

  • What part of the work is the Audit completed for?

  • Please select all methods completed

  • Reason for site visit?

  • What work is being completed on site?

  • Reason for Support?

  • Scope improvement required?

  • Please explain in details support provided and solution.

  • Was Training Required?

Technical Training Record

  • What type of training was conducted?

  • What Health and Safety Training Was Provided

  • Please select Compliance Training Provided?

  • Please Select Standards Training was completed on:

  • Site setup and compliance to TMP and CopTTM standards.

  • Tick the following

  • Oil and dipstick

  • Water and Radiator condition

  • Tyre Pressure including Spare Tyre

  • Visibility (e.g. Windscreen/Mirrors)

  • Compliance (WOF/Rego/RUC/COF)

  • Brakes/ Handbrake

  • Lights (Front/Rear/Indicators/Number Plate)

  • Trailer Maintance

  • Technical training completed

  • Please list Other?

  • List Plant/Equipment trained on:

  • What Systems training was done on:

Technical Training Record

  • What type of training was conducted?

  • What Health and Safety Training Was Provided

  • Please select Compliance Training Provided?

  • Please Select Standards Training was completed on:

  • Site setup and compliance to TMP and CopTTM standards.

  • Tick the following

  • Oil and dipstick

  • Water and Radiator condition

  • Tyre Pressure including Spare Tyre

  • Visibility (e.g. Windscreen/Mirrors)

  • Compliance (WOF/Rego/RUC/COF)

  • Brakes/ Handbrake

  • Lights (Front/Rear/Indicators/Number Plate)

  • Trailer Maintance

  • Technical training completed

  • Please list Other?

  • List Plant/Equipment trained on:

  • What Systems training was done on:

  • Please provide brief description of the training

  • Please select competency after training

  • Personnel
  • Personnel

  • Audited By:

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