Information
-
Document No.
-
Audit Title
-
Client/Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
-
Region
-
Contractor/s
-
Job Description
-
Date
-
Time
1. Site Risk Management
-
Are relevant SWMS available and a Site Risk Assessment (JSA) completed for the work?
-
Has the JSA/site risk assessment identified site specific risks, been signed and dated by all crew members and have SWMS for task been identified.
-
Are all identified risk control measures on SWMS and JSA/site risk assessment in place
-
Have sub-contractors, site visitors been inducted onto the site and signed onto the JSA?
-
Has the Traffic/Pedestrian Management Plan been identified/created and available on site and documented on the JSA?
-
Overall, is the site risk assessment/ JSA adequate for the worksite?
2. Skills and Competency
-
Do all personnel have MG Passports on site?
-
Is all training and are all authorisations current for the functional role of the Passport holder?
-
Are all personnel trained licensed/registered for their functional role?
-
Do subcontractors hold appropriate qualifications?
3. Forms/Documentation
-
Is there a job file available on site?
-
Does the job file contain a daily job sheet / work instruction?
-
Does the job file contain a Dial before You Dig information?
-
Does the job file contain a sequence of operations?
-
Does the job file contain design drawings?
-
Are up to date district plans on site
-
Is a Pipelines work permit required and are there any restrictions?
-
Is a Pipeline Inspector on site or required to be on site?
-
Is a hot work permit required and are there any hot work restrictions?
-
Is a Confined Space permit required and are crew members involved in CSE signed onto Permit?
-
Is a Road Opening Permit required and is it on site.
-
Has notice of intention to excavate been submitted to Work Safe
-
Are MSDS available on site for all chemicals/fuels
4. Traffic and Pedestrian Management
-
Has the appropriate Traffic and Pedestrian Management Plan been identified, and does it meet all requirements?
-
Does the actual traffic/pedestrian layout reflect the Traffic/Pedestrian Management Plan?
-
Is pedestrian traffic safely controlled through the worksite?
-
Are traffic signs and devices legible and undamaged?
-
Are suitable barriers provided to protect the public from the work site?
-
Where site is to be left overnight, are adequate protection measures, lighting and night guidance provided?
5. Personnel Protective Equipment
-
Is PPE in accordance with Multinet Gas Procedure U PR 0006 as a minimum?
-
Is required PPE within inspection or replacement dates?
-
Is other appropriate PPE utilised as required and in good condition? (E.g. Harness, Life lines)?
-
Is PPE in an adequate condition?
6. Vehicles/Plant
-
Are all plant operators licensed as required?
-
Are logbooks available for all plant on site and have they been maintained appropriately?
-
Have pre-start checklists been completed?
-
Are all vehicles on site registered?
-
Are all vehicles/plant within their service range?
-
What is the general condition of the vehicles/plant (cleanliness)?
-
Is all equipment carried on vehicles adequately secured?
-
Is there appropriate identification / branding on contractor vehicles?
7. First Aid
-
Is there an intact First Aid kit?
-
Is the kits location marked on the vehicle?
-
Do the contents appear to be complete, in good condition and within expiry dates?
8. Gas Escape/Outage Management
-
Is the Service Providers level of response consistent with emergency protocols under the conditions observed on site?
-
Have personnel attended to the outage within the guidelines of the response times?
-
Has the service provider isolated the area required
-
Has the Service Provider assessed the number of customers effected
-
Has service provider turned off effected customers
-
Is there evidence of a satisfactory area covered for leakage location and identification?
-
Have all other utilities assets been located/proved prior to excavation
9. Tools and Equipment: Testing and Condition
-
Are all electrical tools, generators, leads, RDCs tagged and within their test date range?
-
Is Poly Fusion equipment within calibration dates?
-
Is percussion bar and mat in good condition and within test date?
-
Is the gas detector within calibration date?
-
Are Oxygen analysers within calibration date?
-
Is voltage tester fit for purpose and tested prior to use?
-
Is Oxy acetylene equipment in good condition and within test date? (AS 4839 section 8)
-
Are the gas bottles within expiry date and stored appropriately?
-
Is lifting equipment in good condition and within test date?
-
Is fire extinguisher charged and in test date?
10. Worksite/Work Practices
-
Is appropriate number of trained and competent crew members on site for task?
-
Effective Safety Observers in place?
-
No go Zones being adhered to
-
Has pipework been tested for stray current?
-
Are cross bonding leads required and used?
-
Are the appropriate numbers of fire extinguisher/s on site and placed in appropriate locations?
-
Is Plant and equipment appropriately set up?
-
Have other authority assets been located and /or exposed by hand prior to mechanical excavation?
-
Are all gas grid materials approved by Multinet?
-
Are all gas grid materials stored to prevent damage or deterioration
-
Are jointing techniques in line with MG SWPs?
-
Have MG standards (including covers, clearances, offsets and bedding materials) been maintained?
-
Are stop off of Mains and Services methods in line with MG SWPs?
-
Is the site tidy with no obvious tripping or other hazards?
-
Are trenches appropriately battered/shored?
-
Is spoil placed in excess of 0.5 from excavation wall?
-
Is a ladder or steps used to access excavation?
-
Is confined space rescue equipment on site and set up as required?
-
Are pits/man holes protected to prevent falls?
-
Is Sleeve/Slabbing/tape protection in place?
-
Has pressure testing and purging been conducted in line with MG SWPs
-
Has Refix / Relight been completed
-
If required, was a red card left with correct information and details
-
Are valve covers, pits etc. appropriately installed and level?
-
Does reinstatement and compaction meet Vic roads, Local Council, property owner’s requirements?
11. Environment and Hazardous Goods
-
Are environmental risks identified in the SWMS/JSA and controlled on site?
-
Are there any chemicals in use and is there a MSDS available for the chemical?
-
Are any hazardous materials and dangerous goods separately stored and labelled?
-
Are there any control measures to manage spills and leaks? (e.g. spill kit)
-
Are Silt traps in place?
-
Is refuelling of equipment in line with EMP section 14.11d?
-
Are there effective erosion and/or sediment controls in place?
-
Has waste been segregated for reuse/recycle/disposal as per EMP section 14.10?
-
Is Waste Water treated and disposed of as per EMP section 14.9? e.g.( Syphon, Trench, Pit water)
-
Is Mains dust disposed of as per EMP section 14.3?
-
Is material containing Asbestos treated as per EMP and VWCA 2007 OHS regulations?
-
Has flora, Fauna and Culture heritage issues been identified and controlled as per EMP section 14.4
-
Is spoil removed from site tested and disposed of in line with EPA requirements and are certificates available
12 Housekeeping
-
Is crush rock laid, level and compacted
-
Evidence of debris or rubbish
-
Evidence of subsidence in compound and around entry exit points
-
Interior of compound clear of fire hazards, tidy
-
Exterior of compound clear of fire hazards, tidy.
-
Fire protection in place. Fire extinguishers in place and within test dates
-
Security of compound fence, gates
-
Paint work on buildings, posts and bollards etc
-
Warning signs, emergency contact details in place with current information
-
PPE signs in place
-
Overall Audit Rating
- 1
- 1.5
- 2
- 2.5
- 3
- 3.5
- 4
- 4.5
- 5
- 5.5
- 6
- 6.5
- 7
- 7.5
- 8
- 8.5
- 9
- 9.5
- 10
-
Add drawing