Title Page
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Contract Name
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Contract Description
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Conducted on
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Recorded By
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Site Address
Contract Types
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Is the Contract value likely to exceed $100,000 (excluding supply of materials)?
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Major Contract
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Is the total value of construction works likely to exceed $350,000 (including GST and supply of materials)?
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Principal Contractor required. Project Manager to nominate proposed Principal Contractor to EGW HSE for validation/approval.
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No Principal Contractor required.
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Minor Contract
High Risk OH&S Hazards (p1)
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Working on or near roadways or railway lines?
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Please provide relevant details of roadways/railway lines.
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Working on or near overhead power supplies?
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Please provide relevant details of overhead power lines.
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Working near underground services?
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Please select relevant underground services:
- Power
- Water
- Sewer
- Gas
- Telstra
- Other
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Please provide details of relevant services.
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Work where there is any movement of powered mobile plant?
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Please provide relevant details of powered mobile plant.
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Trenching greater than 1.5m deep or shafts greater than 2m deep?
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Please provide relevant details of trenches/shafts.
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Work involving the removal or likely disturbance of asbestos?
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Please provide relevant details of works involving asbestos.
High Risk OH&S Hazards (p2)
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Working in confined spaces?
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Please provide relevant details of confined spaces.
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Working in other contaminated, flammable or dangerous atmospheres?
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Please provide relevant details of contaminated, flammable or dangerous atmospheres.
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Hazardous manual handling?<br>(application of high force, sustained awkward postures, repetitive movements, handling live animals or unstable loads) – refer HSE Coordinator or Manager Business Risk & Compliance
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Please provide relevant details of hazardous manual handling.
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Working at height with potential to fall distances greater than 2m?
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Please provide relevant details of working at height.
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Exposure to hazardous chemicals?
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Please provide relevant details of hazardous chemicals.
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Exposure to Acid Sulfate Soils?
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Please provide relevant details of Acid Sulfate Soils.
High Risk OH&S Hazards (p3)
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Work involving structural alterations that require temporary support to prevent collapse?
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Please provide relevant details of proposed structural alterations.
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Working on or near energised electrical installations?
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Please provide relevant details of works proposed on/near energised electrical installations.
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Significant proximity & hazards to the public?
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Please provide relevant details of public hazards.
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Work involving tilt-up or precast concrete construction?
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Please provide relevant details of proposed precast concrete construction.
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Demolition work?
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Please provide relevant details of proposed demolition work.
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Use of Subcontractors?
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Please provide relevant details of proposed subcontractor works.
High Risk OH&S Hazards (p4)
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Construction work on or near water (including diving)?
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Please provide relevant details of proposed construction work on/near water.
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Exposure to UV radiation?
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Please provide relevant details of potential UV exposure.
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Other there any other potential high risk OH&S hazards associated with the works?
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Please provide relevant details of other high risk OH&S hazards.
Environmental Aspects
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Potential for Acid Sulfate Soil disturbance?
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Please provide relevant details of potential Acid Sulfate Soil disturbance.
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Refer Victorian Coastal Acid Sulfate Soils mapping tool
http://vro.agriculture.vic.gov.au/dpi/vro/vrosite.nsf/pages/coastal_acid_sulphate_soils -
Potential for Cultural Heritage sensitivity?
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Please provide relevant details of Cultural Heritage sensitivities.
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Refer ACHRIS mapping tool
https://applications.vic.gov.au/apps/achris/public/public-registry/home -
Potential for significant stormwater runoff?
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Please provide relevant details of stormwater runoff.
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Potential for removal of native vegetation?
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Please provide relevant details of native vegetation removal.
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Potential biodiversity impacts (EPBC referral)?
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Please provide relevant details of biodiversity impacts.
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Refer 'Do you need approval?' internet reference.
http://www.environment.gov.au/epbc/do-you-need-approval -
Are there any other potentially significant environmental aspects?
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Please provide relevant details of potentially significant environmental aspects.
Contract Classification
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Is your proposed contract high risk (did you select yes for any of the High Risk OH&S Hazards or Environmental Aspects)?
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High Risk Contract
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Low Risk Contract
Conclusion
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Please enter any additional comments regarding HSE for communication to tenderers or consideration in costings.