Title Page
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Region
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Crew
- Nowra 1
- Nowra 2
- Nowra 3
- Shellharbour 1
- Shellharbour 2
- Shellharbour 3
- Springhill 1
- Springhill 2
- Springhill 3
- Moss Vale 1
- Moss Vale 2
- Picton
- Narellan
- Hoxton Park
- Parramatta
- Kings Park
- Penrith 1
- Penrith 2
- Windsor 1
- Windsor 2
- Katoomba
- Bowenfels
- Springhill Tx
- Nowra Tx
- Glendenning Tx 1
- Glendenning Tx 2
- Glendenning Tx 3
- Bowenfels Tx
- Ulladulla
- Rapid Response
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Refresher Training Commenced
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Refresher Training Completed
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Prepared by
Crew Members
Crew Members
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Crew Members
Crew Members
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Name
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Service number
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Authorisation Number
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Authorisation date
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Team role
Equipment
HV Live Work Equipment Inspection
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EWP condition/visual Inspection - photograph basket and fly jib and general condition of booms
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EWP next test date
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Weekly Insulation Resistance Test (IRT) completed? Photograph results from IRT / Form
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Condition of earth lead - if response is fail, photograph damage
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Earth Lead next test date
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Mats condition/visual Inspection - if response is fail-remove from service, add photo that includes damage and equipment number
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Mats next test date
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Hard covers condition/visual Inspection - if response is fail-remove from service or repairs needed, add photo of damage and equipment number
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Hard covers next test date
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Sticks condition/visual Inspection - if response is fail-remove from service or repairs needed, add photo with damage and equipment number.
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Sticks next test date
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Temporary bonds condition/visual Inspection - if response is fail-remove from service or repairs needed, include photo of damage and equipment number
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Temporary bonds next test date
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Storage of Equipment on EWP
- Compliant
- Non-compliant
- Needs attention
- Needs urgent attention
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Gloves and Sleeves
Crew Member
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Name
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Glove & Sleeves condition/air test - if the response is fail remove from service, photograph damage/reason for fail
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Next Test Dates
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Leather protectors visual inspection - if response is fail - remove from service, photograph damage
Instruments (calibration dates)
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Laser thermometer calibrated and in date.
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Laser thermometer next calibration date.
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Tong ammeter calibrated and in date?
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Tong ammeter next calibration date.
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Insulation resistance tester calibrated and in date?
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Insulation resistance tester next calibration date.
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Range finder calibrated and in date?
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Range finder next calibration date.
Depot Storage Area
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Inspection
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Amount of Midspan Isolation Links
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Repairs - if response is replace, photograph the damage and equipment number.
Equipment Overall Comments and Summary of Action Items
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Comments
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Summary of action Items
Work Practices
Work Practices
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Worksite
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Date
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Worksite Address
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Task
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Overall photograph(s) of task
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WHRA
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Photograph/Screenshot from IPad WHRA - front and back
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HV Live Work Permit
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Photograph HV Live Work Permit - front & back
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Mechanical loading of conductors calculated before commencing?
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Screenshot of calculations.
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Appropriate HV Live Work Procedure(s) identified for the work?
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Glove & Barrier Procedure(s)
- G1 A
- G2 A
- G3A
- G3 B
- G3 C
- G3 D
- G3 E
- G3 F
- G4 A
- G4 B
- G4 C
- G5 A
- G5 B
- G5 C
- G5 D
- G5 E
- G5 F
- G6 A
- G6 B
- G6 C
- G6 D
- G6 E
- G6 F
- G6 G
- G6 H
- G6 I
- G7 A
- G7 B
- G8 A
- G8 B
- N/A
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Stick Procedure(s)
- S1 A
- S1 B
- S2 A
- S2 B
- S2 C
- S2 D
- S2 E
- S3 A
- S3 B
- S3 C
- S3 D
- S4 A
- S4 B
- S4 C
- S4 D
- S5 A
- S5 B
- S6 A
- S6 B
- S6 C
- S7 A
- S7 B
- N/A
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Position of EWP relative to job
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Photograph of EWP positioning
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Stability of EWP
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Name of Appointed observer(s)
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Observer well positioned to view all work
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Insulation rating
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Application of covers
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Safe Work Practices utilised?
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Quality of EWP operation
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Photograph work in progress
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Communication
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Electronic Communication needed?
Plant
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Endeavour Energy lifter borer / plant
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Name and service number
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Lifter/Borer Drivers Authorisation Number
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Plant Operators authorisation date.
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Contractor - Lifter borer / crane
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Company and name of plant operator
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Contract Plant Operator’s Authorisation Number
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Contractor Plant Operator Authorisation Date.
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Condition and position of earth lead - if response is fail, photograph damage etc...
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Is earth lead compliant with Endeavour Energy standards?<br><br><br><br>
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Next test date of earth lead
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Operator dressed in compliant clothing
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Overall condition of hydraulic system
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Control when lifting?
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Photographs of lift
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MInimum Approach Distance (MAD) maintained?
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Quality of communication between operator & plant safety observer
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Comments
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Action Items
Work Practices Overall Summary of Action Items
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Summary of action items from all worksites
Overall Comments and Sign Off
Overall Comments and Summary of all Action Items
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Comments
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Action items
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Overall rating of refresher training assessment.
Sign Off
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I am a representative of the crew
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Assessor - This is a true and correct assessment of the above HV live work crew