LLS - HSEQ Audit Form

• Work Activity Number

• Location
  Address

• Conducted on

  Date

• Audit Lead By

• Signed

  Sign

• Date/Time

  Date

• Other audit team members

• Work Area

  Civil North Water

  Civil North Sewer

  Civil South Water

  Civil South Sewer

  Customer Service Officers

• Crew Type

  Lend Lease Direct

  Contractor

• Select Contractors Company, if contractor is not shown please select "Other" and type their name in the following field

  Select 4 Civil Solutions AMT Excavations Bannan Excavations Blue Alliance Bodsworth Excavations Brennan Asset Services CJ McDonald Excavations CJP Bros CSA Specialised Services DJ Excavations Do All Drainage Donnaz Underground Eastys Landscaping Fastlift Fenby Maintenance Gem Pipelines JK Excavations L Boyd Construction L&J Ridgeway L&K Earthworks L&R Trucking Lightowlers Mark & Jay Plumbing & Excavation M&L Drainage MJA Maintenance Phil's Water Platinum Excavations RBM Plumbing & Drainage Reservoir Maintenance Contractors Stop Tap King Supersafe (Dunny's R Us) Stows Waste Management The Drain Man Toxfree Waterboy Water 2 Go OTHER

  • 4 Civil Solutions
  • AMT Excavations
  • Bannan Excavations
  • Blue Alliance
  • Bodsworth Excavations
  • Brennan Asset Services
  • CJ McDonald Excavations
  • CJP Bros
  • CSA Specialised Services
  • DJ Excavations
  • Do All Drainage
  • Donnaz Underground
  • Eastys Landscaping
  • Fastlift
  • Fenby Maintenance
  • Gem Pipelines
  • JK Excavations
  • L Boyd Construction
  • L&J Ridgeway
  • L&K Earthworks
  • L&R Trucking
  • Lightowlers
  • Mark & Jay Plumbing & Excavation
  • M&L Drainage
  • MJA Maintenance
  • Phil's Water
  • Platinum Excavations
  • RBM Plumbing & Drainage
  • Reservoir Maintenance Contractors
  • Stop Tap King
  • Supersafe (Dunny's R Us)
  • Stows Waste Management
  • The Drain Man
  • Toxfree
  • Waterboy
  • Water 2 Go
  • OTHER

• Company Name

• People Onsite

Personnel

• Crew Name

• Mobile Plant and Vehicles

Equipment Onsite

• Equipment Onsite

General information

• Has pre-start been completed effectively?

  Yes

  No

  N/A

• Has crew identified all relevant hazards during pre-start/SWMS process?

  Yes

  No

  N/A

• Please list the hazards not identified by the crew:

• Do all personnel onsite have current YVW induction cards and photographic identification onsite?

  Yes

  No

  N/A

• Are YVW signs displayed?

  Yes

  No

  N/A

• Are work crews clothing in good order and correctly identified (incl High Visibility Clothing)?

  Yes

  No

  N/A

• Are Yarra Valley logos being worn?

  Yes

  No

  N/A

• Are vehicles/trailers/plant in good order, clean, clearly identifiable?

  Yes

  No

  N/A

• Is traffic management appropriate and clearly sign-posted including Pedestrian-Footpath Management and adjacent vehicular driveways?

  Yes

  No

  N/A

Excavation

• Has the area been checked for buried services?

  Yes

  No

  N/A

• Is there clear access to the excavation site?

  Safe

  At Risk

  N/A

• Are the top edges and sides of the excavation clear and free of obstructions, sharp objects and other materials?

  Safe

  At Risk

  N/A

• Are sides of the excavation supported (shields/timbers) or otherwise made safe (battered/shored/benched) as necessary?

  Safe

  At Risk

  N/A

• Is safe access provided within the site?

  Safe

  At Risk

  N/A

• Are appropriate fall prevention measures in place (please photograph)?

  Safe

  At Risk

  N/A

• Is area secured at the end of the shift/overnight?

  Safe

  At Risk

  N/A

Customer Service

• Has the Control Room been advised of any potential environmental hazards (eg Sewage Spills)?

  Yes

  No

  N/A

• Have critical users/key customers been identified and catered for?

  Yes

  No

  N/A

• Where water supply is affected, is a tap on hydrant fitted and a "TOH" sign displayed?

  Yes

  No

  N/A

• Is bottled water available?

  Yes

  No

  N/A

• Are valves isolated to ensure a minimal shut-off area is affected?

  Yes

  No

  N/A

• Will service be restored within the required contractual timeframes?

  Yes

  No

  N/A

• Have/will YVW response times been met?

  Yes

  No

  N/A

Plant

• Has the site been left in a clean, tidy and safe manner?

  Yes

  No

  N/A

• Have customer contact cards been left?

  Yes

  No

  N/A

• Has approved electrical detection equipment been used?

  Safe

  At Risk

  N/A

• Have silt/sediment traps been installed correctly and maintained?

  Safe

  At Risk

  N/A

• Has repair been assessed to ensure long-term effectiveness?

  Yes

  No

  N/A

• Are correct work instructions / procedures and SWMS on site?

  Yes

  No

  N/A

• Have approved products been used?

  Yes

  No

  N/A

• Have precautions been taken to prevent/minimise distruption/interruption to authority assets?

  Yes

  No

  N/A

• Has exploratory probing occurred to protect other authorities assets?

  Safe

  At Risk

  N/A

• Where repairs are complete, have mains been flushed to clear dirty water?

  Yes

  No

  N/A

• Was a deflector used to direct water in a safe location?

  Safe

  At Risk

  N/A

• Have all valves been returned to normal operating positions?

  Yes

  No

  N/A

• Has pipe/fittings been wrapped as required?

  Yes

  No

  N/A

• Have cats eyes been (re)fitted?

  Yes

  No

  N/A

• Has backfill been completed to approved and required standard?

  Safe

  At Risk

  N/A

• Has appropriate compaction been undertaken?

  Safe

  At Risk

  N/A

• Has the repair been carried out in accordance with Lend Lease procedures?

  Yes

  No

  N/A

• Have drains and gutters been cleaned and unblocked?

  Yes

  No

  N/A

• Has all excess material been removed from site?

  Yes

  No

  N/A

• Has naturestrip area been topdressed with loam and seed?

  Yes

  No

  N/A

• Has seed been lightly raked to bed into loam and area lightly wetted?

  Yes

  No

  N/A

• Have road reinstatement requirements been recorded and submitted?

  Yes

  No

  N/A

Quality/Records Management

• Has the appropriate assessment of the activity been made and the Control Room advised?

  Yes

  No

  N/A

• Has all information been collected to ensure effective costing?

  Yes

  No

  N/A

• Has consequential damage been identified, managed and reported?

  Yes

  No

  N/A

• Has YVW been advised of changes to asset status/configuration?

  Yes

  No

  N/A

• Has asset management system been updated?

  Yes

  No

  N/A

• Have defective assets been recorded?

  Yes

  No

  N/A

Confined Space

• Has atmosphere reached a stable and safe level and readings recorded?

  Yes

  No

  N/A

• Are harness and lifeline inspected and in good and serviceable condition?

  Yes

  No

  N/A

• Is the permit system for confined space entry being used correctly?

  Safe

  At Risk

  N/A

• Is gas detector within calibration date?

  Yes

  No

  N/A

• Please record serial number

• Are all site personnel trained in Confined Space Entry?

  Safe

  At Risk

  N/A

• Has atmosphere been tested?

  Yes

  No

  N/A

• Have initial test results been recorded?

  Yes

  No

  N/A

• Is ventillation adequate to maintain safe and breathable atmosphere?

  Yes

  No

  N/A

Electrical Safety

• Are there quarterly inspection tags on each power lead and are they in-date for electrical test-and-tag requirements?

  Yes

  No

  N/A

• Are plugs, sockets and switches free from defects and in good condition?

  Safe

  At Risk

  N/A

• Are there any frayed or defective tools/leads onsite?

  Yes

  No

  N/A

Plant / Equipment

• Has the daily log book been completed?

  Yes

  No

  N/A

• Is the area around plant operations kept clear of pedetrian and other vehicular traffic?

  Safe

  At Risk

  N/A

• Is plant being operated in a safe manner?

  Safe

  At Risk

  N/A

• Is all equipment free from defects and in good operating condition?

  Safe

  At Risk

  N/A

• Are safety clips on compressor hoses being used?

  Safe

  At Risk

  N/A

• Are operators correctly licenced?

  Yes

  No

  N/A

Personal Protective Equipment

• Are first aid kits available?

  Yes

  No

  N/A

• Are kit contents in date?

  Yes

  No

  N/A

• Are protective gloves provided (and being worn) to protect hands?

  Yes

  No

  N/A

• Is PPE in good and serviceable condition?

  Yes

  No

  N/A

• Are all personnel on the site wearing long sleeve hi-visibility tops, long pants, boots, helmets and safety glasses?

  Yes

  No

  N/A

• Are personnel exposed to noise using appropriate hearing protection?

  Yes

  No

  N/A

• Are safety glasses/goggles and/or face shields being used in hazardous situations (eg cutting, grinding or chemical handling)?

  Yes

  No

  N/A

• Are correct manual handling techinques being followed (including gloves being worn)?

  Yes

  No

  N/A

• Is mechnical equipment available for lifting heavy loads (as appropriate)?

  Yes

  No

  N/A

Public Health Safeguards

• Are tools, plant and equipment appropriately marked?

  Yes

  No

  N/A

• Are adequate washing facilities available for the crew?

  Yes

  No

  N/A

• Is the vehicle equipped with disinfectant and disposal facilities for contaminated waste?

  Yes

  No

  N/A

Additional Comments

• Additional comments