Information
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Work Order / Service Request Number
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Date and Time of Audit
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Site Address
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Is this required for this audit? SECTION A (Where audit is only to be conducted on external plant hired then go to SECTION B)
- Yes
- No
SECTION A - can be used for Council works that includes Council employees and /or contractors working for Council under minor works or tender. (if an audit is only to be conducted on external plant hired then go to SECTION B)
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Person in Charge:
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Personnel on site:
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Activity at site:
SECTION A - Audit
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1 - Has a worksite Job Risk Analysis been conducted?
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JRA Date:
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JRA Work Order Number:
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JRA Location:
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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2 - Has the Job Risk Analysis been conducted in consultation with affected employees, subcontractors and OH&S representatives on site?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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3 - Pre-start checklists filled out & being returned weekly?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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4 - Plant operators competent: CCF Card (or like), relevant motor vehicle licence sighted?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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5 - Required PPE worn by all on site: including appropriate sun protection?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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6 - Person in charge has current traffic management accreditation.
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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7 - Traffic management plan / procedure developed for work at this site/or for this activity - has it been sighted?
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TMP Date:
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TMP Work Order Number:
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TMP Location:
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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8 - On site traffic guidance scheme installed as per traffic management plan / procedure?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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9 - Changes to TMP / procedures recorded?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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10 - Speed limit used?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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11 - Speed limit relevant?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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12 - Traffic flowing smoothly?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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13 - Are there delays occurring?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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14 - Vehicle mounted warning devices operational?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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15 - All plant free of obvious leaks and defects?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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16 - Traffic controllers being used?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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17 - Traffic controllers appropriately positioned?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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18 - Traffic controllers currency of competency?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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19 - Be prepared to stop signs used with traffic controllers?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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20 - Traffic signals being used (mobile lights)?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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21 - Advance warning signs used?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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22 - Correct location / positioning of advance warning signs?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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23 - Other warning and regulatory signs used and appropriately positioned?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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24 - Inappropriate signs covered?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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25 - Road condition signs required?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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26 - Road condition signs placed?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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27 - All sign mounting systems secure?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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28 - Delineators in good order and placed appropriately?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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29 - Work area / work site delineated appropriately?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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30 - End works / speed limits reapplied?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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31 - Long term after hours traffic management?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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32 - After hours procedure or plan developed?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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33 - After hours plan available to view?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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34 - Traffic management scheme effective?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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35 - Traffic guidance scheme check frequency.
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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36 - Site free of controllable hazards?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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37 - All hazards considered in traffic management plan?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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38 - Other?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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Is this required for this audit? SECTION B (To be used for all external plant hired. If already identified in Section A then Refer Section A column)
- Yes
- No
SECTION B (To be used for all external plant hired. If already identified in Section A then Refer Section A column)
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Person in charge:
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Personnel on site:
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Plant item 1
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Plant type?
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Make?
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Model?
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Rego?
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Plant item 2
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Plant type?
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Make?
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Model?
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Rego?
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Plant item 3
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Plant type?
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Make?
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Model?
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Rego?
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Plant item 4
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Plant type?
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Make?
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Model?
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Rego?
SECTION B - Audit
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39 - Has the Job Risk Analysis been sighted by the operator?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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40 - Pre-start checklists filled out & kept in vehicle?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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41 - Plant operators competent: CCF Card (or like), relevant motor vehicle licence sighted?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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42 - Plant operators White Card?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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43 - Required PPE worn by all on site: including appropriate sun protection?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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44 - Traffic management plan / procedure developed for work at this site/or for this activity - has it been sighted by the operator?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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45 - Vehicle mounted warning devices operational?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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46 - All plant free of obvious leaks and defects?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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47 - Insurance Certificates of Currency current & on file?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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48 - Plant Items Risk Assessments held on file?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
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49 - Other?
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Items to be rectified and resolution if resolved during the audit:
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Attach photo or other if applicable
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Due by?
References
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Traffic Act 1925
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Tasmanian Traffic Control at Work Sites Code of Practice June 2004
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AS1742.3
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Disability Service Act 2011
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Workplace Health & Safety Regulations 2012
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Traffic (Road) Rules Regulations 1999
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General Specs and Conditions of contracts by DIER and local authorities
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Workplace Health & Safety Act 2012
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Roads and Jetties Act 1935
Additional comments?
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General comments:
Section A - Signed by person in charge of site
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Person in charge:
Section B - Signed by person in charge of plant / site
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Person in charge:
Signed Off By Auditor
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Auditor:
Email to: Manager/Coordinator in charge for review i.e. first name.last name@launceston.tas.gov.au CC to: Safety Compliance Officer - aussie.dukeson@launceston.tas.gov.au
Manager/Coordinator Action
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1. Review and take any action if required
2. Forward email and audit onto Safety Compliance Officer - aussie.dukeson@launceston.tas.gov.au acknowledging action already taken at the time of the audit and advising what action will be taken for outstanding non compliances.
Safety Compliance Officer Action
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1. Arrange CRMs if required and action has not already been taken.
2. Forward audit onto Infrastructure Operations Manager advising CRMs have been raised - matthew.millwood@launceston.tas.gov.au
Manager Infrastructure Operations Action
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Email remountroad.admin@launceston.tas.gov.au with approval to register to SF5926
