DWFS SITE DAILY CHECKLIST

• Contract #

  LG314/1211/19/097
• Location
  Address

• Contractor

  DIONA

• Drinking Water Filling Station #

  Select N1 N2 N3 N5 N6 N7 N8 S8 S9 S10 S11 S12

  • N1
  • N2
  • N3
  • N5
  • N6
  • N7
  • N8
  • S8
  • S9
  • S10
  • S11
  • S12

• Date & Time of Visit

  Date

Visible Workers on Site

• Foreman

  Yes

  No

• Concreters

  1

  2

  3

  4

  5

• Construction Workers

  1

  2

  3

  4

  5

• Plant Operators

  1

  2

  3

  4

  5

• Surveyors

  1

  2

• Traffic Controllers

  1

  2

  3

  4

  5

• Other

  1

  2

  3

  4

  5

• Describe worker

• Describe Other Workers

• Describe Other Workers

• Describe Other Workers

  Yes

  No

  N/A

• Describe Other Workers

Visible Plant on Site

• Bobcats

  1

  2

  3

  4

  5

• Concrete Trucks

  1

  2

• Excavator(s)

  1

  2

  3

  4

  5

• Excavator(s)Tonnage

  Select 2 3 4 5 8 12 14 20

  • 2
  • 3
  • 4
  • 5
  • 8
  • 12
  • 14
  • 20

• Line Markers

  1

  2

• Tip-Trucks

  1

  2

  3

  4

  5

• Tool-Trucks

  1

  2

  3

  4

  5

• Traffic Control vehicles

  1

  2

  3

  4

  5

• Utes

  1

  2

  3

  4

  5

• Vac Trucks

  1

  2

• Other

  1

  2

  3

  4

  5

• Plant Description

• Plant Description

• Plant Description

• Plant Description

• Plant Description

Weather Conditions

• Fine or Rain or Shower

  Fine

  Rain

  Showers

• Overcast

  Yes

• Temperature

  Hot

  Mild

  Cold

  Windy

• Work Stopped Due to Weather

  Yes

• Describe Conditions

Activity

• Site Works

  Yes

• Concreting

  Yes

• Earthworks

  Yes

• Electrical

  Yes

• Hydrants

  Yes

• Pipework

  Yes

• Pot-Holing

  Yes

• Restoration Works

  Yes

• Road Works

  Yes

• Signs, Lines, etc.

  Yes

• Solar

  Yes

• Storm Water Works

  Yes

• Testing

  Yes

• Miscellaneous

  Yes

• Describe Activity

Pavement and Civil Works

• Has the Contractor performed and documented a pre start

  Yes

  No

• Why?

• Visual check of licences and induction

  Yes

  No

  Previously sighted

  N/A

• Why?

• Check that the Safe work method statement (SWMS)/work method statement (WMS) are on site, relate to the work and have been implemented

  Yes

  No

  Previously sighted

  N/A

• Why?

• Check Environmental Management Plan (e.g. dewatering acid sulphate soil)

  Yes

  No

  Previously sighted

  N/A

• Why?

• Have underground services been identified (e.g. Dial before you dig &/or potholing)

  Yes

  No

  Previously sighted

  N/A

• Why?

• Have all energy sources been isolated (LOTO)

  Yes

  No

  N/A

• Why?

• Are relevant spotters on-site

  Yes

  No

  N/A

• Why?

• Have the required Traffic Management Plans (TMP’s) been approved by the relevant authority (Council, DTMR etc.)

  Yes

  No

  Previously sighted

  N/A

• Why?

• Are control measures in place (barricading signs,) for both vehicle traffic & pedestrians, & in accordance with the approved TMP

  Yes

  No

  N/A

• Why?

• Fire ant soil management in place (where relevant)

  Yes

  No

  N/A

• Why?

• Check that all permits and risk assessments have been filled out and implemented

  Yes

  No

  N/A

• Why?

• PPE in good condition and being worn

  Yes

  No

• Why?

• Housekeeping adequate (including rubbish), all personnel must be mindful when working in public areas as you are representing GCWW.

  Yes

  No

• Why?

• Any safety or environmental concerns

  Yes

  No

• Describe?

Witness and hold points

• Surface preparation inspection for pavement marking

  Yes

• Sign if accepted

  Sign

• Electrical conduit inspection prior to back fill

  Yes

• Sign if accepted

  Sign

• Concrete pre-pour (formwork, reinforcement, , levels and dimensions)

  Yes

• Sign if accepted

  Sign

• Concrete pour inspection (ready to pour)

  Yes

• Sign if accepted

  Sign

• Pavement inspection (final trim) Council Standard Drawing 05-02-204

  Yes

• Sign if accepted

  Sign

• Tapping band inspection installation inspection (hold for 4 hours)

  Yes

• Sign if accepted

  Sign

• Notes

  Yes

• Verified by

  Sign