Kris Nichols

• Work site name

• Sub-contractor name

• Conducted on

  Date
• Location
  Address

1 Documentation

• 1.1 Does the site have a visitor or daily sign in register ?

  Yes

  No

  N/A

• 1.2 Does the site have adequate fencing with contractors site signage with after hours contacts ?

  Yes

  No

  N/A

• 1.3 Check several inductions against the sign in register.

  Yes

  No

  N/A

2 High risk activities requiring a Safe Work Method Statement(SWMS)

• 2.1 Is there work conducted where a person could fall two metres or more?

• 2.1.1 The worker must have a SWMS for the activity that controls the risk of fall.

  Yes

  No

  N/A

• If scaffold is erected does it have adequate fall protection by way of a top rail, mid rail, mesh guard or toe rail and does it have an inspection tag and dated within the last 30 days?

  Yes

  No

  N/A

• 2.2 On or near electrical installation

• 2.2.1 Contractor must have a SWMS that controls the risk and may have a Lock Out Tag Out (LOTO)process ?

  Yes

  No

  N/A

• 2.3 On or near pressurised gas (air conditioning – LPG – Natural gas)

• 2.3.1 Contractor must have a SWMS that controls the risk and may have a Lock Out Tag Out (LOTO)process ?

  Yes

  No

  N/A

• 2.4 Mobile Plant

• 2.4.1 Contractor must have a SWMS to control the risk of using mobile plant and equipment.

  Yes

  No

  N/A

• 2.5 Possible disturbance of asbestos (any premises that were built before 31 Dec 2003)

• 2.5.1 Has the contractor checked the Asbestos register?

  Yes

  No

  N/A

• 2.5.2 Is the work in an area that has been indicated as having asbestos?

  No

  Yes

• 2.5.2.1 Does the contractor have a SWMS for the work indicating controls to eliminate dust release?

  Yes

  No

  N/A

• 2.5.2.2 Have the workers undertaken working with asbestos awareness training?

  Yes

  No

  N/A

• 2.6 Does the work involve demolition or the temporary support of a structure?

• 2.6.1 Does the contractor have a SWMS?

  Yes

  No

  N/A

• 2.7 Does the work involve a confined space?

• 2.7.1 Do they have a SWMS for the work?

  Yes

  No

  N/A

• 2.7.4 Have they completed an entry permit?

  Yes

  No

  N/A

• 2.8 Does the work involve the risk of drowning?

• 2.8.1 Do they have a SWMS for the task?

  Yes

  No

  N/A

3 General

• 3.1Is the contractor maintaining a clean and tidy work area ?

  Yes

  No

  N/A

• 3.2 Does the contractor have suitable first aid provisions ?

  Yes

  No

  N/A

• 3.3 Does the contractor know how to report an incident or a hazard that they cannot control ?

  Yes

  No

  N/A

• 3.4 Check an electrical switch board to see if leads are routed safely and that testing within 3 months has occurred.

  Yes

  No

  N/A

• 3.5 Generally speaking, are all workers wearing correct PPE, i.e. Safety boots, High Vis clothing and hard hats?

  Yes

  No

  N/A

• 3.6 Are any activities happening where you feel the need that the work is dangerous and harm may come to those involved? If yes ask questions relating the work process.

  Yes

  No

  N/A

4 Summary

• Write comments.

  No

  Yes

Sign Off

• Contractors sign off

  Sign

• Auditor sign off

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