Information
-
Document No.
-
Audit Title
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
Hazard ID
-
Hazard ID is on site and completed by team before commencing work.
-
Hazards and controls are relevant to the work being undertaken.
Service plans and permits?
-
Close access permits handed to contractor?
-
Service plans on site, current, and complete minimum A3 in size?
MARKOUTS completed for gas, power, telco and water services. (Include other if rel. such as fuel lines?
-
Record image of each of these services marked out on site?
-
Gas is marked out in yellow?
-
Water potable marked out in blue?
-
Power marked in orange
-
Sewer water marked out in red?
-
Storm water marked out in pink?
-
Telco marked out in purple?
-
Critical services marked out I.e. mains, high voltage power, hi cap telco etc.
Environmental protection
-
Record image of sediment control in place.
-
Sediment cloth in place minimum of 50 metres down flow of all excavations including: drilling, trenching, hydro vac, pot holing, etc....
Personal protective equipment
-
Excavation work personnel wearing FR overalls, safety glasses, safety footwear.
-
All traffic management PPE in good condition and worn properly?
Traffic management
-
Image of the TMP Signage and setup on site.
-
The CAR NOTICE is on site.
-
CAR IS VALID FOR THE SITE
-
TMP. Is set up according to those TMP approved in the CAR.
-
STMS CONTACT details recorded on site.
-
Equipment and plant setup inside the TMP zones?
Hydro Excavation Activities
-
Work activity is isolated from general operations
-
Operator is wearing correct PPE
-
Safety glasses
-
Hearing protection
-
Hard hat
-
Splatter guard in place
-
Full body FR overalls
-
Safety footwear
-
Face shield
-
Splatter prevention in use
-
Operational pressure is below 2000 psi
Sign off of prestart inspection
-
Contractor/Team Leaders signature
-
Site Supervisors signature.