DHA Civil/Development site inspection -

• CWB Number and audit title

• Site and Contractor details

• Conducted on

  Date

• Conducted by

• Location
  Address

• Personnel

1. ADMINISTRATION

• 1.1 Is there an induction process ?

  Yes

  No

  N/A

• 1.2 Check 2 induction forms against the site register, do they match up ?

  Yes

  No

  N/A

• 1.3 Emergency assembly point identified?

  Yes

  No

  N/A

• 1.4 Were you asked to sign the visitor register ?

  Yes

  No

  N/A

• 1.5.2 Are site inductions carried out as per SMP ?

  Yes

  No

  N/A

• 1.5.3 Is training and licensing maintained as per plan ?

  Yes

  No

  N/A

• 1.5.4 Are SWMS available for all high risk work ?<br>

  Yes

  No

  N/A

• 1.5.5 Is there an incident notification process in accordance with the SMP ?

  Yes

  No

  N/A

• 1.5.6 Are site safety walks and the like carried out in accordance with the SMP ?

  Yes

  No

  N/A

• 1.5.7 Is the emergency response plan posted and displayed for the site ?

  Yes

  No

  N/A

• 1.5.8 Is evacuation procedure posted on site ?

  Yes

  No

  N/A

• 1.5.9 Is there first aid on site with qualified 1st aid personnel ?

  Yes

  No

  N/A

• 1.5.10 Is the plant and equipment register populated and accurate ?

  Yes

  No

  N/A

• 1.5.11 Is there a hazardous chemicals register and safety data sheets on site ?

  Yes

  No

  N/A

• 1.5 .12 Is there a daily sign on sheet and evidence of use ?

  Yes

  No

  N/A

First aid

• 1.6.2 Open the first aid kit and check for verification. Has it been certified in the last 12 months

  Yes

  No

  N/A

• 1.6.3 Is there a 1st aid room? Should be a facility for this if 100 workers or more.

  Yes

  No

  N/A

• 1.6.4 How is 1st aid managed ? Principal contractor is responsible for 1st aid provisions or ensuring the sub-contractors provide qualified 1st aiders.

  Safe

  At Risk

  N/A

• 1.6.1 Is the first aid shed /office clearly identified as such with the correct signage?. (White cross on green background)

  Yes

  No

  N/A

2. Hazard identification and communication

• 2.1 Is there evidence of a hazard notice board displaying main hazards on site?

  Yes

  No

  N/A

• 2.2 Is there evidence of a pre start conducted and signed.

  Yes

  No

  N/A

• 2.3 Is there evidence of site communication and consultation ?

  Yes

  No

  N/A

3. Traffic management and pedestrian safety

• 3.1 Is safe access clearly defined access for plan and equipment?

  Yes

  No

  N/A

• 3.2 Is a copy of the traffic management plan maintained on site?

  Yes

  No

  N/A

• 3.3 Is traffic management set-up is correct and according to the approved TTMP?

  Yes

  No

  N/A

• 3.4 Is safe pedestrian access maintained on site I.e ramps, signage is correct, no trip hazards, trenches are cordoned off properly

  Yes

  No

  N/A

• 3.5 Are manholes and pits are made safe?

  Yes

  No

  N/A

• 3.6 Are cones and barriers in good condition?

  Yes

  No

  N/A

• 3.7 Are cones and barriers set up correctly? I.e. not A frames or laying down.

  Yes

  No

  N/A

4. Personal Protective Equipment

• 4.1 Safety glasses being worn on site correctly?

  Yes

  No

  N/A

• 4.2 Safety footwear being worn on site properly and in good condition? No exposed steels, unlaced, or loosely fitted etc

  Yes

  No

  N/A

• 4.3 Hi-visibility garments are in good condition and worn zipped up correctly?

  Yes

  No

  N/A

• 4.4 Appropriate hearing protection worn as required?

  Yes

  No

  N/A

• 4.5 All PPE in good condition and fit for purpose in accordance with the site rules ?

  Yes

  No

  N/A

5.0 Environmental controls and systems

• 5.1 Is dust and noise minimised or eliminated?

  Yes

  No

  N/A

• 5.2 Are sediment controls are in place. I.e 50 metres down run minimum of any excavation site or stockpiles

  Yes

  No

  N/A

• 5.3 Any hazardous substances stored on site ? I.e containers of ezimud, bentonite, ezimud gold, isopropyl alcohol, medley e, petrol, and diesel in fuel containers etc...

  Yes

  No

  N/A

• 5.3.1 Are chemicals stored in a separate, clearly defined area on site?

  Yes

  No

  N/A

• 5.4 There backfill stored close to environmentally sensitive areas I.e. drains streams, and or dumps leading to storm water pits etc....?

  Yes

  No

  N/A

6.0 Mobile Plant and equipment

• 6.1 Is powered plant and equipment in use?

  Yes

  No

  N/A

• 6.1.1 Has the operator completed the daily pre start on the plant.

  Yes

  No

  N/A

• 6.1.2 Are operators carrying there license or ticket to operate the plant ?

  Yes

  No

  N/A

• 6.1.3 Does the machine have a in service fire extinguisher ?

  Yes

  No

  N/A

• 6.1.4 Does the plant have ROPS ( roll over protection system )?

  Yes

  No

  N/A

• 6.1.5 Does the plant appear to be well maintained with no oil leaks ?

  Yes

  No

  N/A

• 6.2 Safe reversing procedures are being adhered to? (Spotters where necessary)

  Yes

  No

  N/A

• 6.3 Potential entrapment and pinch points are safe guarded?

  Yes

  No

  N/A

• 6.4 Are provisions in place to prevent persons working under the mobile plant or equipment?

  Yes

  No

  N/A

7.0 Underground services and safe practices

• 7.1 Are any excavations happening on site ?

  Yes

  No

  N/A

• 7.2 Is permit to excavate has been issued correctly for all, ground excavation activities?

  Yes

  No

  N/A

• 7.3 Permit is current for the location?

  Yes

  No

  N/A

• 7.4 All relevant services are marked and located on the permit according to SMP ?

  Yes

  No

  N/A

• 7.5 Has the potholing method been used to identify essential services before excavation?

  Yes

  No

  N/A

• 7.6 Are techniques approved on the permit being used?

  Yes

  No

  N/A

8.0 Overhead services

• 8.1 Are excavations occurring close to overhead services ?

  Yes

  No

  N/A

• 8.2 Is a competent spotter in use ?

  Yes

  No

  N/A

9.0 General Excavations

• 9.1 Are deep excavations greater that 1.5m occurring ?

  Yes

  No

  N/A

• 9.1.1 Is work happening in or near to excavations?

  Yes

  No

  N/A

• 9.1.2 Are sides protected by benching, battering or shoring?

  Yes

  No

  N/A

• 9.1.3 If workers are in trench, is there safe access into excavation by way of ladder or similar?

  Yes

  No

  N/A

10.0 Unexpected finds, ACM's or other.

• 10.1 Is there any Asbestos Containing Material on site or previously found?

  Yes

  No

  N/A

• 10.1.1 Have measures been undertakes to isolate and make the area safe from workers and public?

  Yes

  No

  N/A

• 10.2 Are there any soil contaminates that need to be controlled ?

  No

  Yes

• 10.2.1 Record any actions below to control contaminates.

  Safe

  At Risk

  N/A

11.0 Hazardous manual tasks

• 11.1 Is the any repetitive or heavy lifting, pushing or pulling happening ?

  Yes

  No

  N/A

• 11.1.1Can the task be eliminated by using a machine ?

  Yes

  No

  N/A

• 11.1.2 Are regular breaks given or team lifting engaged to alleviate the stress of manual handling ?

  Yes

  No

  N/A

12.0 Electrical

• 12.1 Is power connected to work sheds and is its protected with RCD's?

  Yes

  No

  N/A

• Are any leads running from shed power points to power external appliances or tools ?

  No

  Yes

• 12.2 Are there any temp power boards in use on site ?

  Yes

  No

  N/A

• 12.2.1 Do they have a current test tag and meet AS/NZS 3012 ?

  Yes

  No

  N/A

• 12.2.2 Are all electrical leads ad tools tagged and in good condition as per AS/NZS 3012 ?<br>

  Yes

  No

  N/A

• 12.3 Are generators in use ?

  Yes

  No

  N/A

• Do they have RCD protection on each power outlet ?

  Yes

  No

  N/A

13.0 Safety Behaviour

• 13.1 Is housekeeping of a high standard

  Yes

  No

  N/A

• 13.2 Are workers wearing PPE and is it in good condition ?

  Yes

  No

  N/A

• 13.3 Are work areas organised and clutter free ?

  Yes

  No

  N/A

• 13.4 Watch the supervisors direct workers. Do they speak in a way that encourages safe practices ?

  Yes

  No

  N/A

• 13.5 Are there any indicators that suggest a poor safety culture exists? I.e poor housekeeping. If yes provide details

  Yes

  No

  N/A

14.0 Audit result

• Is the visit deemed acceptable ?

  Yes

  No

  N/A

• No immediate follow-up visit required.

  Yes

  No

  N/A

• Select follow up date

  Date

14.0 Corrective actions

• Action item 1

• Action item 2

• Action item 3

• Action item 4

• Action item 5

• Action item 6

• Action item 7

• Action item 8

• Action item 9

• Action item 10

• Corrective actions due date

  Date

• Auditors signature

  Sign

• Site Representative

  Sign