CONTRACTOR JOB SAFETY INSPECTION REPORT

• Project name/number

• Lead Contractor

• Conducted on

  Date

• Inspection by

• Location
  Address

• Personnel

DOCUMENTATION

• Safe Work Statement/Risk Assessment/Job Safety Analysis completed?<br>

  Yes

  No

  N/A

• Is a copy available to see at the work site?

  Off

  On

• Has the document been signed by a Callaghan Innovation representative and by all workers involved?

  Off

  On

• Any permits required have been filled out & authorised correctly

  Yes

  No

  N/A

• Workers have been made aware of local hazards?

  Yes

  No

  N/A

• Communication - have local WAMs and other affected people been informed of the work?

  Yes

  No

  N/A

• Has a tool box safety talk taken place?

  Yes

  No

  N/A

• If work site is to be left unattended are emergency contact numbers displayed?

  Yes

  No

  N/A

• Action required:

HOUSEKEEPING

• Work areas neat?

  Yes

  No

  N/A

• Projecting nails or screws bent over or removed?

  Yes

  No

  N/A

• Waste containers provided and used?

  Yes

  No

  N/A

• Passageways and walkways clear?

  Yes

  No

  N/A

• Cords and leads off the floor?

  Yes

  No

  N/A

• Action required: Action by:

EMERGENCY PREPARATION

• Are there any specific emergency plans?

  Yes

  No

  N/A

• Comments:

• Workers aware of nearest assembly point?

  Yes

  No

  N/A

• First Aid Kit available?

  Yes

  No

  N/A

• Trained First Aider available?

  Yes

  No

  N/A

• Adequate fire extinguishers provided?

  Yes

  No

  N/A

• Fire Extinguishers accessible?

  Yes

  No

  N/A

• Fire Extinguishers inspected?

  Yes

  No

  N/A

• Action required:

LIGHTING AND VENTILATION

• Illumination sufficient for work being performed?

  Yes

  No

  N/A

• All temporary lighting originated from a separate branch circuit?

  Yes

  No

  N/A

• Temporary Lighting installed at appropriate height?

  Yes

  No

  N/A

• Ventilation sufficient for all jobs to be performed?

  Yes

  No

  N/A

MATERIAL HANDLING

• Materials properly stored or stacked?

  Yes

  No

  N/A

• Employees using proper lifting techniques?

  Yes

  No

  N/A

• Appropriate mechanical lifting aids available and used?

  Yes

  No

  N/A

• Proper number of workers for each operation?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Hard hats being worn?

  Yes

  No

  N/A

• Safety glasses being worn?

  Yes

  No

  N/A

• Gloves properly chosen for work performed?

  Yes

  No

  N/A

• Respirators used when required? Proper respirator documentation available?

  Yes

  No

  N/A

• Hearing protection being worn when required?

  Yes

  No

  N/A

• Traffic vests or high visibility clothing material being worn?

  Yes

  No

  N/A

SPECIFIC HAZARDS - Select all that apply

• Electrical

  Off

  On

• Work is being done by an appropriately qualified electrician.

  Yes

  No

  N/A

• Labels are being added as appropriate and electrical drawings updated?

  Yes

  No

  N/A

• Terminal boxes equipped with required covers and grounded as appropriate?

  Yes

  No

  N/A

• Lock out system in use as appropriate?

  Yes

  No

  N/A

• Hand, power & power actuated tools

  Off

  On

• All tools are in good repair and inspected regularly?

  Yes

  No

  N/A

• Power actuated tools are isolated or fitted with RCDs?

  Yes

  No

  N/A

• Guards in place on machines?

  Yes

  No

  N/A

• Correct tool being used for job at hand?

  Yes

  No

  N/A

• Personnel adequately trained in the use of their tools?

  Yes

  No

  N/A

• Power cords in good condition?

  Yes

  No

  N/A

• Operators of powder actuated tools (e.g. Ramset nail guns) are licensed?

  Yes

  No

  N/A

• Ladders

  Off

  On

• Serviceable?

  Yes

  No

  N/A

• Proper Use?

  Yes

  No

  N/A

• Not standing on two top steps

  Yes

  No

  N/A

• Proper height for the task

  Yes

  No

  N/A

• Stepladders in fully opened and locked position

  Yes

  No

  N/A

• Straight ladders used for access extend three feet above landing

  Yes

  No

  N/A

• Proper Ratio (4:1)

  Yes

  No

  N/A

• Three points of contact when ascending / descending

  Yes

  No

  N/A

• Ladders are secured to prevent slipping, sliding or falling?

  Yes

  No

  N/A

• Ladders with split or missing rungs taken out of service?

  Yes

  No

  N/A

• Scaffolding

  Off

  On

• All scaffolding inspected daily?

  Yes

  No

  N/A

• Erected on sound rigid footing?

  Yes

  No

  N/A

• Tied to structure as required?

  Yes

  No

  N/A

• Guardrails, intermediate rails, toe boards and screens in place?

  Safe

  At Risk

  N/A

• Planking is sound and sturdy?

  Yes

  No

  N/A

• Proper access provided?

  Safe

  At Risk

  N/A

• Employees below protected from falling objects?

  Safe

  At Risk

  N/A

• Working at height

  Off

  On

• Working at height permit completed

  Yes

  No

  N/A

• If over 5m WorkSafe have been notified

  Yes

  No

  N/A

• Safe method of access and egress

  Safe

  At Risk

  N/A

• Bracings, jacks and struts are in place to prevent accidental displacement?

  Yes

  No

  N/A

• Adequate method of fall protection

  Yes

  No

  N/A

• Method:

• Yes

  No

  N/A

• Employees below protected from falling objects?

  Yes

  No

  N/A

• Trenches, excavation & shoring deeper than 1.5m

  Off

  On

• Underground services have been identified and located

  Yes

  No

  N/A

• Protection is in place to prevent the excavation walls from collapsing.

  Yes

  No

  N/A

• Materials, equipment and spoil are stored away from the excavation

  Yes

  No

  N/A

• Warnings and barricades are in place.

  Yes

  No

  N/A

• The excavation is inspected daily.

  Yes

  No

  N/A

• Personal will be entering the excavation?

  Off

  On

• A confined space permit has been completed

  Yes

  No

  N/A

• Gas tests are made before entering to ensure a breathable atmosphere

  Yes

  No

  N/A

• There is emergency rescue equipment available and a standby person on duty.

  Yes

  No

  N/A

• Sufficient ladders or other forms of egress are available.

  Yes

  No

  N/A

• Hot work

  Off

  On

• Hot work permit completed

  Yes

  No

  N/A

• Fire spotter/observer in place

  Yes

  No

  N/A

• Fire extinguishers readily available?

  Yes

  No

  N/A

• Gas cylinders stored upright?

  Yes

  No

  N/A

• Proper separating distances between fuels & oxygen?

  Yes

  No

  N/A

• Goggles or shields used?

  Yes

  No

  N/A

• Hoses in good condition?

  Yes

  No

  N/A

• Mechanical lifting / cranes

  Off

  On

• Approximate weight known?

  Yes

  No

  N/A

• Load secure and balanced?

  Yes

  No

  N/A

• Lifting equipment appropriate and in good repair / certified?

  Yes

  No

  N/A

• Chains and slings inspected and tagged as required?

  Yes

  No

  N/A

• Operator is competent/trained/licenced?

  Yes

  No

  N/A

• There is a competent spotter and agreed hand signals/communication with the lift operator?

  Yes

  No

  N/A

• Cranes - ground is stable, outriggers extended and swing radius barricade in place?

  Yes

  No

  N/A

• Employees kept from under suspended loads, and people around only those necessary?

  Yes

  No

  N/A

• Concrete work

  Off

  On

• Employees are protected from cement dust?

  Yes

  No

  N/A

• Exposed skin covered?

  Yes

  No

  N/A

• Area barricaded and signed

  Yes

  No

  N/A

• Traffic management

  Off

  On

• Local staff have been warned prior to event

  Yes

  No

  N/A

• Appropriate cones and warning signs are in place?

  Yes

  No

  N/A

RECOMMENDATIONS

• List any additional recommendations or corrections

SIGNATURES

• Callaghan Innovation representative

  Sign

• Contractor representative

  Sign