DFG HSE Audit

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Traffic Management

• Safety signage appropriate to job?

  Yes

  No

  N/A

• Safety signs correctly located?

  Yes

  No

  N/A

• Adequate cones used?

  Yes

  No

  N/A

• Is pedestrian safety ensured?

  Yes

  No

  N/A

• Is work site well protected?

  Yes

  No

  N/A

Personal Protective Equipment

• Approved hard hat worn?

  Yes

  No

  N/A

• Approved footwear worn?

  Yes

  No

  N/A

• Approved glasses worn?

  Yes

  No

  N/A

• Approved hearing protection worn?

  Yes

  No

  N/A

• Is UV protection being used? (hats, sunscreen, long sleeve/pants)

  Yes

  No

  N/A

Equipment Testing

• Prestart vehicle checks carried out?

  Yes

  No

  N/A

• Prestart plant checks carried out?

  Yes

  No

  N/A

• Equipment in test/tagged?

  Yes

  No

  N/A

• Vehicle condition (image)?

  Yes

  No

  N/A

• Vehicle/ plant within service date?

  Yes

  No

  N/A

Environmental

• Are environmental risks identified & controlled?

  Yes

  No

  N/A

• Are control measures being used to manage water runoff & collection?

  Yes

  No

  N/A

• Is spill kit available?

  Yes

  No

  N/A

First Aid

• Is the container intact?

  Yes

  No

  N/A

• Is the kits location marked and known to the crew?

  Yes

  No

  N/A

Work Practices

• Is the pipe and fitting installed to required standards?

  Yes

  No

  N/A

• Has excavation been battered/shored/shields used? Access restricted?

  Yes

  No

  N/A

• Is machine access restricted?

  Yes

  No

  N/A

• Are trenches correctly backfilled and compacted? (clean spoil/crushed rock/wacker used)

  Yes

  No

  N/A

• Does broken concrete/bitumen have clean saw cut edges?

  Yes

  No

  N/A

• Does broken concrete/bitumen have a temporary repair?

  Yes

  No

  N/A

• Are Asbestos materials handled and disposed of in accordance with Legislative requirements ?

  Yes

  No

  N/A

• Is the worksite tidy with no trip or slip hazard?

  Yes

  No

  N/A

• Are hoses, pipes etc guarded?

  Yes

  No

  N/A

• Fire equipment in date & available?

  Yes

  No

  N/A

Work Planning

• Has SWMS been completed and signed by all on site?

  Yes

  No

  N/A

• Is the detail contained in the SWMS adequate?

  Yes

  No

  N/A

• Does the SWMS reference the Generic Risk Assessments?

  Yes

  No

  N/A

• Are all employees aware of The identified Hazards and Controls

  Yes

  No

  N/A

• Is a job sheet on site?

  Yes

  No

  N/A

• Is DBYD Dial Before You Dig documentation on site?

  Yes

  No

  N/A

OVERALL RATING

• POSITIVE OBSERVATIONS!!

  Yes

  No

  N/A

Corrective action to be undertaken and by Who and by When

• CORRECTIVE ACTIONS!

  Yes

  No

  N/A

• Add a drawing to assist clarification of an area of concern where appropriate

  Drawing

• Person in control of the Workplace.

  Sign

• Person conduction the Audit

  Sign

NOTE* This form is an IPad version of TSWT-037090-MTP-FO-016