Title Page

  • Conducted on

  • Prepared by

  • Number of people on site

  • Others on site (client, subcontractors, etc.):

Traffic Management

1.0 TRAFFIC MANAGEMENT

  • 1.1) Traffic Management Layout Implemented:

  • Other Traffic Management Layouts implemented:

  • 1.2) Condition of Traffic Management on-site:

  • Items requiring improvement:

  • Other elements of traffic management that require improvements:

  • Instruction given to contractor:

  • Action taken by contractor:

  • 1.3) impact of traffic management on traffic

  • 1.4) Is the site adequately secured?

  • Why not? was the contractor notified?

  • 1.5) Other comments:

  • Insert site photos:

Site condition and H&S

2.0 SITE CONDITIONS

  • 2.1 ) Weather

  • 2.2) Wind

  • 2.3) Site condition

  • 2.4) Other comments:

3.0 HEALTH AND SAFETY

  • 3.1) Site induction / sign in completed?

  • Reason and action taken:

  • 3.2) Additional Hazards not identified in the induction / pre-start:

  • 3.4) H&S incident occur while on site (or on the day)?

  • Description of incident:

  • Actions taken by the contractor:

  • Instructions given to the contractor:

  • Insert Site photos

Environmental Management

4.0 ENVIRONMENTAL MANAGEMENT

  • 4.1) Was the full perimeter of the work site inspected?

  • 4.2) Erosion and sediment control measures installed on site:

  • Action taken / instructions given to contractor:

  • 4.3) Condition of measures on site:

  • Action taken / instructions given to contractor:

  • 4.4) Additional comments

  • Insert site photos:

Work Activities

5.0 Work activities on site / progress / general comments regarding progress

  • 5.1) Plant on site:

  • PLant type and number on site:

  • 5.2) ACTIVITY:
  • Work activity:

  • General Comments on progress - testing, inspections, % complete, delays/issues/ breakdowns:

  • Actions to be followed up:

  • Instructions given to contractor

  • Insert photos:

  • 5.3) Other comments:

  • Insert photos

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