Title Page

  • Conducted on

  • Prepared by

  • Location
  • Contract/work and work site(s):

  • Contract No:

  • Date(s):

  • Inspected by:

Instructions: Where a non-conformance is identified, a brief explanation is to be provided in the corresponding Comments and Actions box. All non-conformances must be rectified immediately and action documented. Where an item is not applicable, the notation NA should be placed in the Comments and Actions box

  • Weather conditions (tick () appropriate boxes):

  • Fine

  • Light rain

  • Heavy rain

  • Light wind

  • Strong wind

  • Other (provide description):

General

  • Is the site in a general tidy condition?

  • Is all equipment, materials, etc contained within work area boundary?

  • Are there any obvious signs of construction-related disturbance outside of construction area(s)?

Documents

  • Has an Environmental Management Plan (EMP) been prepared for this project

  • Is the EMP readily accessible?

  • Has the EMP been read and signed by all employees?

Soil Disturbance and Erosion Control

  • Have required erosion control measures been correctly installed and are they functional?

  • Check that there are:

  • no gaps in silt fences/barriers;

  • no material lying across filter material or build up of silt; or

  • no obvious signs of significant seepage through fences

  • Are there any obvious signs of overflow from sediment detention basins?

  • Are there any obvious signs of uncontrolled drainage leaving the site?

  • Are drainage inlets protected by sediment trapping measures?

  • Are any materials, temporary structures/works in drainage lines?

  • Have works been scheduled to minimise areas exposed at any one time?

  • Are areas where construction activities have ceased being stabilised and rehabilitated?

  • Is there minimal dirt on adjacent public roads?

  • Are diversion banks and drains located appropriately?

Stockpile Management

  • Do stockpiles appear adequately maintained and managed (measures in place to prevent dust and soil run-off)?

  • Are there separate stockpiles for different material, eg weed infested soil and clean soil?

  • Are any stockpiles located within the tree drip line (3m from tree base)?

  • Are stockpiles located on the contour at least 2m from waterways, roads and slopes of greater than 10%?

  • Is the stockpile height less than 2m?

  • Is there dust control for the stockpile?

Water Quality

  • Does water quality in down slope areas appears to be unaffected by construction work?

  • Any there any apparent illegal discharges to sewers – (cleaning of paint brushes – plaster – concrete and the like)?

  • Are all hazardous materials stored in a covered area more than 20m away from drainage lines or flood prone areas?

  • Is a spill kit readily accessible?

  • Is the on-site refuelling of construction plant restricted to a designated area more than 20m away from waterways and stormwater inlets?

  • Is the wash down of construction plant/vehicles restricted to a designated area (eg truck wash out area)?

  • Are there any obvious signs of fuel spills, oil leakage, and the like from construction plant (check both plant and ground)?

  • Are the relevant Material Safety Data Sheets (MSDS) available onsite?

Noise and Vibration

  • Is the relevant plant and equipment switched off when not in use?

  • Have the local residents that are likely to be affected by offensive noise and/or vibration been notified?

  • Have local residents been notified of works to be undertaken outside of normal working hours?

  • Have the siting of work areas, vehicle and plant parking areas, material stockpiles and equipment storage has been arranged to minimise noise?

  • Are there appropriate noise and vibration controls for activities adjacent to local residents and other sensitive receivers?

Air Quality

  • Is dust suppression equipment readily accessible?

  • Are there any obvious signs of dust deposition outside of construction area(s)?

  • Is spoil being prevented from being tracked onto public roads?

  • Are the haul roads being kept damp (where required)?

  • Is there spraying for dust control?

  • Do any vehicles or plan items have visible exhaust for more than 10 seconds?

Waste Management and Minimisation

  • Do trucks removing spoil from the site have their loads covered?

  • Are contaminated land or areas fenced off?

Archaeology/Heritage

  • Have heritage protection zones been identified for this site?

  • Are all required protection measures in place and functional?

  • Are construction materials stored outside heritage protection zones?

  • Are any obvious signs of construction activity within protected areas?

  • Is any vibrating equipment being used adjacent to heritage items?

Vegetation

  • Are all required vegetation protection measures in place and functional?

  • Are any construction materials stored inside vegetation protection zones?

  • Are there any obvious signs of construction activity within protected vegetation areas?

  • Are there measures in place to minimise clearing such as protective fencing, webbing, marker tape and the like?

  • Are disturbed areas stabilised and revegetated?

Traffic Management

  • Have all required traffic control measures been implemented in accordance with the Project EMP (such as warning signs, temporary road closures and the like)?

  • Are all construction plant parked on site?

  • Are any private vehicles of construction personnel obstructing the passage of local traffic?

Community Consultation

  • Have local residents been notified 5 days prior to construction of activities that are likely to cause dust, offensive noise or access?

  • Are complaints being reported to the Principal’s Representative?

OTHER

  • Is the access to any private properties being obstructed?

  • Are pedestrian routes adjacent to work sites being obstructed (or are appropriate alternative routes in place)?

  • General comments about this work site(s) (including follow up action)

  • CONTRACTOR’S REPRESENTATIVE

SIGNATURE & DATE

  • PRINCIPAL’S REPRESENTATIVE

SIGNATURE & DATE

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.