Information
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Vehicle registration number
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Make and Model
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Name of Driver
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Driver ID
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Conducted on
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Site location
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Prepared by (your name)
Personal Protective Equipment
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Safety helmet (3 years)
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Year manufactured / tested
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Date put into service
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Signature
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LV Gloves (3 years)
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Year manufactured / tested
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Signature
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Gas Detector (6 month calibration)
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Year manufactured / tested
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Signature
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Harness (10 years)
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Manufacturer
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Serial /Batch number
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Year manufactured / tested
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Date of purchase
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Date put into service
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Signature
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Pole Strap (10 years)
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Manufacturer
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Serial /Batch number
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Year manufactured / tested
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Date of purchase
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Date put into service
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Signature
Safety Equipment
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Safety helmet wide brim/neck flaps
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Wide brim hat
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Safety vest (hi-vis with reflective tape for night)
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Safety footwear (Steel cap boots)
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Long sleeve shirt (high visibility - SS logo)
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Pole PPE (cotton trousers/shirt or overalls if applicable)
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Safety line & safety bag to store it in
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Insulated rubber mat - drilling into walls
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Lock out tags
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Safety glasses
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Dust mask (P2 when working on ACM)
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Ear protection
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Riggers gloves
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Sharps kit (container, gloves & tongs)
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Traffic signs - retro reflective
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Cones (9 but 5 must be reflective for night work)
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Manhole guards - 1 FULL SET (no inspection guards)
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Manhole Key/Manhole lid lifter/Pit key
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Fire Extinguisher
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Upload photo of fire extinguisher
Electrical Equipment
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240V extension leads - tested and tagged
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240V power tools e.g. Drill - tested and tagged
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Residual Current device (RCD) - tested and tagged
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Cordless tool(s)
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240V Cordless tool(s) charger - tested and tagged
First Aid Equipment
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Appropriate first aid kit
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Adequately Stocked
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Signage to indicate where the kit is located
Tools and test equipment
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Step ladder - fibreglass
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Extension ladder - Fibreglass
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Head and base ropes (if applicable)
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Tool bag / belt (if applicable)
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Test phone or equivalent
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OTDR or equivalent
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Fibre terminating tools
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Wooden handle crowbar or insulated crowbar
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Wooden handle shovel
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Cabinet / pillar / MDF / FDH keys
Documentation
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Management plans - Safety and Environmental
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SWMS - CCD - C - SWMS - FSD - 002
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JSEA - CCD - C - JSEA - 001 - by exception
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Working at heights register - CCD - C - FRM - SFD - 004 - by exception
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Emergency response Guide CCD - C - GLD - 1605
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Material safety data sheets (MSDS)
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Emergency card - CCD - C - FRM - 0625
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Traffic Control Requirement Chart - CCD - C - GLD - 0098
Licences & Accreditation
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H&S Construction Industry Card
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Service Stream Issued Photo ID Card
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Drivers licence
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Power awareness - working near power or poles (if applicable)
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ACA Current
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First Aid officer (At least one if 2 or more workers are on site)
Environmental & Work Site
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Asbestos controls - cup/foam/bag
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Worksite clean and tidy
Vehicle Inspection
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All vehicles lights are operational
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SS Decals fitted to each door (if applicable)
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Vehicle jack, handle & brace
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Vented gas storage facility
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Exterior & interior cleanliness
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Good condition - free of damages<br>
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Conduit carrier with end caps fitted
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Registration current
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Windscreen-cracks / scratches
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Shelving sufficient
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Loosed / unrestrained items
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Cargo barrier
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Ladder straps
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Vehicle ladder racks
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Commercial vehicle
Vehicle Photos
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Drivers side
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Front of vehicle
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Rear of vehicle
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Passenger side
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Odometer reading
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Inside cab
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Inside rear of vehicle
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Auditors signature
