Downer Field Audit Report & Checklist (V 1.0) issued on 26/01/2017

• Client

  CWW

  YVW

  SEW

  Other
• Job Location
  Address

• Conducted on

  Date

• Inspected by

Crew/ Contractor Information

• Select the crew/s from the drop box. Multiple Selection can be made.

  Select Downer Allabout Regal Traffic Other Roadsafe Asphalting Silman Bro Asphalting Urban Formula Precision Asphalting HSG Development Dirty Diggers Ground Paving Mal Paving Bay line Marking Newco Traffic

  • Downer
  • Allabout
  • Regal Traffic
  • Other
  • Roadsafe Asphalting
  • Silman Bro Asphalting
  • Urban Formula
  • Precision Asphalting
  • HSG Development
  • Dirty Diggers
  • Ground Paving
  • Mal Paving
  • Bay line Marking
  • Newco Traffic

• List of names of the site supervisor/ foreman

  Yes

  No

  N/A

• Specify task being carried out.

Critical Control Observation

• * Use this checklist to engage with the whole delivery team when you visit the site.
  * Check with managers whether critical risk controls have been considered during planning the task.
  * Attend the Pre-Start if possible to check whether critical risk controls for the scope of work are discussed.
  * Strike up a conversation with team members to check their understanding of critical risk controls relevant to their work and whether they consider them effective.
  * Record any actions and make sure they are entered in INX as in Observation record.

• CRITICAL RISKS OBSERVED DETAILS

  Select Plant and Pedestrian Interaction Uncontrolled Vehicles and Loads Working with or near Electricity Working at Height Working in a Confined Space Clearance of Protected Areas Hazardous Liquids >1000L Import / Export Contaminated Fill Sediment to Waterways Spread of Declared Weeds & Pathogens

  • Plant and Pedestrian Interaction
  • Uncontrolled Vehicles and Loads
  • Working with or near Electricity
  • Working at Height
  • Working in a Confined Space
  • Clearance of Protected Areas
  • Hazardous Liquids >1000L
  • Import / Export Contaminated Fill
  • Sediment to Waterways
  • Spread of Declared Weeds & Pathogens

• 1.0 Check with the site management team how they addressed the critical risks associated with the work scope during the planning of the work activity.

  EFFECTIVE

  GENERALLY SOUND

  IMPROVEMENT REQUIRED

• 2.0 Discuss with the delivery team how they are controlling the critical risks in their scope of work.

  EFFECTIVE

  GENERALLY SOUND

  IMPROVEMENT REQUIRED

• 3.0 Discuss with the delivery team how the critical risk controls were communicated.

  EFFECTIVE

  GENERALLY SOUND

  IMPROVEMENT REQUIRED

• 4.0 Check the identified critical risk controls identified overleaf for the risks you have observed and discuss their relevance to the work situation you are observing.

  EFFECTIVE

  GENERALLY SOUND

  IMPROVEMENT REQUIRED

Section 1.0: Safety Considerations

• 1.1.a Has the pre-start risk control been completed correctly with all risks identified?

  Yes

  No

  N/A

• 1.1.b Has this been signed by all personnel on site? Please take photo

  Yes

  No

  N/A

• 1.2 Have all controls identified on the pre-start risk control been implemented appropriately?

  Yes

  No

  N/A

• 1.3 Is the proper PPE being worn and in good condition? i.e. long uniform, hard hats, safety glasses, vests, gloves, etc.

  Yes

  No

  N/A

• 1.4 Is the AVDD unit being used for this task? if so, is the AVDD unit within calibration date?

  Yes

  No

  N/A

• 1.5 Are the AVDD cables, earth leads and electrical gloves in good condition? i.e. Special gloves not torn or have holes, cables do not have bare wires exposed or damaged insulation, earth leads dated and tagged.

  Yes

  No

  N/A

• 1.6 Are the Main to Meter operator's tickets current? Please take a photo.

  Yes

  No

  N/A

• 1.7 Is there a first aid kit available and is it appropriately stocked for the activity being carried out?

  Yes

  No

  N/A

• 1.8 Are all hazardous substances correctly labelled and stored correctly in spill trays?

  Yes

  No

  N/A

• 1.9 Is there a refuelling container available, is it fitted with a transfer nozzle and if a plastic fuel container, is it less than 5 years old? (date of manufacture is stamped on the bottom of plastic fuel containers)

  Yes

  No

  N/A

• 1.10 Is ATWP current and has all crew members recorded on it?

  Yes

  No

  N/A

• 1.11 Is the information on the sign board are accurate and up to date (supervisor name and number, after hours number, the mandatory PPE's, etc)?

  Yes

  No

  N/A

Section 2.0: Traffic, Plant, Pedestrian Interaction

• 2.1 Have the listed controls that were identified in the risk assessment been appropriately implemented?

  Yes

  No

  N/A

• 2.2 Is traffic management provided by a third party? Provide name of the company.

  Yes

  No

  N/A

• 2.3 If the traffic management is being provided by a third party, are their JSA/ SWMS and plans completed and appropriate for the tasks being undertaken? Please take a photo.

  Yes

  No

  N/A

• 2.4 Are the Traffic Qualifications held by the crew/s appropriate to the task and current, i.e. current and within the three year period? Take a photo of the ticket/s.

  Yes

  No

  N/A

• 2.5 ls there appropriate pedestrian/traffic protection? Provide a photo of the set up.

  Yes

  No

  N/A

• 2.6 Has the worksite been delineated (eg. bunting, para webbing, taped, etc) to prevent unauthorised entry?

  Yes

  No

  N/A

• 2.7 Is the site housekeeping orderly and in accordance with 5S principles, with no tools, equipment, materials or slip/ trip hazards left on footpaths or public access areas? Please take photos.<br>

  Yes

  No

  N/A

• 2.8 Is there TC escape rout on site/ set up?

  Yes

  No

  N/A

Section 3.0: Environmental Considerations

• 3.1 Has the worksite been maintained as per requirements and standards? i.e. clean up of driveways, gutters, nature strip, etc. Please take a photo.

  Yes

  No

  N/A

• 3.2 Are silt traps correctly placed out to prevent excessive entry of contaminants into storm water drains? List the number of silt traps placed out.

  Yes

  No

  N/A

• 3.3 Are all silt traps in good condition and able to be used? i.e. not split.

  Yes

  No

  N/A

• 3.4 Have trees been protected (barricaded/ fenced) to minimise impact to trunk, root zone?

  Yes

  No

  N/A

• 3.5 Have rocks/sand piles been stored correctly (including pipe along gutter), so as to minimise impact to workers and the public?

  Yes

  No

  N/A

Section 4.0: Residents/ Businesses

• 4.1 Prior to commencing the activity, have all considerations for customers been taken? i.e. blocked driveways, water off, customers notified.

  Yes

  No

  N/A

• 4.2 Has temporary water supply being secured with ramps and fasteners, and installed so as to minimise trip hazards?

  Yes

  No

  N/A

Section 5.0: Excavation

• 5.1 Is the Excavation Permit in place, including DBYD plans available and in dates?

  Yes

  No

  N/A

• 5.2 Have exclusion and No Go Zone been established?

  Yes

  No

  N/A

• 5.3 Is the excavation 1.5 m or deep? If so, are the correct shoring devices being used or is the excavation "battered back"? Are appropriate barricades in place, is an access/egress ladders in place, has the excavation been reported to WorkSafe?

  Yes

  No

  N/A

• 5.4 If the excavation is 2.0 m or deeper are barricades/ barriers in place to prevent fall from heights?

  Yes

  No

  N/A

• 5.5 Is a spotter being used during excavations works (overhead and underground assets/ services)? Does the spotter have the appropriate tickets?

  Yes

  No

  N/A

• 5.6 Is excavated spoil, plant and materials that > 1000 mm from edge of trench?

  Yes

  No

  N/A

Section 6.0: Vehicles Plant and Equipment

• 6.1 Are all vehicles and equipment in good working order, clean and presentable?

  Yes

  No

  N/A

• 6.2 Are vehicle and plant pre-start check books correctly filled out with any faults listed? Provide a photo of the completed documents.

  Yes

  No

  N/A

• 6.3 ls there a fire extinguisher available, is it secured correctly and is it in service, i.e. been checked and tagged within the last 6 months, if the extinguisher was purchased within the last 6 months, sight the receipt of purchase.

  Yes

  No

  N/A

• 6.4 Are wheel nut indicators in place on utilities and trucks?

  Yes

  No

  N/A

Section 7.0: Asbestos Tasks

• 7.1 Is Asbestos removals or repairs involved in the task?

  Yes

  No

  N/A

• 7.2 Is a copy of the Asbestos Removal Licence, competency/ tickets onsite?

  Yes

  No

  N/A

• 7.3 Is the correct PPE available for use/ being worn? at least P2 dust mask, coveralls, gloves, safety glasses, safety gumboots, etc.

  Yes

  No

  N/A

• 7.4 Are Asbestos signs and barricades in place in accordance with work instruction?

  Yes

  No

  N/A

• 7.5 Do all workers entering the excavation zone have adequate PPE (including the plant operator)? ie. at least P2 dust mask, coveralls, gloves, safety glasses, safety gumboots, etc.

  Yes

  No

  N/A

• 7.6 Has all Asbestos waste been removed as per the requirements, i.e. double bagged and stored in allocated and locked bin?

  Yes

  No

  N/A

Section 8.0: Confined Space Entry

• 8.1 Does this activity involve "Confined Space" entry?

  Yes

  No

  N/A

• 8.2 Do all personnel involved in the Confined Space entry have the appropriate training, qualifications and tickets? Confined Space ticket valid for 12 months only. Please take a photo.

  Yes

  No

  N/A

• 8.3 Have the correct Confined Space permit/s been obtained and filled out correctly? Take specific notice of the rescue plan and make comments.

  Yes

  No

  N/A

• 8.4 Is the Confined Space entry being conducted to the Confined Space Entry Plan?

  Yes

  No

  N/A

• 8.5 Is all PPE used for the Confined Space entry in service, including harness, fall arrest system, tripod, etc and in proper condition for it's use?

  Yes

  No

  N/A

Section 9.0: Safety Conversations

• 9.1 Were any critical risk control (or other) conversations conducted during the audit? If so record the topics discussed.

  Yes

  No

  N/A

Section 10.0: Opportunities for improvement (record in INX)

• 10.1 Are there any opportunities for improvement identified in the audit?

  Yes

  No

  N/A

Section 11.0: Signatures and sign off.

• Name and signature of the auditor

  Sign

• Select date

  Date

• Name and signature of the site supervisor/ foreman

  Sign

• Select date

  Date

• Name and signature of the crew member

  Sign

• Select date

  Date

• Name and signature of the crew member

  Sign

• Select date

  Date

• Name and signature of the crew member

  Sign

• Select date

  Date

• Name and signature of the crew member

  Sign

• Select date

  Date