Field Audit Report & Checklist

• SR Number

• Conducted on

  Date

• Prepared by

• Location
  Address

• Additional Personnel present or additional Auditor

• Select date

  Date

• Crew being audited.

  Select Water Sewer Allabout ATP Donnaz LMF M&E Maintech P&B Plumbing Sunny Excavation Underground Logistics

  • Water
  • Sewer
  • Allabout
  • ATP
  • Donnaz
  • LMF
  • M&E
  • Maintech
  • P&B Plumbing
  • Sunny Excavation
  • Underground Logistics

• Task being undertaken

  Crew Onsite

  Crew Offsite

• Enter the names of the crew being audited.

  Yes

  No

  N/A

OHS Considerations

• Has the JSA been completed correctly with all risks identified?

  Safe

  At Risk

  N/A

• Has the JSA been signed by all personnel at the site?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Is the proper PPE being worn?

  Yes

  No

  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 proper Health & Hygiene safeguards in place and being practiced?

  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.

  Safe

  At Risk

  N/A

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

  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

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 tapped off to prevent unauthorized entry?

  Safe

  At Risk

  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

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

  Safe

  At Risk

  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

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

  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

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

  Yes

  No

  N/A

• If so is the appropriate PPE being worn

  Safe

  At Risk

  N/A

• Is the appropriate signage displayed correctly?

  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

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? How many are in place?

  Safe

  At Risk

  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

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

  Safe

  At Risk

  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?

  Safe

  At Risk

  N/A

• Has the excavation been back filled correctly and compacted?

  Safe

  At Risk

  N/A

Road opening

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

  Safe

  At Risk

  N/A

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

  Yes

  No

  N/A

M&E / Sewer

• Is the wet well clean to procedures?

  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

Safety Conversations

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

  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

• Crew signature

  Sign

• Crew signature

  Sign