MGN Maintenance Audit – HSE General

• Audit Title

• Job Description

• Location
  Address

• Conducted on

  Date

• Prepared by

• Contractor(s)

• Work Group (name of crew leader & members)

• Auditor(s)

• Additional Representative(s)

• Employee?

  Yes

  No

• Contractor/s

• Workgroup (name of crew leader & members)

• Task

• Auditor(s)

• Date

  Date

• Time

  Date

Prior to Commencing Work SWP 2.1, SWP 2.5, MG MA E0.001

• Have you checked for Life Support Customers in today’s work area, and was it safe to proceed with works?

  Yes

  No

  N/A

• Do all personnel have MG passports on site?

  Yes

  No

  N/A

• Is all training, authorisations and qualifications current for the functional role of the passport holder including contractors (e.g. traffic management)?

  Yes

  No

  N/A

• Are all relevant SWMS on site?

  Yes

  No

  N/A

• Has the JSEA/risk assessment identified site specific risks, been signed and dated by all crew members and have SWMS been identified for the task?

  Yes

  No

  N/A

• Are all identified risk control measures on SWMS and JSEA/risk assessment in place?<br>Are required high risk work permits and associated checklists in place?

  Yes

  No

  N/A

• Has the Traffic/Pedestrian Management Plan been identified/created and available on site and documented on the JSEA/risk assessment?<br>Has traffic management been implemented and have any changes been recorded on the JSEA/risk assessment?

  Yes

  No

  N/A

• Is PPE in accordance with Multinet Gas as a minimum and Service Providers expectations and within inspection/ replacement dates?

  Yes

  No

  N/A

• Does the excavation / manhole have appropriate support / effective engineering controls (i.e. battered, shields, shoring, etc)?<br>Is the excavation / manhole large enough to work in comfortably and has safe entry/exit been provided (e.g. ladder and consideration for emergency situations)?

  Yes

  No

  N/A

• For deep excavations – Has a permit been authorised by the Supervisor and notification made to WorkSafe?<br>Is the excavation being monitored during work and controls in place for unmanned work?

  Yes

  No

  N/A

• Are field employees aware of the emergency plan and is emergency equipment readily available?<br>Extinguisher located up wind and accessible to the worksite (SWP 2.5)?<br>Is the extinguisher with-in test date?

  Yes

  No

  N/A

• Have environment impacts been considered on the risk assessment, i.e. waste, water (including syphon water), soil management, sediment control, contamination, emission, flora (incl tree mgt) and fauna, heritage? Refer to MG MA E0.001, Environmental Field Manual – Guidelines<br>Has risk / contamination been effectively controlled?

  Yes

  No

  N/A

• Have all hazardous chemicals / substances (including asbestos) been managed and disposed of as per expectations and SWPs by competent and trained persons (SWP 2.11)?

  Yes

  No

  N/A

• Have sources of ignition been eliminated from work area?

  Yes

  No

  N/A

Locate and Prove Assets SWP 8.1

• Have the 5Ps been utilised effectively?<br><br>Plan – has planning been completed prior to work commencing – identify risk / controls to be implemented (including DBYD plans, no go zone rules)?

  Yes

  No

  N/A

• Prepare – have trained and competent (DBYD class/field certified) employees been utilised to identify underground assets – using approved DBYD locators?

  Yes

  No

  N/A

• Pothole/Prove – has Potholing been used to establish the exact location of the asset?

  Yes

  No

  N/A

• Protect – has the infrastructure been protected by – marking assets, identifying exclusion zones, placing barriers and communicate effectively?

  Yes

  No

  N/A

• Proceed – has work proceeded with all the above risk controls in place?

  Yes

  No

  N/A

• Have underground assets been documented on asset location sheet and Supervisor been advised of high-risk scenario (including HV checklist)?

  Yes

  No

  N/A

Specific HSE Checks SWP 1.4, SWP 1.5, SWP 1.7, SWP 2.4, SWP 2.8, SWP 2.9, SWP 2.10, SWP 2.11, SWP 2.14

• Does the task require entering and working in a confined space and, if so, are the personnel competent and compliant (SWP 1.5)? <br>(check passports and ‘prior to work checks’ have been completed)<br>o Is rescue equipment on site?<br>o Has an entry permit been used correctly?

  Yes

  No

  N/A

• Are all persons required to work in a gaseous environment trained and competent in the operation and care of respiratory protection?<br>Is the correct respiratory protection being used? <br>(check passports and ‘prior to work checks’ have been completed) <br>Has the following been considered?<br>o Are there adequate personnel on site?<br>o Have ignition sources been addressed<br>o Is there adequate ventilation to disperse contaminants?<br>o Has a standby been appointed?<br>o Is the B.A equipment and fire extinguisher manned?<br>

  Yes

  No

  N/A

• Has the worksite, all excavations and trenches been secured safely (i.e. signs, barricades, exclusion zones, fencing, plates) when unattended (including overnight)? (SWP 2.4)

  Yes

  No

  N/A

• Has a designated rest area been assigned?

  Yes

  No

  N/A

• Has the Jeavons J106 regulator been handled and disposed of appropriately as per SWP 2.14?

  Yes

  No

  N/A

• Is all electrical equipment calibrated and within test and tag dates?

  Yes

  No

  N/A

Electrical Tests SWP 2.13

• Is the gas meter location in accordance with engineering standard ES-DD-4352?

  Yes

  No

  N/A

• Has service pipe and gas meter assembly been tested to ensure it is not ‘electrically’ live using an approved voltage tester (SWP 2.13)?

  Yes

  No

  N/A

• If voltage is detected – was area restricted, consumer informed, power isolated, supervisor contacted (SWP 2.13)?<br>Note: Do not carry out any work until fault has been determined.

  Yes

  No

  N/A

• Has the meter been disconnected using cross bonding leads (SWP 2.13)?

  Yes

  No

  N/A

• Have wet rags been used where required to eliminate static?

  Yes

  No

  N/A

• Other comment

Sign off

• Auditor(s)

  Sign

• Auditee (Crew Leader)

  Sign