Information
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Conducted on
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Contract Number
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Worksite Location
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Project Notes
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Prepared by
Weather
Overnight / previous period rainfall
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Did it rain the previous night (or preceding period)?
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Has this rain prevented work occurring for this work shift?
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Weather - first work period (eg morning)
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Weather (first period of work ie morning)
- Rain
- Sun
- Windy
- Cloudy / overcast
- Drizzle
- Cold
- Hot
- Warm
- Cool
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Has rain prevented work occurring this period?
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What work activity has been impacted?
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Add media
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Comments on weather conditions
Weather - second work period (eg afternoon)
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Weather (second period of work ie afternoon)
- Rain
- Sun
- Windy
- Cloudy / overcast
- Drizzle
- Cold
- Hot
- Warm
- Cool
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What work activity has been impacted?
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Has rain prevented work occurring this period?
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Add media
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Comments on weather conditions
General
Activity Checklists Completed
Hold Points, Witness Points and Non Conformance Observations
Proof Rolls Conducted
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Was there a proof roll conducted?
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Result
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Location of proof roll and notes
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Related Photo's
Surveillance Advice / Works Instruction Issued
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Was a Surveillance Advice or Works Instruction Issued
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Surveillance Advice Details
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Related Photo's
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Works Instruction Details
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Related Photo's
Surveyor on Site
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Areas surveyed
Testers onsite
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Areas tested
Meetings Attended
Visitors to Site
General Site Observations and Comments
Materials delivered or Removed from Site
Plant Mobilised or Demobilised
Plant out of Service or Stood Down
Complaints from Public
Work Activity Record
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Add work activity diary entry
Work Activity Entry
Activity summary
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Location /zone within site that activity is occurring
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Work activity description
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Is the activity on the critical path
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Subcontractor(s) assisting?
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Subcontractor(s) name
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Time of activity commencement
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Time of activity completion
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Comments on work activity / Directions provider to contractor
Personnel resources
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Supervisor on site
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Supervisors Name
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Leading hand on site
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Leading Hands Name
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Add personnel resource
Personnel
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Personnel description
Plant Resources
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Dogs included?
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Size of excavators?
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Add other plant and equipment (eg tools)
Plant / equipment
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Description of plant or equipment
Photos of work activity
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Add Photos of work activity
photo
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Add media
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Photo description
Traffic Management
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Traffic control been implemented for activity
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Team Leaders Name
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Provide details of controls implemented ie TCP number, VMP, TC contractor, or other controls put in place, etc
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Controls correctly implemented
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Provide details of comments provided to supervisor
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Add media
WHS
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Safety controls been implemented for activity?
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Provide details of controls implemented ie SWMS number, included as part of Toolbox/startup briefing, or other controls put in place, etc
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Safety controls correctly implemented
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Provide details of comments made to supervisor
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Add photo of safety controls
Safety photo
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Safety control photo
Environmental Controls
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Enviromental controls been implemented for activity?
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Provide details of controls implemented ie ESCP, or other controls put in place, etc
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Environmental controls correctly implemented
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Provide details of comments made to supervisor
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Add photo of environmental control
enviro photo
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Enviro control photo
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Sign once completed. Surveillance Officer
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Sign once completed. Project Engineer