Internal Assessment for MC/CC

• Conducted on

  Date

• MC/CC Supplier

• Machine Controller being Checked

• Location
  Address

Inspector/Auditor Details

• Inspector Name

• Inspector Sentinel Number

• Inspector Signature

  Sign

Machine/Crane Controller Details

• Name

• Sentinel Number

• PTS Expiry Date

  Date

• Sponsor name (for current job)

• Photo of Sentinel Card

  Media

• Signature of Machine Controller

  Sign

OTP Operator Details

• Name

• Sentinel Number

• PTS Expiry Date

  Date

• Take a Picture of the sentinel card

  Media

• Operators Capabilities certificate

  CPCS

  Company Issued Certificate

  Other

• Take a photo of the certification

  Media

• Does the certification cover the duties to be conducted/machines and equipment to be used during the shift?

  Yes

  No

  N/A

• Possession & Worksite Limits Defined & Briefed?

  Yes

  No

  N/A

• Are the lines under possession?

  Yes

  No

  N/A

• Has the operator conducted pre-start checks

  Yes

  No

  N/A

• Operator signature

  Sign

Machine Details

• Type & Make of Machine

• Take a picture of the machine

  Media

• Has the machine got an engineering acceptance certificate?

  Yes

  No

  N/A

• Is one or more trailers being used?

  No Trailers

  Yes, one or more being used

• Is the equipment supplied different to that planned has the MC reviewed to determine its suitability to perform the task?

  Yes

  No

• Are any attachments being used?

  Yes

  No

• What type of attachment is it? is it in date and calibrated? is it in good condition?

  Yes

  No

  N/A

Plant Operation Supervisor (POS)

• POS Name

• Sentinel Number

• Photo of Sentinel card

  Media

• Does the POS hold a valid competence ticket for this role?

  Yes

  No

  N/A

• PTS Competence Expiry

  Date

Machine/Crane Controller Checklist OTP

• Have arrangements have been put in place for test the traction current before work?

  Yes

  No

  N/A

• Is the MC/CC acting as the COSS?

  Yes

  No

  N/A

• Task Briefing Sheet number

• Is task briefing valid for actual work been carried out?

  Yes

  No

  N/A

• Has the OTP operator been briefed and signed the task briefing sheet?

  Yes

  No

  N/A

• Does the MC have all the necessary OTP checklist to undertake his duties?

  Yes

  No

  N/A

• Has the MC/CC been issued with a traction current Permit?

  Yes

  No

  N/A

• Does the MC/CC have suitable Detcom/Digital Duplex equipment that has been tested and in working order?

  Yes

  No

  N/A

• Has the MC/CC briefed the operator on the requirements and factors that may influence the work within the method statement?

  Yes

  No

  N/A

• Is the site lighting adequate for the task performed?

  Yes

  No

  N/A

• Does the MC/CC have immediate access to the appropriate protection equipment, (Detonators, Flags etc...) this includes 10 dets, 2 Track Circuit Operating Clips, Red Flag and lamp with Green and Red aspects

  Yes

  No

  N/A

• Are height & side clearances adequate and appropriate arrangements in place?

  Yes

  No

  N/A

• Have the height and slew limits been set as required? (If Required)

  Yes

  No

  N/A

• Are the correct On & Off tracking facilities available to machines that require them and conditions compliant to machine limitations?

  Yes

  No

  N/A

• Has the MC/CC witnessed a functional brake test?

  Yes

  No

  N/A

• Have all pre start functional and operational checks on machinery been completed?

  Yes

  No

  N/A

• Does all the equipment provided meet the requirements of the lifting plan and are SWL's available/<br>

  Yes

  No

  N/A

• Are lifting operations involved in the task?

  No

  Yes

PPE

• High Visibility Clothing (sponsor endorsed) and approved PPE worn correctly?

  Yes

  No

  N/A

• CC/MC wearing their armlet/badge correctly?

  Yes

  No

  N/A

• Are there any Close Calls that need to be raised?

  No close calls to raise

  Yes

• Was any equipment or machinery removed from use?

  No equipment/machinery removed

  Yes, items removed

• Please list any recommendations or feedback that can be given as a result of this inspection

Recommendation/Feedback

• Please give details

MC/CC Supplier follow up required

• This section is to be completed after the inspection/audit by the *** representative assigned to close out this feedback/recommendation

• Name of *** Representative

• Details of what actions were taken in relation to this feedback/recommendation

• Date this action was closed out

  Date