Hydrant clean out audit

• Document No.1

• Hydrant maintenance

• Conducted on

  Date

• Nick Ambrosini

• Location
  Address

WH&S

• Do all workers have construction induction cards on site?

  Safe

  At Risk

  N/A

• Does the contractor have current level 2 traffic control?<br>Maintenance agreement No C656. 3.1a)

  Safe

  At Risk

  N/A

• Are all workers wearing appropriate PPE?

  Safe

  At Risk

  N/A

• Is there adequate traffic control in place?<br>Scope of services: specifications <br>Provision of inspection and corrective maintenance. 10

  Safe

  At Risk

  N/A

• Is there an adequate first aid kit on site?

  Yes

  No

  N/A

Work quaity

• Does the team communicate well?

  Yes

  No

  N/A

• Has the hydrant been satisfactory cleaned out?<br>Maintenance agreement No. C656. 9.2b)

  Yes

  No

  N/A

• Have the lug bolts been cleaned?<br>Bolts to be cleaned so condition can be recorded in report

  Yes

  No

  N/A

• Are all hydrant. markings to QUU requirements?<br>Cats eye & yellow arrow replaced as required and cover & surround<br> of hydrant painted yellow

  Yes

  No

  N/A

• Has the hydrant inspection form been complete?

  Yes

  No

  N/A

• Has the site been left clean &tidy?<br>Maintenance agreement No. C656. 10.3a)

  Yes

  No

  N/A

• Comments/Observations

• Completed by

  Sign