HSR 33 C - Site Audit Check

• Project Name

• Project No.

• Audited by

• Location
  Address

• Date

  Date

• Project Manager

• Supervisor

• Score

  Select 1 2 3 4

  • 1
  • 2
  • 3
  • 4

Crew Truck

• 1.1 First Aid Kit

  OK

  Needs Action

  N/A

• 1.2 Fire Extinguisher

  OK

  Needs Action

  N/A

• 1.3 Burns Kit

  OK

  Needs Action

  N/A

• 1.4 Spill Kit

  OK

  Needs Action

  N/A

• 1.5 Flashing Lights

  OK

  Needs Action

  N/A

• 1.6 Reversing Alarm

  OK

  Needs Action

  N/A

• 1.7 Burns Card

  OK

  Needs Action

  N/A

• 1.8 Emergency Procedures

  OK

  Needs Action

  N/A

• 1.9 Emulsion Tank

  OK

  Needs Action

  N/A

• 1.10 Emulsion Handspray Lance / Hose

  OK

  Needs Action

  N/A

Crew Van

• 2.1 First Aid Kit

  OK

  Needs Action

  N/A

• 2.2 Fire Extinguisher

  OK

  Needs Action

  N/A

• 2.3 Burns Kit

  OK

  Needs Action

  N/A

• 2.4 Spill Kit

  OK

  Needs Action

  N/A

• 2.5 Flashing Lights

  OK

  Needs Action

  N/A

• 2.6 Burns Card

  OK

  Needs Action

  N/A

• 2.7 Emergency Procedures

  OK

  Needs Action

  N/A

Signs Truck

• 3.1 First Aid Kit

  OK

  Needs Action

  N/A

• 3.2 Fire Extinguisher

  OK

  Needs Action

  N/A

• 3.3 Burns Kit

  OK

  Needs Action

  N/A

• 3.4 Spill Kit

  OK

  Needs Action

  N/A

• 3.5 Flashing Lights

  OK

  Needs Action

  N/A

• 3.6 Reversing Alarm

  OK

  Needs Action

  N/A

• 3.7 Burns Card

  OK

  Needs Action

  N/A

• 3.8 Emergency Procedures

  OK

  Needs Action

  N/A

Supervisors Ute

• 4.1 First Aid Kit

  OK

  Needs Action

  N/A

• 4.2 Fire Extinguisher

  OK

  Needs Action

  N/A

• 4.3 Burns Kit

  OK

  Needs Action

  N/A

• 4.4 Spill Kit

  OK

  Needs Action

  N/A

• 4.5 Flashing Lights

  OK

  Needs Action

  N/A

• 4.6 Burns Card

  OK

  Needs Action

  N/A

• 4.7 Emergency Procedures

  OK

  Needs Action

  N/A

Car Trailer

• 5.1 COF / WOF / Time Licence

  OK

  Needs Action

  N/A

• 5.2 Chains / Twitches

  OK

  Needs Action

  N/A

Transport Trailer

• 6.1 COF / WOF / Time Licence

  OK

  Needs Action

  N/A

• 6.2 Chains / Twitches

  OK

  Needs Action

  N/A

Chip Truck

• 7.1 First Aid Kit

  OK

  Needs Action

  N/A

• 7.2 Fire Extinguisher

  OK

  Needs Action

  N/A

• 7.3 Flashing Lights

  OK

  Needs Action

  N/A

• 7.4 Reversing Alarm

  OK

  Needs Action

  N/A

• 7.5 Roller Spreader

  OK

  Needs Action

  N/A

Chip Truck

• 8.1 First Aid Kit

  OK

  Needs Action

  N/A

• 8.2 Fire Extinguisher

  OK

  Needs Action

  N/A

• 8.3 Flashing Lights

  OK

  Needs Action

  N/A

• 8.4 Reversing Alarm

  OK

  Needs Action

  N/A

• 8.5 Roller Spreader

  OK

  Needs Action

  N/A

Tools and Equipment

• 9.1 Gas Bottles

  OK

  Needs Action

  N/A

• 9.2 Signs

  OK

  Needs Action

  N/A

• 9.3 Stands

  OK

  Needs Action

  N/A

• 9.5 Stop / Go Paddles

  OK

  Needs Action

  N/A

• 9.6 Brooms

  OK

  Needs Action

  N/A

• 9.7 Leaf Blower

  OK

  Needs Action

  N/A

• 9.8 Concrete Saw

  OK

  Needs Action

  N/A

• 9.9 Pic's

  OK

  Needs Action

  N/A

• 9.10 Shovels

  OK

  Needs Action

  N/A

• 9.10 Shovels

  OK

  Needs Action

  N/A

• 9.11 Leads Tagged - every 3 months

  OK

  Needs Action

  N/A

Machinery - Roller

• 10.1 ROPS / / BOPS / TOPS

  OK

  Needs Action

  N/A

• 10.2 Flashing Lights

  OK

  Needs Action

  N/A

• 10.3 Seat Belts

  OK

  Needs Action

  N/A

• 10.4 Handrails

  OK

  Needs Action

  N/A

• 10.5 Reversing Alarm

  OK

  Needs Action

  N/A

• 10.6 COF / WOF

  OK

  Needs Action

  N/A

Machinery - Roller

• 11.1 ROPS / / BOPS / TOPS

  OK

  Needs Action

  N/A

• 11.2 Flashing Lights

  OK

  Needs Action

  N/A

• 11.3 Seat Belts

  OK

  Needs Action

  N/A

• 11.4 Handrails

  OK

  Needs Action

  N/A

• 11.5 Reversing Alarm

  OK

  Needs Action

  N/A

• 11.6 COF / WOF / Time Licence

  OK

  Needs Action

  N/A

Machinery - Loader

• 12.1 ROPS / / BOPS / TOPS

  OK

  Needs Action

  N/A

• 12.2 Flashing Lights

  OK

  Needs Action

  N/A

• 12.3 Seat Belts

  OK

  Needs Action

  N/A

• 12.4 Handrails

  OK

  Needs Action

  N/A

• 12.5 Reversing Alarm

  OK

  Needs Action

  N/A

• 12.6 COF / WOF / Time Licence

  OK

  Needs Action

  N/A

Machinery - Broom

• 13.1 ROPS / / BOPS / TOPS

  OK

  Needs Action

  N/A

• 13.2 Flashing Lights

  OK

  Needs Action

  N/A

• 13.3 Seat Belts

  OK

  Needs Action

  N/A

• 13.4 Handrails

  OK

  Needs Action

  N/A

• 13.5 Reversing Alarm

  OK

  Needs Action

  N/A

• 13.6 COF / WOF / Time Licence

  OK

  Needs Action

  N/A

Machinery - Paver

• 14.1 Burners

  OK

  Needs Action

  N/A

• 14.2 ROPS / FOPS

  OK

  Needs Action

  N/A

• 14.3 Flashing Lights

  OK

  Needs Action

  N/A

• 14.4 Seat Belts

  OK

  Needs Action

  N/A

• 14.5 Handrails

  OK

  Needs Action

  N/A

• 14.6 Reversing Alarm

  OK

  Needs Action

  N/A

• 14.7 COF / WOF / Time Licence

  OK

  Needs Action

  N/A

• 14.8 First Aid

  OK

  Needs Action

  N/A

• 14.9 Fire Extinguisher

  OK

  Needs Action

  N/A

Machinery - Plate Compactor

• 15.1 Handrails

  OK

  Needs Action

  N/A

• 15.2 Plate

  OK

  Needs Action

  N/A

Sprayer

• 16.1 E2 Certificate

  OK

  Needs Action

  N/A

• 16.2 Transfer Hoses

  OK

  Needs Action

  N/A

• 16.3 Camlocks

  OK

  Needs Action

  N/A

• 16.4 Burner Tubes

  OK

  Needs Action

  N/A

• 16.4 Burner Tubes

  OK

  Needs Action

  N/A

• 16.5 Handspray Lances / Hoses

  OK

  Needs Action

  N/A

• 16.6 Handrails

  OK

  Needs Action

  N/A

• 16.7 Fire Extinguisher

  OK

  Needs Action

  N/A

• 16.8 First Aid Extinguisher

  OK

  Needs Action

  N/A

• 16.9 Burns Card

  OK

  Needs Action

  N/A

• 16.10 First Aid Kit

  OK

  Needs Action

  N/A

• 16.11 Burns Kit

  OK

  Needs Action

  N/A

• 16.12 Spill Kit

  OK

  Needs Action

  N/A

• 16.13 MSD Sheet

  OK

  Needs Action

  N/A

• 16.14 Emergency Plaquard / Stickers

  OK

  Needs Action

  N/A

Sprayer

• 17.1 E2 Certificate

  OK

  Needs Action

  N/A

• 17.2 Transfer Hoses

  OK

  Needs Action

  N/A

• 17.3 Camlocks

  OK

  Needs Action

  N/A

• 17.4 Burner Tubes

  OK

  Needs Action

  N/A

• 17.5 Handspray Lances / Hoses

  OK

  Needs Action

  N/A

• 17.6 Handrails

  OK

  Needs Action

  N/A

• 17.7 Fire Extinguisher

  OK

  Needs Action

  N/A

• 17.8 First Aid Extinguisher

  OK

  Needs Action

  N/A

• 17.9 Burns Card

  OK

  Needs Action

  N/A

• 17.10 First Aid Kit

  OK

  Needs Action

  N/A

• 17.11 Burns Kit

  OK

  Needs Action

  N/A

• 17.12 Spill Kit

  OK

  Needs Action

  N/A

• 17.13 MSD Sheet

  OK

  Needs Action

  N/A

• 17.14 Emergency Plaquard / Stickers

  OK

  Needs Action

  N/A

Bitumen Trailers

• 18.1 Transfer Hoses

  OK

  Needs Action

  N/A

• 18.2 Camlocks

  OK

  Needs Action

  N/A

• 18.3 Handrails

  OK

  Needs Action

  N/A

• 18.4 Burner Tubes

  OK

  Needs Action

  N/A

PPE

• 19.1 Hard Hats

  OK

  Needs Action

  N/A

• 19.2 Overalls

  OK

  Needs Action

  N/A

• 19.3 Safety boots worn

  OK

  Needs Action

  N/A

• 19.4 Safety Glassess

  OK

  Needs Action

  N/A

• 19.5 Ear Muffs / Ear Plugs

  OK

  Needs Action

  N/A

• 19.6 Day Glows

  OK

  Needs Action

  N/A

• 19.7 Gloves

  OK

  Needs Action

  N/A

• 19.8 Face Masks

  OK

  Needs Action

  N/A

Site Office / Yard

• 20.1 First Aid Kit

  OK

  Needs Action

  N/A

• 20.2 Fire Extinguisher

  OK

  Needs Action

  N/A

• 20.3 First Aid Extinguisher

  OK

  Needs Action

  N/A

• 20.4 Burns Card

  OK

  Needs Action

  N/A

• 20.5 Safety Shower

  OK

  Needs Action

  N/A

• 20.6 Safety Procedures

  OK

  Needs Action

  N/A

• Auditor Name & Signature

  Sign

• Project Manager Name & Signiture

  Sign

• Next audit date

  Date