Information

  • Branch/ Location:

  • Inspected by:

  • Sub Contractor:

  • Job Number:

  • Job Name:

  • Conducted on

Revision Information

  • This record is compliant with the requirements of HSF14.4 issue 0. This is electronic issue 1.0 issued on 08/11/2016

Sub standard condition

  • If sub standards exist please use the following codes:
    A = Issue to be attended to immediately
    B = To be attended to by the indicated date
    C = Investigation meeting required
    T = Training required

Site / Vehicle / Resource

  • Punctual (checking signing in / out)

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Parked in a designated area?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Reverse parked?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Number of operative(s) on site satisfactory

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • All operatives hold ECS or equivalent

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Waste material and storage of kit?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Work standard (current progress)

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • General quality of workmanship

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

Personal protective equipment / uniform

  • Correct PPE for the task?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Correct plant for the task?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Plant tagged and valid?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Appropriate Attire (Tyco T Shirt)?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • All 230v devices PAT Tested?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Valid relevant license for plant e.g. IPAF ?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

Documentation / General

  • Job spec / method statement?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Copy of RAM's / Zero Harm Form.

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Company Identity Card?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Drawings?

  • Please provide any comments

  • Please select the follow up category:<br>

  • Please indicate the follow up date.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please record your actions.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please indicate the time and date of the investigation meeting.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

  • Please provide details of the training requirements.

  • Please provide any comments

  • Is manager escalation required?

  • Please provide names and issues

Site Operatives

  • List all names of operatives on site working for the contractor / vendor

  • Please record any relevant notes regarding the operatives on site

Audit completion

  • Any comments / Actions:

  • Managers Signature

  • Contractors Signature

  • Are any further actions required?

Corrective Action

  • Removal of plant

  • Please provide your comments

  • Removal of operative(s)

  • Please provide your comments

  • Report to procurement / management

  • Please provide your comments

  • Suspend works

  • Please provide your comments

  • Training / TBT

  • Please provide your comments

  • Investigation meeting required

  • Date carried out

  • Yellow / Red card issued

  • Please provide your comments

  • Additional details from corrective action(s): (detail any supporting documents)

Closed out / confirmation of Corrective Actions Complete

  • All corrective actions are complete and this spot check is now closed.

  • Name

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