CWW - CAPITAL WORKS SITE INSPECTION (SUMMARY)

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Date and Time of Inspection

  Date

Contract Information

• Contractor

• Location

  Select Road Nature Strip Reserve Park Private Property Greenfields Other

  • Road
  • Nature Strip
  • Reserve
  • Park
  • Private Property
  • Greenfields
  • Other

• Asset

  Water

  Sewer

  Recycled

  Storm Water

• Type

  Retic

  Distribution

  Pumping Station

  Treatment

  Other

• Current Site Activities

• Weather

  Dry

  Damp

  Wet

  Rain

  Other

• Visibility

  Day

  Night

• Ground Type

  Select Clay Greasy Back Mixed Rock Sand Fill Contaminated Other

  • Clay
  • Greasy Back
  • Mixed
  • Rock
  • Sand
  • Fill
  • Contaminated
  • Other

OH&S

• Personal Protective Equipment is worn and appropriate for works?

  Yes

  No

  N/A

• General work site notification in place (signage)?

  Yes

  No

  N/A

• Areas free of slip and trip hazards?

  Yes

  No

  N/A

• Site exclusions (zones/barricades) in place and being followed?

  Yes

  No

  N/A

• Site is maintained appropriately (clean, neat and tidy)?

  Yes

  No

  N/A

• Stockpiles are appropriately maintained?

  Yes

  No

  N/A

• Materials stored safely and secured?

  Yes

  No

  N/A

• Excavation, penetrations and openings covered where required?

  Yes

  No

  N/A

• Excavations - Ground support in place, clear access and secure?

  Yes

  No

  N/A

• Excavations - Exclusion zones/barricades in place and being followed?

  Yes

  No

  N/A

• Excavations - Fall protection, handrails, platforms, guarding in place?

  Yes

  No

  N/A

• Underground services located, marked and appropriately protected?

  Yes

  No

  N/A

• Traffic management in place and appropriately managed?

  Yes

  No

  N/A

• Plant and Equipment in use is fit for purpose, operational and used appropriately?

  Yes

  No

  N/A

• Confined Space Entry procedures being followed?

  Yes

  No

  N/A

• Temp services in place and in good working order?

  Yes

  No

  N/A

Environmental

• Exclusion zones in place and being followed - Enviro?

  Yes

  No

  N/A

• Exclusion zones in place and being followed - Cultural?

  Yes

  No

  N/A

• Exclusion zones in place and being followed - Flora and Fauna?

  Yes

  No

  N/A

• Silt fencing and run-off areas appropriately treated?

  Yes

  No

  N/A

• Management controls in place for Flora and Fauna where in the vicinity of the works?

  Yes

  No

  N/A

• Management controls in place for handling Hazardous Materials (Asbestos Handling)?

  Yes

  No

  N/A

• Management controls in place for storage and handling of Hazardous Goods and Substances?

  Yes

  No

  N/A

Sign Off

• Comments

• Has the contractor been made aware of any issues or observations arising from this inspection?

  Yes

  No

  N/A

• Signed

  Sign