Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Job number

  • Please enter date and time

  • Operatives on site

  • Do all operative carry identification cards?

  • Is there a NRSWA ticket holder on site?

Whereabouts

  • Is the gang on site as per whereabouts

  • Location including grid refs

Chapter 8 NRSWA

  • Is site set up to current code of practice?

  • Please add picture of site from both ends

  • Are there sufficient signs barriers walk boards and ramps cones and info boards on site?

Equipment

  • Is CAT and GENNY on site working and calibrated?

  • Is GDU on site working and calibrated?

  • Take picture of CAT GENNY and GDU

  • Is there a water test kit on site?

  • Is there a fire extinguisher on site?

  • Is eye wash available

  • Is first aid kit available and adequately stocked?

Job pack

  • Is job pack complete with gas water and electric prints for the area of work?

  • Is point of work risk assessment completed?

  • Pic of POWRA

Vehicle

  • Registration number

  • If vehicle is parked are keys out of the ignition and not left in vehicle

  • Please record mileage

  • Please record level of fuel 0 is empty 2.5 is quarter 0.5 is half and so on

  • Tax disc in date

  • Is vehicle clean and dashboard clear?

  • Take picture of vehicle from outside

  • Please add signature

Work in progress

Duct

  • Duct

  • Is correct duct being installed?

  • Is duct at correct depth?

  • If not why not

  • Is duct roped?

  • Has box / chamber been entered in the correct entry point?

  • Duct entry information

  • Other information

  • If duct is not at correct depth a TDFS is required please record the reference number on the job pack diary page

  • Please take picture of duct entry

Frame and Covers

  • Frame and covers

  • Have Lockable frame and covers been fitted?

  • Have Security plates been fitted?

  • If applicable please take picture of security locks in place

  • Is all debris and mortar removed from box and cables?

  • Please take a picture of the box from directly above

Cabinets

  • Has correct cabinet been fitted?

  • Has resin been applied to correct thickness?

  • Has resin set and is it free of debris?

  • Please take picture of inside of cabinet showing resin and new ducts

Reinstatement

  • Is reinstatement complete?

  • Has correct material been used for reinstatement?

  • Has edge sealant been used on Tarmac?

  • Is customer happy with reinstatement on private property?

  • I/we the property owners/tenants/representatives agree that all work is complete to a satisfactory condition

  • Customer Signature

  • Take picture of completed works.

  • Take pictures of any snagging or remedial works

  • Supervisor/ Agent Signature

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.