Essential Energy Network Safety Worksite Audit Form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• D&R/LLW Request No:

• ATW/Access Authority No:

(n/a - not applicable, c - compliant, n/c - non compliant)

• 1. Can staff identify the appointed 'Worksite Coordinator'?

  compliant

  non compliant

  not applicable

• 2. Has the 'Worksite Hazard & Risk Assessment' been correctly completed for the tasks being undertaken?

  compliant

  non compliant

  not applicable

• 3. Have Safe Work Method Statements (SWMS) relevant to the work being carried out been noted on the WHRA and the associated control measures have been implemented and SWMS on site?

  compliant

  non compliant

  not applicable

• 4. Has a ‘Safe Area for Work’ been defined if identified as necessary by taping, signs, or barriers?

  compliant

  non compliant

  not applicable

• 5. Is there a ‘Traffic Control Plan’ in place?

  compliant

  non compliant

  not applicable

• Is the traffic control set-up consistent with approved traffic management plan/RTA requirements and adequate for the work site and are Pedestrian safety measures in place?

  compliant

  non compliant

  not applicable

• 6. Do all staff being audited on site have an Endeavour Energy Network Access Authorisation card with appropriate authorisations for work to be carried out?

  compliant

  non compliant

  not applicable

• 7. Are all staff wearing ‘protective clothing’ in the correct manner to appropriate protection to head, body, arms, legs and feet at all times?

  compliant

  non compliant

  not applicable

• 8. Is all ‘safety equipment’ on site in good order and being used correctly?

  compliant

  non compliant

  not applicable

• 9. Are ‘first aid kits’ available on site?

  compliant

  non compliant

  not applicable

• 10. Are ‘safety (rescue) kits’ positioned and ready for immediate use as required. As per Electrical Safety Rules?

  compliant

  non compliant

  not applicable

• 11. Has all paperwork appropriate for the work completed correctly?<br>AA LL  ATW  D&R Instruction  Switching Folder 

  compliant

  non compliant

  not applicable

• 16. Is ‘HV test and operating equipment’ is in good condition, within due test date and properly stored for mechanical protection on vehicles?

  compliant

  non compliant

  not applicable

• 12. Is the ‘Access Authority for Work’ consistent with the work being performed, as per the D&R Instruction and are all staff working within the “AA” signed on?

  compliant

  non compliant

  not applicable

• 13. If an Observer is required is he/she positioned to ensure good visibility and communication with person at all times?

  compliant

  non compliant

  not applicable

• 14. Do ‘isolation points’ have appropriate danger tags applied correctly?

  compliant

  non compliant

  not applicable

• 15. Are all ‘operational and working earths’ applied to the h/v apparatus in a correct manner and are earth stakes driven into at least 600mm?

  compliant

  non compliant

  not applicable

• 16. Is ‘HV test and operating equipment’ is in good condition, within due test date and properly stored for mechanical protection on vehicles?

  compliant

  non compliant

  not applicable

• 17. Are approved ‘portable operational earths, personal protective bonding leads’ and ‘L.V. bonding equipment’ in current test date?

  compliant

  non compliant

  not applicable

• 18. What is the general condition of vehicles?

  Select Good Tidy Poor Leaks Broken Parts Dangerous

  • Good
  • Tidy
  • Poor
  • Leaks
  • Broken Parts
  • Dangerous

• 19. What is the standard of general housekeeping on site?

  compliant

  non compliant

  not applicable

• 20. Are all ‘elevated work platforms’ and ‘other mobile plant’ on site within ‘due electrical test date’ and is the daily check sheet completed?

  compliant

  non compliant

  not applicable

• 21. Do drivers of heavy vehicles > 12 Tonne GVM have the required RTA Work Diary and is it correctly filled out?

  compliant

  non compliant

  not applicable

Comments

• Notes.

• Signed (Auditor)

  Sign

• Signed (Worksite Coordinator)

  Sign

Non Conformances:

Actions Taken to resolve non-conformances:

• Notes.

• Date Completed:

  Date

• Signed (Responsible Manager)

  Sign