Title Page
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Audit Title
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Site
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Conducted on
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Location
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Client
- Queensland Urban Utilities - QUU
- Unity Water
- Watercorp
- Sydney Water
- Gold Coast City Council
- Other
Safety Conversation
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Safety Share/ Discussion (Details)
Personnel Details
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Work Group?
- Lining Crew
- Cutting Crew
- Civil Crew
- Cleaning Crew
- Interfit Crew
- Grouting Crew
- Office Staff
- Subcontractor
- Other
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SNRP Details
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Interflow Worker(s) Details
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Add media
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Contractor(s) Details
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Add media
Work Pack Risk Assessment Process
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Work Pack completed in full consultation- includes Subcontractors?
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WMS correctly identified and reviewed?
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Are any High Risk Activities Being Undertaken? If yes identify activities
- Confined Space Entry
- Excavation & Trenching
- Electrical
- Hazardous Chemicals
- Working At Height
- Hazardous Manual Tasks
- Plant & Equipment - use of VLC
- Working Adjacent to Roadway - Traffic Management
- Energy Isolation Lock Out Tag Out
- Lifting & Pulling Activities
- Working Adjacent to Water
- Lone Worker
- Demolition Works
- Scaffolding
- Asbestos removal or handling
- High Pressure Equipment
- Diving Work
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Identify Discussion Points: i.e. Safety Alert/ Lessons to be learned (L2BL)
Photos
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Representative Completing Safety Observation
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First and last name
