Title Page
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Site conducted
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Contract No
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Conducted on
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Prepared by
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Location
DOT OH&S Checklist - Northern Region
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Contract No
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Item Number
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Contractor
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Surveillance By
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Contract Site Manager
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Activity being undertaken
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Quality System Reference (Standard Section)
1. Safe Work Method Statements (SWMS,s)
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1.1 Pre - Start / project hazard analysis completed and appropriate controls conveyed to employees, contractors and sub contractors sighted.
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1.2 Safe Work Method Statements reviewed to compliment item 1.1
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1.3 Observed the following contractors / Sub contractors SWMS,s being used as stipulated (List comments in column)
2. Training
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2.1 Induction Training Records for contractors / Sub contractors sighted.
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2.2 Construction Induction Records for contractors / Sub contractors sighted (Induction Card)
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2.3 Competency training records sighted for contractors / Sub contractors.
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2.4 Tool Box Meeting minutes or Pre Start meetings sighted for Shift.
3. Site Safety
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3.1 Site amenities in accordance with Health and Safety Co-ordination Plan (eg: toilets - lunch room - water)
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3.2 OH&S policy displayed on site.
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3.3 Emergency procedures and emergency contact details for relevant authorities displayed on site.
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3.4 Safe Operating Procedures on site.
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3.5 Qualified first aiders on site.
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3.6 Are people on site following site safety rules.
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3.7 First aid kits are available on site, ensure stock list are available and have been checked.
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3.8 Permit to work documentation completed (power/gas/Telstra etc).
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3.9 Personnel Protective Equipment (PPE) and clothing used/warn
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3.10 Plant speed restrictions / No Go Zones for pedestrians enforced.
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3.11 Summary and records of accident / incident reports and investigations maintained on site.
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3.12 Corrective actions for accidents / WorkSafe Notices / Safety inspections / Hazard reports implemented and working.
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3.13 Plant and Equipment daily safety checks completed.
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3.14 Flashing lights / Reversing cameras / proximity warning devices / reversing alarms / communication systems operational.
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3.15 Are all items of plant registered or issued with unregistered vehicle permit as per the Road Safety Act (1986)
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3.16 Dangerous Goods Register / MSDS,s current.
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3.17 Dangerous Goods storage secure and signage displayed.
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3.18 Ensure appropriate fire extinguishers / equipment is on site. Check extinguishers for in date tag and are full.
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3.19 Is a qualified spotter required due to overhead powerlines?
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3.20 Who is the spotter ? Do they have current certificate / card / ticket.
4. Worksite Traffic Management - Planning
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4.1 Is there a approved traffic management plan available on site.
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4.2 Is there a valid Memorandum of Authorisation (MOA) on site.
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4.3 Has there been any changes to the approved traffic management plan. Are these documented.
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4.4 Is there a trained traffic controller on site, do they have current card / certificate / ticket.
Advance Warning / Signage
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4.4B Are all roadworks signs and devices installed according to the traffic management plan?
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4.5 Have any contradictory, distracting of superfluous signs or markings been covered up or removed?
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4.6 Are signs appropriate for current conditions?
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4.7 Is signage suitably placed, especially for vehicles approaching at high speed.
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4.8 Are multi message signs being used correctly?
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4.9 Are the signs free from damage and defects?
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4.10 Are signs securely mounted and stable?
Work Zone Separation
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4.11 Are clearances between workers and adjacent traffic being maintain?
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4.12 Are the safety barriers the same as depicted in the TMP and are no-go zones observed?
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4.13 Has containment fence been installed where required?
Other Road Users
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4.14 Has possible traffic congestion been consider and steps taken to avoid it?
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4.15 Have the effects of the works on public transport been considered.
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4.16 Have the needs of other road users been provided for (e.g. pedestrians, cyclists, wheelchairs)?
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4.17 Has proper access to side roads and properties been provided?
5. Other Comments
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Signature