Information

  • Conducted on

  • Contract Number

  • Worksite Location
  • Project Notes

  • Prepared by

Weather

Overnight / previous period rainfall

  • Did it rain the previous night (or preceding period)?

  • Rainfall recorded previous night (mm)

  • Has this rain prevented work occurring for this work shift?

  • undefined

  • undefined

Weather - first work period (eg morning)

  • Temperature

  • Weather (first period of work ie morning)

  • Enter rainfall recorded(mm)

  • Has rain prevented work occurring this period?

  • What work activity has been impacted?

  • Add media

  • Comments on weather conditions

Weather - second work period (eg afternoon)

  • Temperature

  • Weather (second period of work ie afternoon)

  • Enter rainfall recorded(mm)

  • What work activity has been impacted?

  • Has rain prevented work occurring this period?

  • Add media

  • Comments on weather conditions

General

Activity Checklists Completed

Hold Points, Witness Points and Non Conformance Observations

Proof Rolls Conducted

  • Was there a proof roll conducted?

  • Result

  • Location of proof roll and notes

  • Related Photo's

Surveillance Advice / Works Instruction Issued

  • Was a Surveillance Advice or Works Instruction Issued

  • Surveillance Advice Details

  • Related Photo's

  • Works Instruction Details

  • Related Photo's

Surveyor on Site

  • Areas surveyed

Testers onsite

  • 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

  • Add work activity diary entry

  • Work Activity Entry

Activity summary

  • Location /zone within site that activity is occurring

  • Work activity description

  • Is the activity on the critical path

  • Subcontractor(s) assisting?

  • Subcontractor(s) name

  • Time of activity commencement

  • Time of activity completion

  • Comments on work activity / Directions provider to contractor

Personnel resources

  • Supervisor on site

  • Supervisors Name

  • Leading hand on site

  • Leading Hands Name

  • Labourers (including plant operators)

  • Spotters / Marshalls

  • Add personnel resource

  • Personnel
  • Personnel description

  • Number of personnel

Plant Resources

  • Number of trucks

  • Select from range

  • Dogs included?

  • Number of excavators

  • Size of excavators?

  • Number of support vehicles (Utes or small work truck)

  • Add other plant and equipment (eg tools)

  • Plant / equipment
  • Description of plant or equipment

  • Number of plant

Photos of work activity

  • Add Photos of work activity

  • photo
  • Add media

  • Photo description

Traffic Management

  • Traffic control been implemented for activity

  • Team Leaders Name

  • Provide details of controls implemented ie TCP number, VMP, TC contractor, or other controls put in place, etc

  • Controls correctly implemented

  • Provide details of comments provided to supervisor

  • Add media

WHS

  • Safety controls been implemented for activity?

  • Provide details of controls implemented ie SWMS number, included as part of Toolbox/startup briefing, or other controls put in place, etc

  • Safety controls correctly implemented

  • Provide details of comments made to supervisor

  • Add photo of safety controls

  • Safety photo
  • Safety control photo

Environmental Controls

  • Enviromental controls been implemented for activity?

  • Provide details of controls implemented ie ESCP, or other controls put in place, etc

  • Environmental controls correctly implemented

  • Provide details of comments made to supervisor

  • Add photo of environmental control

  • enviro photo
  • Enviro control photo

  • Sign once completed. Surveillance Officer

  • Sign once completed. Project Engineer

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.