Title Page

  • Conducted on

  • Auditor

  • Operative 1

  • Operative 2

  • Contract

  • Project Manager

  • Address

1. Site Documentation

  • 1.1 Have the team completed the SSRA and have all visitors & agents signed on?

  • 1.2 Is a copy of the van pack on site?

  • 1.3 Are copies of all mains records on site, in colour and in date?

  • 1.4 Is the team in possession of a DNO ID Card or covering letter and are their copies of authorisations on site?

  • 1.5 Do team have NERS passport on site and is it signed by all visitors?

  • 1.6 Do team have a copy of the Distribution safety rules onsite?

2. Vehicle

  • 2.1 Have the team completed a Visual daily check of the vehicle?

  • 2.2 Does the vehicle have fitted an in date secured 2kg dry powder fire extinguisher?

  • 2.3 Is the vehicle parked as not to cause obstruction or hazard?

  • 2.4 Is a no smoking sign present in the vehicle cab and is the vehicle smoke free?

  • 2.5 Are loads safe and correctly secured to the vehicle?

3. Tools

  • 3.1 Are all tools of the approved type?

  • 3.2 Are all insulated tools in good condition?

  • 3.3 Are any test lamps in good working order and of the correct type?

  • 3.4 Are all tool in good condition? (i.e. no loose hammer heads, mushroomed chisel heads etc)

  • 3.5 If a rule is available, is it made of a non-metallic material?

4. Are all electrical tools within their test calibration period and labelled accordingly? Please provide calibration due date.

  • 4.1 Loop Tester

  • 4.2 Proving Unit

  • 4.3 Megga

5. PPE

  • 5.1 Is PPE ARC rated where required and in suitable condition? (No rips/tears or scratches on visor etc)

  • 5.2 Are the jointers wearing insulated boots and gloves?

  • 5.3 Does Jointer have spare PPE available (e.g. Gloves, Visor, Coveralls)

  • 5.4 Is the correct PPE being worn for the task being undertaken?

6. Excavation

  • 6.1 Is excavation sufficient depth and width?

  • 6.2 Is suitable access and egress made available for the excavation? (step in/out)

  • 6.3 Is street furniture suitable supported?

7. Chapter 8

  • 7.1 Does Jointer/ Jointers Mate have NRSWA Card?

  • 7.2 Is all chapter 8 on site in place and secured?

  • 7.3 Is courtesy board and correct permit number onsite and visible?

8. First Aid

  • 8.1 Is at a minimum 1 x First Aider on site?

  • 8.2 Is a First Aid kit available?

  • 8.3 Is a Burns kit available?

9. Health

  • 9.1 If vibrating tools are being used on site, are Jointers aware of controls?

  • 9.2 Where dust is being produced, are staff segregated from activities to prevent inhalation or have suitable PPE available?

  • 9.3 Is ear defence available on site if required and in good condition?

  • 9.4 Are arrangements in place to allow hand cleaning prior to eating?

  • 9.5 Have suitable welfare facilities been identified for use?

  • 9.6 Does the team have sufficient COVID 19 sanitising equipment? I.e. hand gel, wipes/disposable gloves/visors etc?

10. Quality

  • 10.1 Is the cable depth correct?

  • 10.2 Is the duct at the correct depth?

  • 10.3 Is the Tile Tape correct at point of installation?

  • 10.4 Is the Tile Tape secure?

  • 10.5 Are works provided by 3rd parties i.e. builders to correct spec? If not have team reported it?

11. Environment

  • 11.1 Is a spill kit available on site?

  • 11.2 Is waste correctly segregated for disposal?

  • 11.3 COSHH stored correctly?

  • 11.4 Are the team aware of their environmental controls (Spills etc)?

  • 11.5 Is van engine kept running when not in use?

12. Working at Heights (WAH)

  • 12.1 Are the team using assisted WAH (ladders/harness/MEWP) equipment? If yes complete WAH inspection For specific WAH compliance, if not continue on QF023

  • 12.2 Are the controls in the RAMS for working at height suitable for the task (discuss with the team)?

13. Pre / Post Commissioning test's

  • 13.1 Have all Pre / Post commissioning test’s been completed?

  • 13.2 Have all appropriate test readings been recorded?

14. Incident Reporting & Briefings

  • 14.1 Are team aware of correct incident reporting process?

  • 14.2 Do the team know how to a raise close call and have access to do so?

  • 14.3 Have the team raised any close calls on this site (if there are none, tick pass).

  • 14.4 Are the team aware of how briefings are being distributed (email and Metacompliance) and if so are they up to date with all communicated briefings? (ask them to confirm the last issued brief).

15. Materials

  • 15.1 Does the jointer and team believe they have all the correct material to complete the task in hand?

Debriefing

  • Have the team been debriefed on the findings?

  • Any further feedback?

Non-Conformances / Sign Off

  • Is this audit free from any NON-CONFORMANCES. If you have identified any non-conformances what have you done about it before leaving site.

  • Auditors Signature

  • Team Leaders Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.