J&R Site Audit - Original

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. Adminstrative

• 1.1. Has a Hazard ID has been filled out, everyone signed on and Hazards recorded including pre-start meeting

  Yes

  No

  N/A

• 1.2. Have you been asked to sign in and informed of hazards on this site

  Yes

  No

  N/A

• 1.3. Drill checklist filled out - (check with drill crew) - Excavation & Drilling Permit filled in

  Yes

  No

  N/A

• 1.4. H&S folders readily accessible

  Yes

  No

  N/A

• 1.5. A written H&S plan for project was prepared prior to work commencing and is available to view by all on site?

  Yes

  No

  N/A

• 1.6. Have you had Near Miss, First Aid or Incident Reports from this site

  Safe

  At Risk

  N/A

• 1.7. Has the supervisor on site done the "Summary of Findings" on all incidents

  Yes

  No

  N/A

2. Training and General

• 2.1. All workers carrying out work have received the general H&S induction training

  Yes

  No

  N/A

• 2.2. All workers have had on site induction training

  Yes

  No

  N/A

3. Work Environment

• 3.1. Has the site been maintained such that it is clean and in a safe condition

  Yes

  No

  N/A

• 3.2. Work areas are clearly defined

  Yes

  No

  N/A

• 3.3. Workers have been provided with protection whilst working in extremes of heat or cold

  Yes

  No

  N/A

• 3.4. Workers have adequate sun protection

  Yes

  No

  N/A

• 3.5. Workers are not exposed to noise in excess of the exposure standard for noise

  Yes

  No

  N/A

• 3.6. The risks to H&S associated with any hazardous manual tasks have been identified and managed

  Yes

  No

  N/A

• 3.7. Are there adequate facilities for workers, including toilets and washing facilities

  Yes

  No

  N/A

• 3.8. Is clean, potable drinking water available on site

  Yes

  No

  N/A

• 3.9. Is a first aid kit available and sufficiently stocked

  Yes

  No

  N/A

• 3.10. Is there an adequate number of first aiders on site

  Yes

  No

  N/A

4. Housekeeping

• 4.1. Layout of site allows, and site is maintained as to allow, for persons to enter and exit and move about without risk, both under normal working conditions and in an emergency?

  Yes

  No

  N/A

• 4.2. Spoil is covered and disposed of appropriately

  Yes

  No

  N/A

• 4.3. Sufficient area has been allowed to safely store materials or plant

  Yes

  No

  N/A

• 4.4. Protruding objects that are a hazard have been made safe

  Yes

  No

  N/A

• 4.5. Steel plates are used correctly and present no trip hazard

  Yes

  No

  N/A

• 4.6. Are specific dangers on site, e.g. excavations, being made safe during non- working periods

  Safe

  At Risk

  N/A

• 4.7. Are Kerblines free of stones and debri - sucker truck in use

  Yes

  No

  N/A

5. Plant, Vehicles & Equipment, incl, Diggers & Drills

• 5.4. Has a recent maintenance, inspection been carried out?

  Yes

  No

  N/A

• 5.1. All Plant & Equipment chained up or locked away when not in use or overnight?

  Yes

  No

  N/A

• 5.2. Are all attachments used with plant/equipment safe?

  Safe

  At Risk

  N/A

• 5.3. Is the correct plant /equipment being used for job? (e.g. grinding discs for cutting)

  Yes

  No

  N/A

• 5.6. Has a daily inspection been done today, checking oil, water, controls where appropriate?

  Yes

  No

  N/A

• 5.5. Have all drivers / operators got the correct licenses?

  Yes

  No

  N/A

• 5.7. Fire extinguisher is available and has been recently serviced

  Yes

  No

  N/A

• 5.8. Chocks are available and are being used

  Yes

  No

  N/A

• 5.9. Loading is correct and not overfilled

  Yes

  No

  N/A

• 5.10. Beacon lamps are in operation while vehicles are in use?

  Yes

  No

  N/A

• 5.11. All plant operation procedures are available on site, e.g. Jack hammer, Concrete Saw?

  Yes

  No

  N/A

6. Hazardous Substances (including fuel and oil)

• 6.1. Are hazardous substances stored correctly? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)

  Yes

  No

  N/A

• 6.2. Is there spill containment equipment on site

  Yes

  No

  N/A

• 6.3. Are Safety Data Sheets accessible on site?

  Yes

  No

  N/A

• 6.4. Are suitable storage containers being used for 4 stroke, 2 stroke and diesel?

  Yes

  No

  N/A

7. Emergency Response

• 7.1. Has an Evacuation Point been established and communicated to all?

  Yes

  No

  N/A

• 7.2. Is there an Emergency Plan on site?

  Yes

  No

  N/A

• 7.3. Are all methods of communication in good working condition?

  Yes

  No

  N/A

• 7.4. Are all staff clear on what to do in an Emergency?

  Yes

  No

  N/A

8. Traffic Management

• 8.1. A Traffic Management Plan (TMP) has been approved and is on site?

  Yes

  No

  N/A

• 8.2. Is there is a trained STMS or TC on site, have they got their card with them?

  Safe

  At Risk

  N/A

• 8.3. Dates on TMP are current? (if not is an extension letter on site?)

  Yes

  No

  N/A

• 8.4. Any changes to TMP have been recorded?

  Yes

  No

  N/A

• 8.5. Cones and signs in good condition?

  Yes

  No

  N/A

• 8.6. Daily records are being maintained?

  Yes

  No

  N/A

• 8.7. Signs are erected as per TMP?

  Yes

  No

  N/A

9. Personal Protective Equipment (PPE)

• 9.1. Correct PPE being worn - FR for Vector sites

  Yes

  No

  N/A

• 9.2. Hard hats worn except in digger/truck?

  Yes

  No

  N/A

• 9.3. Glasses worn except in digger/ trucks?

  Yes

  No

  N/A

• 9.4. Lace up over ankle boots worn by all?

  Yes

  No

  N/A

• 9.5. Have workers been trained in safe use of PPE?

  Yes

  No

  N/A

10. Electrical Hazards

• 10.1. Electrical leads are arranged to avoid damage

  Safe

  At Risk

  N/A

• 10.2. Leads and tools not used in damp or wet conditions unless they have been specifically designed to do so

  Safe

  At Risk

  N/A

• 10.3. Electrical equipment has been inspected, tested and tagged?

  Yes

  No

  N/A

11. Environmental Hazards

• 11.1. Is there an environmental plan on site

  Yes

  No

  N/A

• 11.2. Is there silt control in place and is it doing its job?

  Yes

  No

  N/A

• 11.3. Check for trees on site - are they protected and nothing is stored under dripline ?

  Yes

  No

  N/A

• 11.4. Has an arborist been contacted and work approved?

  Yes

  No

  N/A

• 11.5. Is there a copy of a tree consent on site

  Yes

  No

  N/A

• 11.6. Have Environmental issues been discussed at pre site meeting? Check Hazard ID

  Yes

  No

  N/A

12. Confined Spaces / Deep Excavations

• 12.1. All confined spaces /excavations over 1.5m deep have been reported to Worksafe NZ?

  Yes

  No

  N/A

• 12.2. Risk assessments for CS/DE hazards are reviewed by competent person to reflect any review or revision of control measures?

  Yes

  No

  N/A

• 12.3. Workers that have been or about to enter CS or DE hold appropriate qualifications?

  Yes

  No

  N/A

• 12.4. Appropriate signage has been erected for all CS / DE?

  Yes

  No

  N/A

• 12.5. Unauthorized entry has been restricted by barriers and appropriate shoring is in place?

  Yes

  No

  N/A

• 12.6. Spoil, stacked materials or plant is stored at least 600mm from edge of excavation?

  Safe

  At Risk

  N/A

• 12.7. All staff know what to do in the event of a collapse?

  Yes

  No

  N/A

• 12.8. Confined spaces procedure is available on site?

  Yes

  No

  N/A

13. Underground Services - Drilling Crews (Check Excavation & Drilling Permit)

• 13.1. The risks associated with any essential services have been identified and managed?

  Yes

  No

  N/A

• 13.2. Appropriate service plans are on site?

  Yes

  No

  N/A

• 13.3. Mark outs have been done and are visible?

  Yes

  No

  N/A

• 13.4. Utility lines located by hand digging?

  Yes

  No

  N/A

• 13.5. Stand overs have been organised or have been done where appropriate?

  Yes

  No

  N/A

14. Excavations including exit and entry holes

• 14.1. Barricades have been erected around hole?

  Safe

  At Risk

  N/A

• 14.2. Barricades are in good repair?

  Yes

  No

  N/A

• 14.3. Backfilling has been completed to the required standard?

  Yes

  No

  N/A

Corrective Actions

• Enter any corrective actions that will be undertaken

Sign Off

• On site representative

  Sign

• Auditor's signature

  Sign