Information

  • Location(s) of high hazard work inspection

  • Conducted on

  • Prepared by:

  • Location
  • Personnel

HH and SBO

  • Time audit conducted

  • Track any corrective actions to closure. Identify owners of issues and due date. All issues should be documented with M+W EHS.

1) Working at Heights and Fall Protection

  • Is 100% Fall Protection in place for all WAH achieved by collective or personal measures

  • Are Method Statements / Submittals and Risk Assessments in place approved by M+W?

  • Is Collective (passive) fall protection given priority over personal (active) fall protection?

  • Are harness lanyards tied-off to suitable anchorage points with adequate load capacity per person?

  • Are mobile scaffolds or podium steps used in preference to straight, step, A-frame ladders?

  • Are mobile towers & scaffolds safely errected and "safe tagged"?

  • Are access points to work platforms on scaffolds / mobile towers protected by a gate, hinged hatch or trap door?

  • Are scaffolds fitted with a top and mid rail, toeboards and fully boarded? Free from rubbish?

  • Are harnesses with restraint lanyards attached to safe anchorage points within MEWP's?

2) Excavations

  • Is an "excavation permit" in place for each excavation?

  • Are approved Method Statements / Submittals and Risk Assessments in place for all excavations?

  • Is edge protection around all excavations adequate to prevent fall by people, machines or material?

  • Are all excavations safely battered, stepped or supported regardless of depth?

  • Is there safe access to and egress from all excavations?

  • Are spoil heaps positioned at a safe distance away from the excavation?

  • Have all excavations been inspected by a Competent Person before person entry?

  • Is the work area well barricaded, protected and marked at day? Fenced or covered and lit at night?

  • Is the excavation a confined space or is gas monitoring required due to CO2 emissions?

3) Confined Space

  • Is the confined space work absolutely necessary? Are all required confined space permits in place?

  • Are approved Method Statements / Submittals and Risk Assessments in place for all confined spaces?

  • Is atmospheric monitoring undertaken before an during work with the atmospheric hazards tested?

  • Is rescue and emergency response equipment in place with trained personnel present?

  • Is at least one spotter stationed outside the confined space for the duration of the entry?

  • Are persons in the confined space attached to a retrieval line to enable "non-entry" rescue?

  • Is all required access, egress and communication equipment present and appropriate?

  • Has the confined space been isolated from electrical, mechanical, chemical, heat + hazards?

  • Are confined space danger signs posted at the entrance(s) to all known confined spaces?

4) Falling Objects from Heights

  • Is the public / site personnel protected (scaffold netting / guards / fans, walk-ways, "no lift zones")?

  • Are "Lifting Plans" in place approved by M+W for works involving lifting of equipment and materials?

  • Are test and inspection records on file for all lifting appliances and lifting equipment? (cranes ans slings?)

  • Are lifting operations being undertaken by competent personnel using appropriate communication means?

  • Are all loads made secure before lifting i.e. steel banding to timber, banding to blocks, brick cages)?

  • Are all floor openings securely covered or protected by barriers with toe boards to prevent falling objects?

  • Are safety nets suspended beneath roofing activities to capture falling personnel, materials or tools?

5) Energized Electrical

  • Is live work necessary and are all required Energized Electrical Work Permits in place?

  • Are approved Method Statements / Submittals and Risk Assessments in place for all EEW?

  • Is all required Personal Protective Equipment (PPE) available, suitable and in good working order?

  • Have all conductive items been removed / covered when working by exposed energy electrical sources?

  • Are all required tools, equipment and testing instruments appropriate, available and in good order?

  • Is all appropriate safety equipment in place (body hook, CO2 fire extinguisher(s), barricades)?

  • Any other Energized Electrical Work safety issues?

6) Control of Hazardous Energy

  • Is a "Permit to Work" in place for each activity involving COHE?

  • Is an approved Method Statement / Submittal and Risk Assessment in place for each COHE activity?

  • Have hazardous energy sources been identified and are required hazardous energy isolations in place?

  • Are isolation records in the job documentation (on the PreTask Plan)?

  • Are all required Lock Out / Tag Out ( LOTO) devices in place and are they adequately secured?

  • Is LOTO being undertaken and controlled by an "Authorized Person" with affected persons notified?

  • Any other Control of Hazardous Energies related issues?

Safe Behavior Observation (SBO)

  • Face / Eye PPE

  • Foot PPE

  • Hand / Arm PPE

  • Head PPE

  • Hearing PPE

  • Respiratory PPE

  • Fall Protection

  • Mobile Lifts

  • Electrical / GFCI

  • LOTO

  • Work Permits

  • Excavations

  • Hot Work

  • Storage Areas

  • Body position

  • Ladders

  • Scaffolds

  • Access / Egress

  • Barricades / signage

  • Slip / Trip / Fall

  • Lifting / Rigging

  • Confined Space

  • Equipment / Tools

  • Housekeeping

  • Lighting

  • Chemical

  • Material Handling

  • Other

  • Corrective Action
  • Description of issue including names

  • Owner of Corrective Action

  • Enter any corrective actions that will be undertaken (include ownership of CA)

  • Due Date of Corrective Action

  • Check if completed

PTP audit

  • Good PTP

  • All job steps identified

  • All hazards identified

  • All controls identified

  • Crew and foreman signatures

  • Observed work activities match PTP

  • Comments or corrective action(s)

Sign Off

  • Time completed

  • Lead M+W participant

  • Second M+W participant

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.