Customer Site Safety Audit

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 - Operator Specific Tasks

• 1.1 - Operators WP ticket and relevant licenses sighted?

  Yes

  Partial

  No

  N/A

• 1.2 - Travel Tower operator wearing appropriate uniform & PPE?

  Yes

  Partial

  No

  N/A

• 1.3 - Does the customer posses the appropriate P.P.E?

  Yes

  Partial

  No

  N/A

• 1.4 - Is the customer operating the tower?

  Yes

  Partial

  No

  N/A

• 1.5 - If the customer is operating the Tower, has the FT Operator sited the<br>Customer's EWP ticket and confirmed that they are competent to operate<br>the Tower?

  Yes

  Partial

  No

  N/A

2.0 - Safety Systems

• 2.1 - Customer has been briefed regarding Full Body Safety Harness Requirements?

  Yes

  Partial

  No

  N/A

• 2.2 - Has the Force Towers operator been briefed on site specific safety by the customer?

  Yes

  Partial

  No

  N/A

• 2.3 - Customer shown Emergency Decent Device and EDD procedure fully explained?

  Yes

  Partial

  No

  N/A

3.0 - Site specific items

• 3.1 - Pre-Start checklist completed, Signed & Sighted.

  Yes

  Partial

  No

  N/A

• 3.2 - Operator completed Delivery Docket as required to satisfy OH&S tasks?

  Yes

  Partial

  No

  N/A

• 3.3 - Site Specific Risk Assessment completed?

  Yes

  Partial

  No

  N/A

• 3.4 - Customer shown SWMS prior to job starting?

  Yes

  Partial

  No

  N/A

• 3.5 - If undertaking tree work, has the Operator read and retained<br>a copy of the Safe Work Method Statement for Tree Work?

  Yes

  Partial

  No

  N/A

• 3.6 - Are there copies of the latest 90 Day / Annual / Electrical test inspection in the truck?

  Yes

  Partial

  No

  N/A

4.0 Setup Specific Items

• 4.1 - Travel Tower setup in safest location?

  Yes

  Partial

  No

  N/A

• 4.2 - Travel Tower Stabilizers setup correctly and timbers positioned correctly?

  Yes

  Partial

  No

  N/A

• 4.3.1 - Is the Travel Tower setup near power lines?

  Yes

  No

  N/A

• 4.3.2 - If "At Risk" Is the tower within safe working distance?

  Yes

  Partial

  No

  N/A

• 4.3.3 - Does this setup / site require an approved electrical spotter? (I.e M31A)

  Yes

  Partial

  No

  N/A

• 4.3.4 - Has one been supplied?

  Yes

  Partial

  No

  N/A

• 4.4.1 - Is there an "electro-magnetic" exposure risk present?

  Safe

  At Risk

  N/A

• 4.4.2 - If so, Has the operator taken measures to reduce exposure?

  Yes

  Partial

  No

  N/A

• 4.5 - Has appropriate signage been put out as required?

  Yes

  Partial

  No

  N/A

• 4.6 - Has a work zone been cordoned off?

  Yes

  Partial

  No

  N/A

5.0 - Emergency Specific Items

• 5.1 - Has a First Aider been identified on site between operator and customer?

  Yes

  Partial

  No

  N/A

• 5.2 - First Aid Kit Available?

  Yes

  Partial

  No

  N/A

• 5.3 - Spill Kit Available?

  Yes

  Partial

  No

  N/A

• 5.4 - Fire Extinguisher available?

  Yes

  Partial

  No

  N/A

• 5.5 - What is the action of the operator in the event of an emergency?

  Select Notify Management Apply First Aid if Necessary Fill out Incident report form All of the Above

  • Notify Management
  • Apply First Aid if Necessary
  • Fill out Incident report form
  • All of the Above

Sign Off

• Force Towers Operator Signature

  Sign

• Customer Signature

  Sign

• Auditor's signature

  Sign

• This audit is now to be sent via PDF to: Craig English - cenglish@forcetowers.com.au Your local branch CSO for filing in P:/ Drive. Customer Site Controller email whom the site was just visited.