Mainstream South Africa audit pro forma template

• Audit No.

• Site (location)

• Conducted on

  Date

• Prepared by

• Audit team:

• Previous audit scores

• Health & Safety %

• Environmental %

• Add names of persons that attended the pre-audit meeting

• Confirm the following have been undertaken

• Confirm purpose and scope of audit

• Identify resources and assistance required

• Obtain a description of the project and labour force

• Induction before entry to site operations

• Date and time of exit meeting

  Date

• Zero compliance zc=0, Partial compliance <50% lc=1, Partial compliance >50% hc= 2, Full Compliance fc=3

Element 1.0 H&S Policy

• Are there H&S policies signed by the MD on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Are policies communicated at induction?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Are policies posted in the public area of the office?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

ELEMENT: 2.0 Planning

2.1 Hazard Identification, Risk Assessment

• 1. Risk assessor appointed (CR7)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Has a Project Risk Assessment been conducted?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Does the Project Risk Assessment covers all major hazards?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Does the Project Risk Assessment identifyappropriate controls?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Have Project H&S and Env. Plans been developed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Do the plans reflect the current operations on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. issue based risk assessments performed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Method statements developed and relevant?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

2.2 Legal & Other Requirements

• 1. Are there current copies of legislation on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Has the PC been appointed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. PC has a HS Plan and it is approved by the Client?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Contract signed between Client and PC?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Have all contractors been assessed and adequately resourced?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Has the PC notified the DOL?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Letter of good standing with the CC (COIDAct)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Sec 16.2 appointment done?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. CR6.1 appointment done?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 10. CR6.2 appointment done?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 11. Sufficient amount of qualified first aiders appointed (GSR3)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 12. Lifting equipment inspector appointed (DMR18)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 13. Fall protection coordinator appointed (CR8)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 14. Scaffolding Supervisor appointed (CR 14.2)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 15. Scaffold erctors appointed and competent (CR 14.2)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 16. Temporary electrical installation supervisor appointed (CR22)

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 17. Explosive power toolinspector appointed (CR19)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 18. Excavation inspector appointed (CR11)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 19. Stacking supervisor appointed (CR26)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 20. Fire fighting equipment inspector appointed (CR27)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 21. Construction Safety Officer Appointed (CR6.6)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 22. Are all legal appointments done and up to date?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

2.3 Objectives and Targets

• 1. Are objectives and targets set for project?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Are objectives and targets displayed on notice boards?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

3.0 Implementation and Operations

3.1 Resources Roles and Responsibilities

• Is there an Organisation Chart for the Project?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Does the Project HSE Manager report to the PM?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Does everyone in HSE team have appropriate qualifications?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Do All Supervisory personnel have HSE Training?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Are internal audits and inspections presented to the PM?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

3.2 Competence, Training & Awareness

• 1. Does everyone on site attend a site induction?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Is there a visitors induction?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are workers operating plant & equipment assessed as competent?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Are workers trained & assessed before commencing high risk tasks?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Are there records of training activities?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

3.3 Communication & Participation

• 1. Is there a Project HSE Committee?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Committee appointments done (Sec 17)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. H&S Rep appointments done (Sec 19)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Are meeting conducted at least monthly?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Are there tool box talks conducted daily?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Do all workers attend the tool box talks?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Is there a system for identification of hazards?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Are identified hazards controlled & recorded?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. Are all contractors provided with information related to HSE?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

3.4 Operational Controls

• 1. Are task Risk Assessments conducted?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Do supervisors have JSA's in the field?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Do supervisors complete HSE Verification Checklist?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Is there a register of JSA's & HSE Verfication Checklists?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

3.5 Emergency Preparedness & Response

• 1. Have all potential emergency situations been identified?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Have Emergency Plans been prepared & approved?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Have all the plans been tested?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Are there trained emergency response personnel on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Is there adequate emergency equipment on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Is an evacuation plan available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Evacuation procedures posted?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Alarm & alarm points appropriate?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. Alarms regularly tested?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 10. Adequate escape routes and kept clear?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 11. Assembly points sign posted?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

Element 4 Checking

4.1 Performance Measure and Monitoring

• 1. Are inspections of the site conducted & recorded?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Is a monitoring program established and implemented?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are inspection & monitoring reports evaluated by the PM?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

4.2 Incident Investigation

• 1. Incident investogator appointments done (GAR8)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Are all reported incidents & public complaints investigated?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Do incident investigation reports identify all causal factors?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Are the recommended controls adequate to prevent recurrence?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Does the PM sign off the incident investigation reports?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Are recommended control measures implemented?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Are incident alerts developed following LTI and HIPO incidents?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

4.3 Internal Audits

• 1. Are there internal audits scheduled?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Are audits conducted in accordance with the schedule?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Is the audit report presented to the PM?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Is the audit findings discussed at Project HSE Committee Meeting?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Are the findings of the previous audit closed-out?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Are the findings of the previous external audit closed-out?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

ELEMENT 5.0 Award Scheme

• 1. Is there a HSE Award Program established?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Does the program acknowledge individuals & the group?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are award certificates presented?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Zero compliance =0, Partial compliance <50% =1, Partial compliance >50%= 2, Full Compliance =3

Element 1.0 Environmental Policy

• Are there Environmental policies signed by the MD on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Are Environmental policies communicated at induction?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Are Environmental policies posted in the public area of the office?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

Element 2.0 environmental planning

2.1 Environmental Hazard identification, Risk Assessment

• Environmental Risk assessor appointed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Has a project environmental risk assessment been conducted?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Does the risk assessment cover all the major hazards?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Does the risk assessment identify all appropriate controls?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Have project environmental plans been developed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Do plans reflect the current operations on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Are issue based environmental risk assessments performed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Have method statements been developed and are these relevant?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

2.2 Legal and Other Requirements

• Are there current copies of legislation on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• PC has an Environmental plan and it has been approved by the Client?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Have all contractors been assessed and adequately resourced?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

3.0 Implementation and Operations

3.1 Resources Roles and Responsibilities

• Does the Project Environmental Manager report to the PM?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Does everyone in HSE team have appropriate qualifications?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Do All Supervisory personnel have HSE Training?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Are internal audits and inspections presented to the PM?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

3.2 Competence, Training & Awareness

• 7. Is there a system for identification of environmental hazards?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Are identified hazards controlled & recorded?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

3.5 Emergency Preparedness & Response

• 1. Have all potential environmental emergency situations been identified?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Have Emergency Plans been prepared & approved?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Have all the plans been tested?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Are there trained emergency response personnel on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Is there adequate emergency equipment on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

Element 4 Checking

4.1 Performance Measure and Monitoring

• 1. Are environmental inspections of the site conducted & recorded?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Is a monitoring program established and implemented?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are inspection & monitoring reports evaluated by the PM?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

4.3 Internal Environmental Audits

• 1. Are there internal audits scheduled?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Are audits conducted in accordance with the schedule?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Is the audit report presented to the PM?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Is the audit findings discussed at Project HSE Committee Meeting?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Are the findings of the previous audit closed-out?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Are the findings of the previous external audit closed-out?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

ELEMENT 5.0 Award Scheme

• 1. Is there a HSE Award Program established?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Does the program acknowledge individuals & the group?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are award certificates presented?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.1 SITE SET UP / SECURITY

• 1. Safe and suitable access to site established?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Site security properly established - 24/7 available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Perimeter fence sufficient, secure & undamaged?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Are all gates secured?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Are site security arrangments adequate?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.2 SIGNAGE

• 1. Statutory signage displayed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Notice boards erected?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. HSE performance board erected in a prominent location?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Road signage adequate?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.3 PPE

• 1. PPE policy and issue matrix available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. PPE issued on an induvidual basis?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Users trained?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Regular checks on condition?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Staff and visitors wear hi-viz vests?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. PPE worn as required?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. PPE in a good condition

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Respiratory protection correct type?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Users or respiratory equipment trained?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. Fit tests performed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.4 MOBILE PLANT

• 1. Plant inspected before use on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Operators assessed as competent?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Safety devices fitted & fire extinguisher attached?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Pre-start inspections conducted & recorded?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Reversing alarms operable?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Seat belts fitted & in use?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Maintenance log book up to date?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Plant being operated safely?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.5 CRANES / LIFTING MACHINERY / LIFTING GEAR

• 1. Lifting plans developed where necessary?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Lifting operations coordinated by lifting supervisor?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Crane / MEWP / Forklift / certified?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Operators / Riggers competent?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Pre-start inspection conducted & recorded?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. All safety devices are fitted & operable?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Cranes set up on level ground with outriggers extended?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Cranes / MEWP / Forklift being operated safely?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. Lifting activities barricaded?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 10. All lifting operations coordinated by competent lifting supervisor?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 11. All lifting gear colour coded and recorded in register?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 12. Lifting machinery inspected every 6 months and load tested annually?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 13. Lifting tackle inspected every 3 months?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 14. SWL marked on all lifting gear?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 15. Lifting gear inspected by competent persons ?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 16. Proof test certificates available for slings?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 17. Lifting gear stored correctly?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 18. Is the lifting gear in good condition?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 19. No lifting activities near overhead powerlines / excavations?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 20. All lifting activities barricaded?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 21. Is the lifting gear in good condition?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.6 WORKING AT HEIGHT

• 1. Fall preventionplan developed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Access and egress adequate?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Adequate railings provided?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Adequate edge protection in place?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• SCAFFOLDING

• 4. Working platforms safe?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Scaffolding complies to SANS085?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Scaffolding erected by competent persons?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Guard rails, toe-boards and safe access provided

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Scaffolding tags used and up to date?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. Scaffolding supervisor inspect scaffold after erection, weekly, after drastic change of weather?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 10. Scaffold rgister up to date?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• SAFETY HARNESSES

• 11. Full body harness / restraints provided ?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 12. Full body harness / restraints used, where appropriate & appropriately attached?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 13. Users of harnessess received training?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 14. All harnesses, lanyards etc on register?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 15. Full body harness inspected before use and at set frequencies?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 16. Attaching points suitable?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 17. Harness inspector appointed and competent?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 18. Rescue plan available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• LADDERS

• 19. Ladders in use appropriste

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 20. Ladders in a good condition

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 21. Ladders on register and inspected regularly

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 22. Straight ladder extend to at least 1m above anchor point?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 23. Ladders fixed to structure or footed by another person?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 24. User not standing on last upper to steps?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 25. Rescue plan available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.7 ELECTRICITY

• 1. Are ELCB's for all electrical appliances provided to all switchboards?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Are gensets earthed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are all switchboards protected from the weather?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Are all switchboards, ECB's and equipment inspected & labelled?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Is there an electrical register?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Electrical tools regularly visually checked and inspected?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. All connections are properly made and suitable plugs are used?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. No damage to cables?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. All detachable electrical tools protected by earth leakage units?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 10. Are underground and overhead cables clearly identified?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 11. Are all cables double insulated?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• Cartridge Operated Tools

• 12. Register for issue and return of cartridges?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 13. Operators trained?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 14. Safety devices in order?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 15. Is the operator(s) wearing eye protection?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 16. Tools and cartridges locked away?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.8 EXCAVATIONS

• 1. Has the PTW been issued prior to excavating?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Excavation inspected on a daily basis and as per law?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are side scopes/shoring adequate?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Is there safe accress and egress?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Are barricades erected around the perimeter?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Is appropriate signage displayed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Spoils at least 1m away from edge of excavations?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.9 FIRE / EMERGENCY MANAGEMENT

• 1. Are there adequate fire extinguishers available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Are fire extinguishers charged & inspected?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Annual maintenace performed on fire fighting equipment?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are fire extinguishers clearly identified with signs?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Are fire extinguishers unobstructed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. First aid facilities established and sign posted?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. First aid equipments available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. No prescription drugs administered?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. First aid treatments recorded?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 10. First aid boxes checked and replenished on a regular basis?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 11. Names of first aiders displayed at first aid box and notice boards?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 12. First aid supplies adequated, within use-by date and inspected?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.10 HOUSEKEEPING

• 1. Are walkways clear of obstructions and protected against traffic?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Stair accesses clear?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Is there adequate lighting through out the site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.11 PERMITS TO WORK

• 1. Has a PTW system been established?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Are permits available at the location of work?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are workers trained in the use of PTW?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. All permits closed out?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Permits kept in archive?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• LOTO

• 6. Energy isolation procedure available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Users trained?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Are all switches which are locked out provided with lock and tags?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. Are the tags being used as per procedure?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• HOTWORK

• 10. Are hot work in uncontrolled areas controlled by a PTW?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 11. Are flammable materials removed from the area?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 12. Are fire extinguishers available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 13. Are welding screens available and in use?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 14. Are operations wearing correct clothing & PPE?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• CONFINED SPACE ENTRY

• 15. All entrants received training and certified competent?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 16. Standby / holewatch trained and certified competent?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 17. Confind space entry properly planned i.e. escape, alarms, communication etc.?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 18. Are atmospheric testing performed at start of shift, after breaks and emergencies?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 19. Has the gas tester received training and certified competent?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.12 HAZARDOUS SUBSTANCES

• 1. Is there a hazardous substances register?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Are there MSDS's for all hazardous substances?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Controls as specified in MSDS's implemented?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Are hazardous substances stored correctly?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Is the storage area correctly sign posted?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Is there equipment available to deal with spills?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Are MSDS's available in the first aid boxes?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Are all containers correctly labelled?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• COMPRESSED GASES

• 9. Are they away from flammable liquids?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 10. Gases stored upright / secured /purpose made cages?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 11. Are gases segragated by type?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 12. "No smoking" & "No naked flames" signs posted at storage areas?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 13. Cylinder valves fully closed when not in use?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 14. Do all lines have flash back arrestors fitted?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 15. Do all line connections only have approved fittings and clips (no jubilee clips)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 16. Gas cylinders transported in an upright position and secured?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 17. Storage areas provided with appropriate fire extinguishers?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.13 OCCUPATIONAL HEALTH

• NOISE

• 1. Noise zones / producing equipment identified and sign posted?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Baseline audiometry done?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Appropriate hearing protection provided?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Workers received training in the risks of noise and use of hearing protection?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Attempts to reduce noise levels / exposure?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• HEAT STRESS

• 6. Heat stress prevention plan available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Workers informed about hazards, risks, symptoms and control measures?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Sufficient cold water / supplements and shading available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. Temperatures constantly measured?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 10. Temperatures communicated?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 11. Exposure managed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• COLD TEMPERATURES

• 12. Appropriated warm clothing available and provided

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 13. Exposure monitored?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.14 TOOLS

• 1. Rigth tools fot the job?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Hand tools in a good condition?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. No home made tools used?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Operatives trained in the use of tools?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Dangerous parts guarded?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Stones / cuttingn wheels compatible with designed RPM of equipment?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. RPM marked on grindstone / grinders?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.15 WELFARE FACILITIES

• 1. Adequate mess facilities provided (seats, tables, shade, handwash facilities)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Mess facilities maintained / cleaned regularly?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Welfare facilities accessible for all persons?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Water facilities provided (sufficient, cold, cups, shade)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Sufficient toilets available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Handwash facilities, soap, toweling & toiletpaper available at toilet facilities?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

1.16 TRAFFIC MANAGEMENT

• 1. Has a Traffic Management Plan been developed and implemented?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Are roadways maintained and well defined?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are directional signs erected?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Are there adequate speed signs erected?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Are roadways the correct width?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Are safety berms constructed along the edge of roads?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 7. Are there safe areas for pick up an set set down of worker on buses

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 8. Are there road delineators installed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 9. Are vehicles observing the site speed limits?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

2.1 EROSION AND SEDIMENT CONTROL

• 1. Controls implemented to reduce erosion?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Cleared areas stabilised as soon as possible?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Sediment controls established around unstabilised stockpiles abattersnd

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Control devices installed, as required e.g silt traps, silt fences etc.

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Contaminated water from the site prevented from entering drains, streams, rivers prior to proper treatment?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Water monitoring prior to release to drains and streams etc.

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

2.2 DUST CONTROL

• 1. Dust suppression on haul road and stockpiles?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Vehicles speeds within project speed limits?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Adequate watering of high dust potential areas?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

2.3 NOISE AND VIBRATION

• 1. Have permissable noise levels been determined?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Noise monitoring program established (i.e. testing PPE and signage)?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Noise levels within acceptable limits?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Nearby community been advised of blasting/piling activities?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

2.4 STORAGE OF CHEMICALS AND FUELS

• 1. Chemicals storage areas bunded (110% of max contents) or drip trays provided?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Is the bund's rain water discharge valve is closed?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are all drums and tanks clearly marked with contents & quantity?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Storage facility at least 30m away from water courses?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Adequate spill management equipment/materials available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

2.5 WASTE MANAGEMENT

• 1. Wate management plan developed and suitable?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. All waste is separated and stored in clearly marked bins?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Bulk wast containers covered with lids or netting?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Regulated waste removed by licenced collector?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Waste manifests on record?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Adequate litter bins provided on site?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

2.6 GROUND CONTAMINATION

• 1. Drip trays used for in field re-fueling.

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Contaminated soil remediated on site.

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 3. Are spill kits available?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 4. Located in the correct areas?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 5. Location sign posted?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 6. Are the contents regularly checked?

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

2.7 HOUSEKEEPING

• 1. Control of stagnant water (promoting breeding of mosquitors / insects)

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• 2. Disposal of waste water from site facilities to sewage of septic tank

  zero compliant

  < 50% compliant

  >50% compliant

  fully compliant

  not applicable

• General Comments

• Have there been any health and safety hazard observations?

• Add observation potential consequence high=100, medium=50, low=25

Observation

• Tap to Type observation, add "media" and give potential consequence ranking

  low -25

  medium -50

  high.-100

• Have there been any environmental hazard observations?

• Add observation potential consequence high=100, medium=50, low=25

Observation

• Type observation, add "media" and give potential consequence ranking

  low -25

  medium -50

  high.-100

• Lead auditors comments

• Lead auditors signature

  Sign

• Project Managers Comments

• Project managers signature

  Sign