Title Page

  • Contract Name

  • Contract Description

  • Conducted on

  • Recorded By

  • Site Address

Contract Types

  • Is the Contract value likely to exceed $100,000 (excluding supply of materials)?

  • Major Contract

  • Is the total value of construction works likely to exceed $350,000 (including GST and supply of materials)?

  • Principal Contractor required. Project Manager to nominate proposed Principal Contractor to EGW HSE for validation/approval.

  • No Principal Contractor required.

  • Minor Contract

High Risk OH&S Hazards (p1)

  • Working on or near roadways or railway lines?

  • Please provide relevant details of roadways/railway lines.

  • Working on or near overhead power supplies?

  • Please provide relevant details of overhead power lines.

  • Working near underground services?

  • Please select relevant underground services:

  • Please provide details of relevant services.

  • Work where there is any movement of powered mobile plant?

  • Please provide relevant details of powered mobile plant.

  • Trenching greater than 1.5m deep or shafts greater than 2m deep?

  • Please provide relevant details of trenches/shafts.

  • Work involving the removal or likely disturbance of asbestos?

  • Please provide relevant details of works involving asbestos.

High Risk OH&S Hazards (p2)

  • Working in confined spaces?

  • Please provide relevant details of confined spaces.

  • Working in other contaminated, flammable or dangerous atmospheres?

  • Please provide relevant details of contaminated, flammable or dangerous atmospheres.

  • 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

  • Please provide relevant details of hazardous manual handling.

  • Working at height with potential to fall distances greater than 2m?

  • Please provide relevant details of working at height.

  • Exposure to hazardous chemicals?

  • Please provide relevant details of hazardous chemicals.

  • Exposure to Acid Sulfate Soils?

  • Please provide relevant details of Acid Sulfate Soils.

High Risk OH&S Hazards (p3)

  • Work involving structural alterations that require temporary support to prevent collapse?

  • Please provide relevant details of proposed structural alterations.

  • Working on or near energised electrical installations?

  • Please provide relevant details of works proposed on/near energised electrical installations.

  • Significant proximity & hazards to the public?

  • Please provide relevant details of public hazards.

  • Work involving tilt-up or precast concrete construction?

  • Please provide relevant details of proposed precast concrete construction.

  • Demolition work?

  • Please provide relevant details of proposed demolition work.

  • Use of Subcontractors?

  • Please provide relevant details of proposed subcontractor works.

High Risk OH&S Hazards (p4)

  • Construction work on or near water (including diving)?

  • Please provide relevant details of proposed construction work on/near water.

  • Exposure to UV radiation?

  • Please provide relevant details of potential UV exposure.

  • Other there any other potential high risk OH&S hazards associated with the works?

  • Please provide relevant details of other high risk OH&S hazards.

Environmental Aspects

  • Potential for Acid Sulfate Soil disturbance?

  • Please provide relevant details of potential Acid Sulfate Soil disturbance.

  • 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?

  • Please provide relevant details of Cultural Heritage sensitivities.

  • Refer ACHRIS mapping tool
    https://applications.vic.gov.au/apps/achris/public/public-registry/home

  • Potential for significant stormwater runoff?

  • Please provide relevant details of stormwater runoff.

  • Potential for removal of native vegetation?

  • Please provide relevant details of native vegetation removal.

  • Potential biodiversity impacts (EPBC referral)?

  • Please provide relevant details of biodiversity impacts.

  • 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?

  • Please provide relevant details of potentially significant environmental aspects.

Contract Classification

  • Is your proposed contract high risk (did you select yes for any of the High Risk OH&S Hazards or Environmental Aspects)?

  • High Risk Contract

  • Low Risk Contract

Conclusion

  • Please enter any additional comments regarding HSE for communication to tenderers or consideration in costings.

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