Title Page

  • Asset Number

  • Type of Device

  • Location
  • Conducted on

  • Prepared by:

WHS Requirements

Pre Start Checklist

  • Have all personnel onsite been inducted?

  • Are records of toolbox talks available?

  • Are all personnel equipped with appropriate PPE gear?

  • Are first aid kits and nominated first aid officers available onsite?

  • Are spill kits available onsite?

  • Photograph of site:

Maintenance Form

Maintenance Form

  • Details of Unit (type, capacity, access requirements)

  • Quantity of material removed (t)

  • Type of material

Condition of GPT and Surrounds

  • Is there any vandalism evident?

  • Add media

  • Is there any erosion evident?

  • Action taken

  • Add media

  • Condition of Inlet

  • Details

  • Add media

  • Condition of Outlet

  • Details

  • Add media

  • Condition of Downstream Line

  • Details

  • Add media

  • Photos of Completed Works

  • Add media

Cost Sheet

Cost Sheet

  • Labour Daily Costs

  • Plant Daily Costs

  • Materials & Storage Issues

  • Total Hours Onsite

  • Type of Machinery Used

  • Future Recommendations

  • Recommended frequency

Contractor Details

  • List Contractors Used

  • Contractor Performance

  • MCC Representative

  • Add signature

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