Title Page
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Project Name / Number
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Contractor Company Name
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Conducted on
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Recorded By
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Site Address
General
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Work area clean & tidy?
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Comments on work area cleanliness
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Amenities provided for staff?
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Comments on staff amenities
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Amenities clean & tidy?
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Comments on cleanliness of amenities
Site HSE Administration
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Signage & warning signs in place as appropriate? Consider size, location, legibility, etc.
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Comments on signage.
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Are all employees (including subcontractor employees) inducted?
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Comments on inductions.
Chemicals
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Chemical Register & MSDS on site?
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Comments on Chemical Register & MSDS.
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Are all chemical containers appropriately labelled?
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Comments on chemical container labelling.
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Are site storage locations / bunds appropriate?
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Comments on chemical storage locations / bunds.
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Are there appropriate spill response kits and other emergency equipment available?
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Comments on availability of spill response & emergency equipment.
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Are appropriate risk assessments (relating to chemicals) kept on site?
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Comments on chemical risk assessments.
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Are the risk assessments being followed (i.e. appropriate PPE & other risk control measures in use)?
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Comments on risk controls & PPE.
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Have contractor/subcontractor staff been trained in the use of chemicals, including for spill response?
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Comments on training.
Plant & Equipment
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Visible inspection of plant & equipment.
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Comments on appearance of plant & equipment.
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Are plant & equipment operators suitably certified/qualified?
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Comments on operator training/certification.
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Are daily inspection checklists in use for relevant plant & equipment?
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Comments on daily inspection checklists.
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Is there a system/process/procedure in place to rectify faults identified in plant & equipment?
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Comments on fault rectification processes.
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Is plant & equipment kept safe when not in use?
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Comments on plant & equipment safety when not in use.
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Are there overhead powerlines in the vicinity?
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Comments on overhead powerlines.
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Is all electrical equipment appropriately tested, tagged and in date?
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Comments on electrical test & tag.
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Is all lifting equipment appropriately tested, tagged & in date?
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Comments on lifting equipment test & tag.
Hazard Reporting
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Is a suitable hazard reporting system in place?
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Comments on hazard reporting system.
First Aid
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Are adequate first aid kits available?
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Comments on first aid kits.
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Are sufficient employees (including subcontractors) trained in first aid?
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Comments on first aid training.
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Are emergency contact numbers displayed clearly?
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Comments on emergency contact numbers.
Fire Protection Equipment
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Are fire extinguishers on site & in suitable condition (including compliance with 6 monthly inspections)?
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Comments on fire extinguishers.
Safe Work Procedures
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Are relevant work instructions (SWMS, JSA, etc.) on site and in use?
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Comments on work instructions.
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Is a work permit system in use?
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Comments on work permit system.
Incident/Injury Reporting
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Have any incidents or injuries been reported?
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Comments on injuries/incidents.
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Have any incidents/injuries been reported to WorkSafe?
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Comments on incident/injury reporting to WorkSafe.
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Have any environmental incidents been reported to EPA?
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Comments on environmental incident reporting to EPA.
Excavations & Fall Protection
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Have existing underground services been located?
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Comments on service proving.
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Are any trenches greater than 1.5m deep? Are these adequately supported (shoring, shields, etc.)?
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Comments on trenches greater than 1.5m deep.
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Is adequate protection in place for trenches less than 1.5m deep?
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Comments on trenches less than 1.5m deep.
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Is adequate fall prevention in place to control any potential height safety hazards? This includes trenches greater than 2m deep, raised platforms or equipment, etc.
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Comments on control of height safety hazards.
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Are public safety issues adequately controlled? This includes site security fencing, pedestrian & vehicle traffic management, etc.
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Comments on control of public safety.
PPE
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Is appropriate Hi-Vis clothing being worn? Is Hi-Vis clothing in good condition?
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Comments on Hi-Vis.
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Is long-long clothing being worn? Are long-longs in good condition?
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Comments on long-long clothing.
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Is appropriate footwear being worn? Is footwear in good condition?
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Comments on footwear.
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Are safety helmets being worn? Are safety helmets in good condition and in date?
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Comments on safety helmets
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Are other PPE equipment items available where required (eyewear, hearing protection, gloves, face masks/shields, etc.)? Is this PPE being used? Is this PPE in good condition?
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Comments on other PPE.
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Is UV protection available (sunscreen, sun hats, sunglasses, shade, etc.)? Is this UV protection in use?
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Comments on UV protection.
Site Supervision
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Is there adequate supervision on site (consider high risk activities, interaction of multiple work crews, proximity to the public, etc.)?
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Comments on site supervision.
Insurances
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Have details of Worker's Compensation & Public Liability insurance policies been provided? Are they in date?
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Comments on insurances.
Environment
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Are environmental aspects being appropriately managed (refer HSE Management Plan and/or site specific Environmental Management Plan)?
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Comments on environmental aspects.
Other
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Provide details of any other relevant outcomes of the Worksite Inspection.