DoT Environmental Surveillance Checklist

• Site conducted

  Select

• Contract Number

• Contractor Name

• VicRoads Business Area

• Conducted on

  Date

• Prepared by

• Location
  Address
Current Temperature

• Get weather details here
  http://www.weatherzone.com.au/

• Personnel on site

Contaminated Materials

• Have contaminated materials been encountered on site?

  Yes

  No

  N/A

Upon encountering contaminated material on site

• Has the contractor notified the Superintendent and where applicable EPA?

  Yes

  No

  N/A

• Has the contractor engaged an environmental specialist to undertake sampling & analysis to determine the type and levels of contamination?

  Yes

  No

  N/A

• Have documents on the investigation been provided to the Superintendent?

  Yes

  No

  N/A

• Has the opportunity to reuse the contaminated soil/material as fill on-site been investigated?

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

• What was the resulting treatment?

  Reused on site

  Disposed to landfill

Reusing contaminated material

• Has the contaminated material been assessed by a suitably qualified consultant to verify that it is suitable for reuse on-site?<br>(Record document used in the photo's / comments section)<br>

  Yes

  No

  N/A

• Has the contractor developed an Environmental Improvement Plan (EIP)?

  Yes

  No

  N/A

• Has the EIP been approved by the EPA?

  Yes

  No

  N/A

• Has the appropriate documentation been provided to VicRoads including the source, location, type and volume of contaminated material reused on site?

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Disposal of contaminated materials

• During storage and removal of contaminated material, are works being monitored to ensure that it is contained? <br>(Review monitoring records to confirm that monitoring has been undertaken at the required frequency).<br>

  Yes

  No

  N/A

• Is the contaminated material being disposed of off-site using an EPA licensed vehicle and transported to an EPA licensed facility?

  Yes

  No

  N/A

• Company, Vehicle and Facility Details

• Has the contractor signed the EPA transport certificates?<br>(Review transport certificates)<br>

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Monitoring

• Has visual assessment of the site for contaminated soils and materials been undertaken?<br>Monitoring should be undertaken at the following intervals<br>• When stripping – Daily<br>• During excavations – Daily<br>• When importing filling material - Daily

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Environmental Incident

• Has an incident occurred resulting in soil contamination?

  Yes

  No

  N/A

• Has the incident been reported through the contractor’s quality system (i.e. non-conformance raised)? <br>(Provide details of incident in the comments section).

  Yes

  No

  N/A

• Has the contractor identified procedures/actions that need to be implemented in the NCR and have they been undertaken?

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Environmental Management Plans (EMPs) Does the EMP adequately address the management of the flora/fauna sites:

• Has a risk assessment been undertaken for work activities that may impact on flora & fauna?

  Yes

  No

  N/A

• Have the control measures/processes been identified to address those risks?<br>(Review the procedures against the requirements of the contract and the scaled drawings to identify the location and extent of environmental controls.)

  Yes

  No

  N/A

• Has all contractor and sub- contractor’s staff been informed of the flora/fauna issues and identified management and mitigation measures to address them?<br>(Review and assess the induction records. Assess whether personnel working in proximity to vegetation are aware of contractual and EMP requirements.)

  Yes

  No

  N/A

• Have the required permits been obtained prior to the disturbance of flora/fauna sites or relocation of native fauna?<br>(Refer to PEPS Commitments table and Specification for the list of permits required.)

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Identification & protection of significant flora & fauna before removal

• Has an inspection been undertaken to identify and agree on the extent of vegetation to be protected and removed?<br>(Review the Contract Specification to determine who is required to attend and agree on the extent of vegetation removal.)

  Yes

  No

  N/A

• Is the extent of vegetation removal consistent with the conditions of the relevant permits and the Specification?<br>(Review permit conditions and the Specification for the list of vegetation/habitat sites and native flora/fauna areas of significance)

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Vegetation Protection

• Has ‘No Go Zone’ fencing and signage been erected around designated areas to be retained and established prior to the removal of vegetation?<br>Vegetation protection is required for vegetation identified in the specification as well as that agreed on- site.

  Yes

  No

  N/A

• Drip Line Diagram

  

• Has all plant, equipment, material or debris been placed or stored beyond the limit of the root zone/drip line (canopy of the tree) or agreed No-Go Zone for vegetation to be protected?

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Clearing and ground works

• Have the appropriate sedimentation controls been installed prior to any clearing/disturbing activities?<br>(Refer to sediment and erosion checklist for a detailed surveillance checklist on sediment and erosion management.)

  Yes

  No

  N/A

• Has a zoologist and/or botanist, with an appropriate permit/licence been present at the time of vegetation removal to identify, capture and relocate fauna identified within the zone to be cleared?<br>(Review ITP’s, invoices or letters from the zoologist/botanist to verify presence on site at the time of vegetation removal.)

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Management of felled vegetation

• Has the removed vegetation been managed in accordance with the specification (and the following table)?

  Yes

  No

  N/A

• Waste Management Option

  

• Attach Photo's / Documents

  Media

Weed control

• Have declared weeds been treated prior to the commencement of ground disturbing activities?<br>(Review weed management records created by subcontractors using herbicides. Inspect the site for presence of regionally prohibited weeds.) <br>

  Yes

  No

  N/A

• Refer to the Agriculture Victoria website for a list of regionally prohibited weeds.
  http://agriculture.vic.gov.au/agriculture/pests-diseases-and-weeds/weeds/a-z-of-weeds

• Is plant, equipment clean:<br>• Prior to arrival on site;<br>• Prior to departure on site;<br>• Prior to movement within the site from infested to non-infested area.<br>(Review records that verify that plant and equipment is inspected prior to entering or leaving the site. Undertake and record the observations of a visual inspection of any plant and equipment as it arrives, leaves or moves between sections of the site.)

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Monitoring

• Has monitoring been undertaken to verify that controls established for the protection of vegetation & habitat are effective at the recommended intervals:<br> Everyday when construction activities are in place in the vicinity of the sites; and<br> At least every 7 days at other times unless as specified in the contract<br>(Review site monitoring records to verify that weekly monitoring has been undertaken. Undertake a site inspection to verify that controls have been maintained. Note - Daily records will generally be by exception. Review foreman diary/notes.)

  Yes

  No

  N/A

• Has monitoring been conducted to verify the presence of any declared weeds, pests and diseases?<br>(Review site monitoring records to verify that monitoring has been undertaken. Undertake a site inspection to verify that declared weeds, pest and diseases have been treated)

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Dust Control

• Does the EMP state requirement for dust control measures?

  Yes

  No

  N/A

• Have the required controls been implemented?

  Yes

  No

  N/A

• Are the implemented controls performing to the required standard?

  Yes

  No

  N/A

• Is monitoring of the controls and site requirements being conducted?

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Water Quality

• Does the EMP state requirement for Water Quality measures?

  Yes

  No

  N/A

• Have the required controls been implemented?

  Yes

  No

  N/A

• Are the implemented controls performing to the required standard?

  Yes

  No

  N/A

• Is monitoring of the controls and site requirements being conducted?

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Incident Reporting

• Have incidents (impacts on water quality) been reported to the Project?

  Yes

  No

  N/A

• Has an incident report been generated in the contractor’s quality system?

  Yes

  No

  N/A

• Attach Photo's / Documents

  Media

Other

• Please attach documents, photos or comments on any other concerns you may have:

  Media

• Comments

• Sketch any details if you wish e.g. location

  Drawing