Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Hazard management

  • Risk assessment and hazard identification form on site

  • Is risk assessment current for today's activities signed and dated by crew

  • Is risk assessment completed in job pack and signed?

Traffic management and pedestrian safety

  • Copy of the traffic management plan maintained on site?

  • Traffic management setup is correct and according to the approved TMP?

  • Site Traffic Management Contact number listed on the Risk assessment sheet.

  • There is safe pedestrian access maintained on site I.e ramps, signage is correct, no trip hazards, trenches are cordoned off properly

  • Manholes and Joint boxes. Are barriers in place or lids closed?

  • After hours TM in place?

  • Cones and barriers in good condition?

  • Cones and barriers set up correctly? I.e. not A frames or laying down.

Environmental controls and systems

  • Dust and noise own site is minimised or eliminated?

  • Any hazardous substances on site other than in fuel tanks of vehicles? Resins concrete cement petrol diesel.

  • Where hazardous substances are on site the relevant safety data sheets (SDS) are held in the attachment to the risk assessment or within gang pack.

  • There is no backfill stored on the roads or within 500 mm of environmentally sensitive areas I.e. drains streams, and or dumps leading to storm water pits etc....?

  • Are waste materials segregated and re used where possible?

  • Cable ands and other waste materials. Are they taken back to the depot for recycle/re use?

Underground services and safe practices

  • Notice is valid and current for the location?

  • All relevant services are marked and located according to Safe Working with Underground Services Guide and HSE guide HSG47

  • Current service plans are held on site and understood by the crew?

  • Are service drawings marked and signed by team leader to show correct location of work?

  • Service plans have locators, site managers, site supervisors, and contractor crews signature and dates of hand over showing management of change?

Personal Protective Equipment

  • Fire retardant overalls in use? This includes being worn correctly in ankle to wrist covering with minimal synthetic under covering

  • Safety glasses being worn on site correctly?

  • Safety footwear being worn on site properly and in good condition? No exposed steels, unlaced, or loosely fitted etc

  • Hi-visibility garments are in good condition and worn zipped up correctly?

  • All persons working near overhead loads, suspended equipment, or booms on mobile plant and equipment wearing hard hats or compliant to other hard hat designated zones?

  • Appropriate hearing protection worn as required?

  • All PPE in good condition and fit for purpose in accordance with the non-negotiable requirements?

  • Emergency assembly point identified?

Plant and equipment including mobile plant

  • All mobile plant and machinery maintained within the confines of the established TM under Code of practice requirements (allowances made for setup and disestablishment)

  • Selecting one or two plant items - equipment is in current fit for purpose use and certification?

  • Powered tools such as concrete cutters have safety guards fixed and in good condition?

  • Where diggers and drills etc are in operation these are isolated from the general public and other workers?

  • Safe reversing procedures are being adhered to?

  • Potential entrapment and pinch points are safe guarded?

  • No person is operating under the mobile plant and equipment?

Other general

  • General housekeeping is good?

  • Good response to inspection?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.