Field Audit Report & Checklist V4

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Select date

  Date

• Select the crew/s from drop down list

  Select 24/7 Traffic A1 Groundforce Allabout ATMS Citywide Donnaz Evolution Traffic Global Traffic IV Plumbing Jetstream JMH Excavations L&K Earthworks LMF M&E Maintech McLean Civil Meiss Other P&B Plumbing PFM Sewer PFM Traffic PFM Water Rangedale RJPW Storm Traffic Sunny Excavations Taylord Plumbing TDG Traffic Tox Free Underground Logistics Gramac MRBM Excavations Metro Utilities Traffic

  • 24/7 Traffic
  • A1 Groundforce
  • Allabout
  • ATMS
  • Citywide
  • Donnaz
  • Evolution Traffic
  • Global Traffic
  • IV Plumbing
  • Jetstream
  • JMH Excavations
  • L&K Earthworks
  • LMF
  • M&E
  • Maintech
  • McLean Civil
  • Meiss
  • Other
  • P&B Plumbing
  • PFM Sewer
  • PFM Traffic
  • PFM Water
  • Rangedale
  • RJPW
  • Storm Traffic
  • Sunny Excavations
  • Taylord Plumbing
  • TDG Traffic
  • Tox Free
  • Underground Logistics
  • Gramac
  • MRBM Excavations
  • Metro Utilities Traffic

• List the names of the crew/s?

  Yes

  No

  N/A

• Enter the task being carried out

  Yes

  No

  N/A

OHS Considerations

• Has the JSA been completed correctly with all risks identified? Has the JSA been signed by all personnel on site?

  Safe

  At Risk

  N/A

• Are all personnel on site wearing or carrying their Identification Cards?

  Yes

  No

  N/A

• Is the proper PPE being worn? For example, long long uniform, hard hats, vest etc.

  Safe

  At Risk

  N/A

• Is the PPE in good condition and being worn correctly?

  Safe

  At Risk

  N/A

• Is there a First Aid Kit available and is it stocked appropriately for the activity being undertaken?

  Safe

  At Risk

  N/A

• Are all hazardous substances correctly labelled?

  Safe

  At Risk

  N/A

• Is the AVDD unit being used for this task? If so, is it being used correctly and is it within the required calibration period-date? Record the calibration/service date and unit number. Are the correct type of gloves being used etc?

  Safe

  At Risk

  N/A

• Are all activities being conducted within written procedures?

  Safe

  At Risk

  N/A

• Are correct manual handling techniques being used by all personnel?

  Safe

  At Risk

  N/A

• Have all other services in the vicinity of the Site been identified and located?

  Yes

  No

  N/A

Traffic & Pedestrian Management

• Has the Traffic Management Assessment been completed? If so, has the appropriate Traffic Management Plan been implemented?

  Yes

  No

  N/A

• If Traffic Management is being provided by a third party, are their JSA's and Plans completed and appropriate for the task/s being undertaken?

  Safe

  At Risk

  N/A

• Is there appropriate Pedestrian / Traffic protection?

  Safe

  At Risk

  N/A

• Has the worksite been taped off to prevent unauthorized entry?

  Safe

  At Risk

  N/A

• Is there Para Webbing available for use, if required, to restrict entry to the area?

  Yes

  No

  N/A

• Are all signs and equipment being used in required condition?

  Yes

  No

  N/A

Confined Space Entry

• Is this activity involving Confined Space Entry?

  Yes

  No

  N/A

• Do all personnel performing the Confined Space Entry have the appropriate training and licenses?

  Safe

  At Risk

  N/A

• Have the correct Confined Space permit/s been obtained and filled out correctly? Take specific notice of the rescue plan and make comment.

  Safe

  At Risk

  N/A

• Is the Confined Space Entry being conducted to the Confined Space Entry Plan?

  Yes

  No

  N/A

• Has the OCC been notified of the Confined Space Entry?

  Yes

  No

  N/A

• Is all PPE being used for the Confined Space Entry in service and in proper condition for it's use?

  Safe

  At Risk

  N/A

Vehicles Plant and equipment

• Are all vehicles and equipment in good working order and clean and presentable?

  Yes

  No

  N/A

• Are the correct tools/truck/crew being used for the task, I.e. no cross contamination due to a sewer spill carrying out a water task, or vice versa?

  Yes

  No

  N/A

• Carry out a vehicle, Plant and Equipment inspection and report any deficiencies.

  Safe

  At Risk

  N/A

• Are vehicle and plant log books correctly filled out with any faults listed?

  Yes

  No

  N/A

• Is there a Fire Extinguisher available, is it secured correctly and is it in service, I.e. been checked and in date with the regular service checks?

  Safe

  At Risk

  N/A

• Is there a refueling container available, is it fitted with a fuel transfer nozzle?

  Safe

  At Risk

  N/A

• Is the Plant and Equipment being operated as per requirements, I.e. not overloading or using appropriate actions and work practices?

  Yes

  No

  N/A

Asbestos Tasks

• Is there Asbestos removal or repairs involved in this task?

  Yes

  No

  N/A

• Are all personnel involved in the task appropriately trained and certified to carry out asbestos tasks?

  Safe

  At Risk

  N/A

• Has the Asbestos Plan been completed and the Supervisor nominated? Note: take specific notice of names and signatures.

  Yes

  No

  N/A

• Has all waste been removed as per the requirements, i.e. double bagged, SR Number written on outer bag.

  Safe

  At Risk

  N/A

• Is the correct PPE being worn?

  Safe

  At Risk

  N/A

Environmental Aspects

• Has the worksite been reinstated as per requirements and standards? (eg. The cleanup of driveways, gutters nature strip etc.)

  Yes

  No

  N/A

• Are silt traps in place to prevent excessive entry into storm water drains?

  Safe

  At Risk

  N/A

• Are the silt traps placed correctly to ensure that contaminants are trapped?

  Safe

  At Risk

  N/A

• How many silt traps are placed out? How many silt traps are available for use, I.e. minimum of three required.

  Yes

  No

  N/A

Customer

• Have customers been notified of the activity if required?

  Yes

  No

  N/A

• Prior to commencing the activity, have all considerations for customers been taken, I.e. blocked driveways, water off to their property whilst the repairs are being carried out?

  Safe

  At Risk

  N/A

• Has the water been shutdown? Have the "water off" times been minimized?

  Yes

  No

  N/A

• During the task has the water main been kept free of contamination?

  Yes

  No

  N/A

• On completion of the task was the main, service, or hydrant flushed and or disinfected to ensure a clean supply?

  Yes

  No

  N/A

• Does the worksite require a specific clean up/ disenfection due to a sewer spill etc.

  Yes

  No

  N/A

• Has there been any damage caused to other assets or customers property?

  Yes

  No

  N/A

• If there are damages, have all of the relevant details been recorded and reported?

  Yes

  No

  N/A

Excavation

• Is the excavation for the activity appropriate in size?

  Yes

  No

  N/A

• Is the excavation over 1.5 mt deep? Are proper shoring devices being used?

  Safe

  At Risk

  N/A

• Does the operator of the excavator have the appropriate license? Who is the appointed operator? Are they licensed? Name the spotter.

  Safe

  At Risk

  N/A

• Was the correct equipment used for the excavation, I.e. shovel digging first and then a mud bucket?

  Safe

  At Risk

  N/A

• Is the available back fill material appropriate, and is there sufficient quantity available to complete the task?

  Yes

  No

  N/A

• Has the excavation been back filled correctly and compacted?

  Yes

  No

  N/A

• Is the black carried separately in the tray of the truck, I.e. small amount in a hessian bag?

  Yes

  No

  N/A

Road opening

• Have the correct materials been used, compacted and all cuts and drill holes filled?

  Yes

  No

  N/A

• Has the road opening been measured and correctly marked for completion?

  Yes

  No

  N/A

• Provide a photo of the road opening.

  Yes

  No

  N/A

M&E / Sewer

• Is the wet well/site clean to the procedures?

  Yes

  No

  N/A

• Are fall from heights barriers available and being used?

  Yes

  No

  N/A

• Is the area around the well/manhole clear of obstructions that could cause slips, trips, or falls?

  Safe

  At Risk

  N/A

• Are all alarm inhibit override/s reset?

  Safe

  At Risk

  N/A

• Are all covers correctly refitted and in proper condition?

  Safe

  At Risk

  N/A

• Are log book details entered and station locked up?

  Yes

  No

  N/A

• Have all materials and rubbish been bagged and removed from the site? I.e. rags, old parts etc.

  Yes

  No

  N/A

Safety Conversations

• We're any safety conversations conducted during this audit? If so please record the conversation.

  Yes

  No

  N/A

• Has the crew been practicing their SafeStart exercises as a warm up before commencing the task?

  Yes

  No

  N/A

• Has the crew been doing reset exercises?

  Yes

  No

  N/A

Opportunity for Improvement

• Were there any opportunities for improvement identified during this audit? If so please record the details and ensure that the OFI is reported, registered and followed up.

  Yes

  No

  N/A

Sign off

• Auditor signature

  Sign

• Additional Auditor Signature

  Sign

• Crew signature

  Sign

• Crew signature

  Sign