Title Page
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Work Activity
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Workplace/Location
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Conducted on
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Verifier (Name) and Signature
Verification Criteria
1. Worker Compliant:
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a) Is any person who is required to carry out any electrical work (whether de-energised or live) an authorised licensed or registered electrician?
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b) Is the licence appropriate for the type of work being done e.g. HV live assets?
2. Authorised Live Work:
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a) Has any live work on any electrical equipment and/or installation been authorised by the asset owner?
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b) Is any live work undertaken in accordance with an approved plan?
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c) Are the correct insulated tools and equipment being used (gloves, barriers, mats rated for the voltage)?
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d) Are trained safety observers in place for any live electrical work?
1. Isolate and Verify:
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a) Apart from authorised live electrical work, has the electrical equipment being worked on been isolated, locked-out and tagged?
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b) Have isolation been verified by an authorised, licenced person (to prevent unexpected contact with energised parts by anyone)?
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c) Have any redundant power lines or equipment been verified as dead and safe?
4. Electrical Equipment Compliant:
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a) Has electrical equipment on the worksite been visually checked to ensure it is fit-for-purpose and: <br>• Tested and tagged<br>• Undamaged<br>• Secure or locked where appropriate <br>• and correctly labelled. <br>
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b) Are all relevant isolators and reset switches easily and safely accessible?
5. Overhead and Underground Electrical Services:
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a) Have all service locations been confirmed prior to commencing any work in proximity to electrical overhead or underground services?
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b) Have all electrical services been confirmed as either live or dead?
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c) Have safe work clearances/restrictions been confirmed and implemented in accordance with the known voltage?
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d) Have service locations been communicated before work commences to prevent contact by plant and/or people with the live electrical services?
6. Earthing:
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a) Is all electrical equipment earthed in accordance with manufacturer’s instructions?
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b) Has a risk of induced voltage been determined for the worksite and, if so,have earthing requirements been determined by a specialist and strictly implemented?
7. Minimum approach distances:
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a) Is all work near electrical assets being conducted in accordance with regulated minimum safe approach distances?
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b) Has arc flash/explosion risk from electrical installations been assessed and controlled by trained electricians/electrical technicians?
Critical Control Effectiveness
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Indicate the overall level of effectiveness of the Critical Control