Title Page
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Audit Title (Task Description)
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Project / Site
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Personnel / Work Group Completing Task
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Conducted on
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Prepared by
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Location
General
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Employees understands the task they have been given
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Work order document on person
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Correct PPE worn for the situation and in good condition
Critical Controls
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Electrocution
Electrocution
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For electrical work?
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Has the installation been tested to standard requirements?
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Are barriers in place for exposed live electrical conductors?
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Is test equipment and tools in good working order?
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Was the isolation and proving process followed (including test before touch)?
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Is insulating PPE is being worn for testing?
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Are permit conditions and work instructions being adhered to?
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Are controls in place for working in a lighting prone environment?
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Is the correct supervision in place for apprentices and contractors?
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Does the work team have the required qualifications?
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For electrical appliances?
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Have portable RCD devices been tested prior to use?
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Are portable appliances tagged and in good order?
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For arc welding?
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Are arc welding machines fitted with Voltage Reduction Devices?
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Is the return clamp adjacent to the activity?
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Is the welding PPE dry?
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Switchboard Explosion or Arc Flash
Switchboard Explosion or Arc Flash
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For Operator Switching?
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Is CAT4 PPE being worn?
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Is the correct remote racking device being used?
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Does the work team have the required qualifications?
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For Electrical work?
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Is PPE being worn in accordance with the Arc Flash Dossier?
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Is the correct isolation process being followed?
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Are mitigating controls in place (Maintenance mode used)?
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Are the correct testing for dead and earthing practices being followed?
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Does the work team have the required qualifications?
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Work at Heights & Dropped Objects
Work at Heights & Dropped Objects
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Are identified anchor points being used, equipment fitted correctly, tagged and compliant to site standard?
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Has a quality pre-start check been conducted on the elevating work platform?
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Dropped objects hazard is controlled; minimal risk of dropping objects below, or having objects dropped from other workgroups above.
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Is the barricade and drop protection erected as per design?
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Does the work group understand the no go zone?
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Does the work team have the required qualifications?
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Confined Space
Confined Space
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Is a positive isolation in place to cover the work scope and all energy sources included?
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Is there a safe atmosphere - Ventilation plan in place, current atmospheric test, no introduced hazards?
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Stored energy managed, hangups, dropped object potential etc
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Access points have hard barricading and signs, standby person to be used and conpetent
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Does the work team have the required qualifications?
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Lifting Operations
Lifting Operations
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Is the lift being executed as per lift study design?
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Is the crane in the designated location?
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Is the landing area identified being used?
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Has a pre-start check been conducted on the crane?
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Is the rigging gear tagged and rated, and has it been inspected prior to use?
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Does the work group understand the no go zone?
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Is the barricade erected as per design?
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Does the work team have the required qualifications?
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Isolation of Hazardous Energy
Isolation of Hazardous Energy
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Recipient has checked isolation points exist and are locked and check integrity
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Equipment ID tag hung on correct equipment
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Electricians are Isolation Officer trained if doing isolations
Task Photo
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Take a photo of the task or task area
Sign off
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Any other general remarks?
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Auditor full name and signature