Title Page
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Workplace
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Staff/Subcontractors
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Date & Time
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Inspected by
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Location
PERSONNEL ON SITE
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Are personnel wearing safety gear as required for the job they are doing?
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Is the correct PPE being used as required by the task? (e.g. Safety vest, safety boots, safety glasses, hard hat, gloves, earplugs/muffs, long - long compliance, dust mask, respirator, face guards, guards evident on machines)
GENERAL SITE
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Has the site been established correctly and are items safe and tidy?
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Are hazards identified, recorded and =trolled on the Daily Job Start?
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Have all staff and visitors signed the Daily Job Start?
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Are work instructions on site for work being undertaken?
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Are waratahs / reinforcing steel capped?
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Is the work site dean and free of clutter?
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Are tools and equipment safely stored? If excavating - have underground services been located?
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Has the Ministry of Business Innovation and Employment been informed if work is notifiable?
ENVIRONMENTAL WORK PRACTICES
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Are all environmental issues being addressed?
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1. If the work being undertaken under resource or building consent, is a copy of the consent onsite? And if required an up to date copy of the E&SC Plan on site? (PSMC If yes - tan TSL E&SC Inspection Form)
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2. If there is a dump site — Is the dumpsite clean, clear of debris and compliant with Env controls (If applicable?)
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3. Are fuels and chemicals properly stored on site?
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4. Is there any unplanned flora or fauna damage?
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5. Have dean water diversion bunds/channels been installed to separate run-offtstormwater from earthworks and tracking activities?
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6. Have the erosion control measures been installed in accordance with local Regional Council guidelines (e.g. contour drains, no-rap, geotextile, mulch)?
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7. Have the sediment control measures been installed in accordance with local Regional Council guidelines (e.g. silt fences, decanting earth bunds)?
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8. Are vehicle wheels and tracks carrying material off site?
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9. If lime, concrete, asphalt or emulsion is being used, have curb & channel, water-tables and cesspits been bunded or sealed.
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10, Is waste material being disposed of or stored correctly? (29 Rubbish)
PLANT/EQUIPMENT
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Is the following current and certified?
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Are all WOF / COF / Rego / RUC / TUC current?
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Do all drivers / operators have licences and endorsements?
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Is all tie down equipment in good condition?
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Are all drivers / operators wearing seat belts?
PUBLIC SAFETY
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Are the following being use where appropriate?
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Safety Mesh or Tape?
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Solid Barriers?
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Walkways or Temporary Footpaths?
TRAFFIC CONTROL
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Are the following being use where appropriate?
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Is a TMP required and on site?
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If so, is the TMP approved and current?
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Has the site been set out in accordance with the TMP?
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Is there an accredited STMS responsible for the site?
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Is the STMS available within the required timeframes?
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Has a traffic control checklist/audit been completed?
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Is there an escape route for the Traffic Controller?
EMERGENCY EQUIPMENT
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Are the following items of safety equipment available and checked?
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First Aid kits? Contents within expiry dates?
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Fire Extinguishers? Fire Extinguisher within test date?
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Is the site able to call for emergency assistance? (e.g. Fire, Police, Ambulance)
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Spill Kits? Check content.
ELECTRICAL EQUIPMENT
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Is all electrical equipment tested.tagged and protection used where required?
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Tools? (e.g. Drills and grinders)
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Extension Leads?
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RCD Protection?
GENERAL
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Are the following people safe/ visible and using the appropriate safety gear?
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Visitors
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Client/s Representative
SIGN OFF
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Any Other Comments
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Subcontractor's Signature
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Supervisor's Signature
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Contract Manager's Signature
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Auditor's Signature