HSEQ SIte Inspection Report - Do Not Use - duplicate

• ACE Job No.

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel Attending

Information on display

• Refer to the following Documentation and/or Standard Operating Procedures;
  'Health Safety Policy', 'Fitness for Work Policy', 'Equality and Diversity Policy', 'Quality Policy', 'Environmental Policy' & 'Code of Conduct Policy'.

• Are the abovementioned company policy's current & on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• 'If you are injured at work' poster on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Are the RTW Coordinator's contact details correct & on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP33EA) 'Important Return to Work Imformation' on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP20A) Site environmental protection plan on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP37A) Health and safety co-ordination plan on Display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Project Risk Register on Display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP33A) Site emergency evacuation plan & assembly points on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP33B) Site emergency contact numbers on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Administration

• Refer to the following Documentation and/or Standard Operating Procedures;

• (SOP09B) PMP (Project Management Plan) current & available onsite?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP09) Roles & Responsibilities have been defined and understood?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• TMP (Traffic Management Plan - incl. Traffic Guidence Scheme) approved & available onsite?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Submission, notification's & permits

• Current 'Dial before you dig' current?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• 'Notice of intention to perform construction excavation work' current?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• VicRoads MOA (Memorandum of Authorisation) current & valid?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP17V) Confined space entry permit current & valid?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18M) Hot works permit current & valid?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18P) Demolition permit current & valid?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Subcontractor

• (SOP14C) Subcontractor cababiliity assessement completed?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SPO18K) Review of Subcontractor SWMS current & Valid?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18K1) Subcontractor SWMS field implentation review current?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Project specific requirements

• Refer to the following Documentation and/or Standard Operating Procedures;
  

• (SOP18I) All workers onsite have completed a project induction?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18H) Site induction register current?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18G1) All plant has been inducted onto the project?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18G) All plant has been inducted onto the project?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18G) All plant has been inducted onto the project?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Category

• Refer to the following Documentation and/or Standard Operating Procedures;

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Site Security, Access & Egress

• Does this section relate to the project at the time of this Inspection?

  Yes

  Not Applicable

• Are fences in place and in good condition?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Ace's (Builders/construction) project information board located at the access gates and current?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Site signage appropriate placed and current to works being conducted?

  Yes

  No

  Not Applicable

• Is the Emergency Evacuation Point/s identified, marked and signage installed if/when placed outside work zone boundary?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Access for Emergency services observed to be unobstructed when request to attend site?

  Yes

  No

  Not Applicable

• Is there Fire Equipment located within the compound/site shed?

  Safe

  At Risk

  N/A

Trenching & Excavation

• Does this section relate to the project at the time of this Inspection?

  Yes

  Not Applicable

• What is the purpose of the Excavation/Trench works onsite?

  Select Telecommunications Drainage Non Destructive Digging Electrical Gas Sewer Water Other

  • Telecommunications
  • Drainage
  • Non Destructive Digging
  • Electrical
  • Gas
  • Sewer
  • Water
  • Other

• Have all underground services been located?

  Yes

  No

  N/A

• Is earth moving plant being used safely?

  Yes

  No

  N/A

• Are workers protected from trench collapse?

  Yes

  No

  N/A

• Are confined space precautions needed?

  Safe

  At Risk

  N/A

• Are people safeguarded from falling into excavations (i.e. webbing/temp fencing barriers installed)?

  Yes

  No

  N/A

• Is there safe access to trenches and shafts?

  Yes

  No

  N/A

• Is someone else always present when a worker is below ground?

  Yes

  No

  N/A

• Is placement of excavated materials/spoil appropriate?

  Yes

  No

  N/A

• Is there any evidence of surface cracking?

  Safe

  At Risk

  N/A

• Are walkways and bridges in good condition?

  Yes

  No

  N/A

Information on display

• Refer to the following Documentation and/or Standard Operating Procedures;
  'Health Safety Policy', 'Fitness for Work Policy', 'Equality and Diversity Policy', 'Quality Policy', 'Environmental Policy' & 'Code of Conduct Policy'.

• Are the abovementioned company policy's current & on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• 'If you are injured at work' poster on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Are the RTW Coordinator's contact details correct & on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP33EA) 'Important Return to Work Imformation' on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP20A) Site environmental protection plan on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP37A) Health and safety co-ordination plan on Display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Project Risk Register on Display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP33A) Site emergency evacuation plan & assembly points on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP33B) Site emergency contact numbers on display?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Administration

• Refer to the following Documentation and/or Standard Operating Procedures;

• (SOP09B) PMP (Project Management Plan) current & available onsite?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP09) Roles & Responsibilities have been defined and understood?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• TMP (Traffic Management Plan - incl. Traffic Guidence Scheme) approved & available onsite?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Submission, notification's & permits

• Current 'Dial before you dig' current?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• 'Notice of intention to perform construction excavation work' current?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• VicRoads MOA (Memorandum of Authorisation) current & valid?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP17V) Confined space entry permit current & valid?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18M) Hot works permit current & valid?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18P) Demolition permit current & valid?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Subcontractor

• (SOP14C) Subcontractor cababiliity assessement completed?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SPO18K) Review of Subcontractor SWMS current & Valid?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18K1) Subcontractor SWMS field implentation review current?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Project specific requirements

• Refer to the following Documentation and/or Standard Operating Procedures;
  

• (SOP18I) All workers onsite have completed a project induction?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18H) Site induction register current?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18G1) All plant has been inducted onto the project?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18G) All plant has been inducted onto the project?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• (SOP18G) All plant has been inducted onto the project?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

Site Security, Access & Egress

• Does this section relate to the project at the time of this Inspection?

  Yes

  Not Applicable

• Are fences in place and in good condition?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Ace's (Builders/construction) project information board located at the access gates and current?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Site signage appropriate placed and current to works being conducted?

  Yes

  No

  Not Applicable

• Is the Emergency Evacuation Point/s identified, marked and signage installed if/when placed outside work zone boundary?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Access for Emergency services observed to be unobstructed when request to attend site?

  Yes

  No

  Not Applicable

• Is there Fire Equipment located within the compound/site shed?

  Safe

  At Risk

  N/A

Trenching & Excavation

• Does this section relate to the project at the time of this Inspection?

  Yes

  Not Applicable

• What is the purpose of the Excavation/Trench works onsite?

  Select Telecommunications Drainage Non Destructive Digging Electrical Gas Sewer Water Other

  • Telecommunications
  • Drainage
  • Non Destructive Digging
  • Electrical
  • Gas
  • Sewer
  • Water
  • Other

• Have all underground services been located?

  Yes

  No

  N/A

• Is earth moving plant being used safely?

  Yes

  No

  N/A

• Are workers protected from trench collapse?

  Yes

  No

  N/A

• Are confined space precautions needed?

  Safe

  At Risk

  N/A

• Are people safeguarded from falling into excavations (i.e. webbing/temp fencing barriers installed)?

  Yes

  No

  N/A

• Is there safe access to trenches and shafts?

  Yes

  No

  N/A

• Is someone else always present when a worker is below ground?

  Yes

  No

  N/A

• Is placement of excavated materials/spoil appropriate?

  Yes

  No

  N/A

• Is there any evidence of surface cracking?

  Safe

  At Risk

  N/A

• Are walkways and bridges in good condition?

  Yes

  No

  N/A

• Does this section relate to the project at the time of this inspection?

  Yes

  Not Applicable
Asset/Plant No.

• Asset/Plant Image (for refernce only)

  Media

• Asset/Plant Identification Number :

• Plant Type?

  Select Excavator Backhoe/Loader Compactor Dozer Articulated/Dump Truck Grader Pad Foot Roller Water Cart Road Sweeper Scraper Posi Track/Skid Steer Elevated Work Platform Telescopic Handler Forklift Mobile Crane

  • Excavator
  • Backhoe/Loader
  • Compactor
  • Dozer
  • Articulated/Dump Truck
  • Grader
  • Pad Foot Roller
  • Water Cart
  • Road Sweeper
  • Scraper
  • Posi Track/Skid Steer
  • Elevated Work Platform
  • Telescopic Handler
  • Forklift
  • Mobile Crane

• Has operator correctly filled out & completed the daily pre-start?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Are the 'OEM (original equipment manufacturers) manual' available to operator/service person and in English?

  Yes

  No

  N/A

• Is the 'Plant Risk Assessment' available & current (no older than 2 years available on site)?

  Yes

  No

  N/A

• Are 'maintenance records' available & current (incl. Date/Hrs/Kms of last service)?

  Yes

  No

  N/A

• Have all and any previous faults with the plant or equipment all been repaired and signed off?

  Yes

  No

  N/A

• Is plant using incompatible or unsafe attachments?

  Safe

  At Risk

  N/A

• Flashing lights/beacons & movement warning alarms (squawker/beeper) fitted to plant in good condition & functioning as designed?

  Yes

  No

  N/A

• Are 'ROPs (rollover protection structures)'/'FOPs (falling object protective structures)' provided on all mobile plant that require ROPs/FOPs?

  Yes

  No

  N/A

• Is fire extinguisher mounted in cab or externally & inspected within last 6 months?

  Yes

  No

  N/A

• Is the 'SWL (Safe Working Load)' of the plant clear & displayed?

  Yes

  No

  N/A

• Are 'seat belt/s' available for all plant in good condition & functioning as designed?

  Yes

  No

  N/A

• Other safety features operable? E.g. Emergency STOP, reversing camera or sensors?

  Yes

  No

  N/A
Observation (i.e. hazards and/or faults, ) No.

• Observation details:

  Safe

  At Risk

  N/A

Inspection Sign Off

• Refer to the following Documentation and/or Standard Operating Procedures
  - SOP03 Management System
  - SOP19 Quality Management
  - SOP30 Communication & Consultation
  

• HSEQ Advisor

  Sign

• Project Manager

  Sign

• Site Manager

  Sign
Other

• Name & Sign

  Sign

Category

• Refer to the following Documentation and/or Standard Operating Procedures;

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable

• Question?

  Conforming aspects:

  Observations:

  Nonconforming

  Not Applicable