Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Client / Site

  • 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?

  • Does the JSA meet the KPI standard?

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?

  • Does the training meet the KPI standard?

3. Forms/Documentation

  • Do all personnel have MG approved identification Cards?

  • 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 or route 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?

  • Are seat belts fitted and worn on mobile plant as per requirements

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 gas specific equipment fit for purpose, in a suitable condition and being used in accordance with MG SWPs?

  • 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 Spotter/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 gas grid materials appropriate for the task

  • 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 purging procedure or 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 owners requirements?

11. Environment and Hazardous Goods

  • Does the JSA identify environmental risks and controls?

  • Have the appropriate controls been put in place on site?

  • Are all fuels and/or chemicals properly marked and identified?

  • Are all fuels and/or chemicals stored in containers that are in good condition (i.e. no leaks present) as per MNG-CG-0016?

  • Does mobile plant have adequate drip tray coverage?

  • Is there equipment available for the safe refuelling of plant and machinery in line with EMP section 14.11d?

  • Are erosion and/or sediment control structures in place and stable?

  • Are erosion and/or sediment control structures located between source (i.e. spoil) and receptor (i.e. drain)?

  • Is waste (inc. soil) stored suitably in line with MNG-CG-0008 and MNG-CG-0018 (if applicable sealed, covered, bunded)?

  • Is material containing asbestos treated as per EMP and VWCA 2007 OHS regulations?

  • Is waste water treated and disposed of as per EMP section 13.9? e.g.( syphon, trench, pit water)

  • Is mains dust disposed of as per EMP section 14.12?

  • Is noisy plant and machinery switched off when not in use?

  • Are dust generating activities (i.e. concrete cutting), being managed correctly i.e. water hoses attached to cutting equipment?

  • Are the drip lines of any trees on site free of large/heavy equipment?

  • If applicable, have tree roots been cut in accordance with EMP 14.4? (i.e. clean cut at a 45 degree angle and not torn).

  • Have flora, fauna and culture/heritage issues been identified and controlled as per EMP section 14.4 and 14.8?

  • Is spoil removed from the site tested and disposed of in line with EPA requirements and are certificates available?

  • Is Bushfire mitigation equipment available? (e.g. knapsack, rakes permit)

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?

13. Hazards Identified

  • Biological - Potential for harm caused by exposure to biological hazards, e.g. flora , fauna, marine, bacteria, livestock, flu

  • Climate - Potential for harm or damage to equipment / assets resulting from exposure to an extreme climatic event e.g. drought, fire, flood, winds, rain, snow, lightning, fog

  • Electrical - Potential for harm or damage equipment/ assets resulting from exposure to electrical sources e.g. HV, LV, ELV, induction, static, magnetic fields

  • Manual Handling / Ergonomics - Potential for harm associated with physical stress on the human body i.e. exertion, excessive repetitive movement; poor posture e.g. load handling, bending, twisting, repetitive workplace task

  • Gravity - Potential for harm or damage equipment/ assets resulting from a person/object falling or moving unexpectedly e.g. fall at level / heights/ depth, falling object, slope stability

  • Land / Water - Potential impact on the natural environment due to the use/ management of land / water e.g. modification/change to natural environment, pollution, land closure, vegetation clearing, water diversion

  • Mechanical - Potential for harm or damage to equipment/ assets resulting from exposure to sources of mechanical energy e.g. cutting, grinding, rotating equipment, projectile, pinch point, stored energy

  • Behavioural Actions - Potential for harm to people and equipment/assets associated with undesired behavioural actions e.g. not following policies/procedures, wilful misbehaviour, alcohol/drug use, fatigue, shift work

  • Pressure - Potential for harm to people and equipment/assets associated with the sudden release of a source of pressure e.g. compressed air or gas , hydraulics

  • Radiation - Potential for harm to people and equipment/assets associated with exposure to or contact with radiation waves from either natural or manufactured sources e.g. UV, infrared, X-Ray, laser, radioactive dust

  • Compliance /Cultural - Potential for harm to people and equipment/assets associated with not complying with internal, external and legal expectations and social-cultural expectations e.g. legal, business and stakeholder expectations, economic, cultural heritage

  • Noise - Potential for harm resulting from prolonged exposure to excessive noise e.g. noise from continuous sources and via impact

  • Substances - Potential for harm to occur as a result of exposure to chemicals whose properties are normally controlled e.g. asbestos, lead, SF6, Oils, dust (inhalable/respirable). Refer to chemical Inventory if required

  • Fire / Thermal - Potential for harm or damage to person or equipment/ assets resulting from exposure to fire / hot surfaces e.g. fire from ignition of bush land/ equipment, explosion, combustible materials, gas / acetylene torches

  • Vehicle / Transport - Potential for harm or damage to person or equipment/ assets resulting from the use/operation of vehicles or any mode of transpiration e.g. vehicles, aircraft, construction and maintenance vehicles including cranes and forklifts

  • Waste - Potential impact on the environment due to the inadequate management/disposal of waste e.g. hazardous/prescribed waste (e.g.: asbestos, oil, contaminated water), non hazardous waste, office paper/cardboard, biological

  • Work Environment - Potential for harm resulting from hazards associated with workplace conditions e.g. housekeeping, inadequate design, impact to pedestrian (broken ground, slippery conditions, demarcation), ventilation, confined space, travel health

  • Comments

  • Overall Audit Rating

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