Information
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Report No.
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Site:
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Client:
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What type of structure is being audited
- Warehouse
- School
- Shops
- Apartments
- Treatment Plant
- Water holding tank
- Shopping Centre
- Other
- Service Station
- Warehouse with attached office / Showroom
- Car Dealership
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Conducted on
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Prepared by
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Location
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Other Personnel onsite
Access to System
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How Is Access Gained To Systems
- Fold Down Access Ladder
- Fixed Access Ladder
- Fixed Ladder Support Bracket
- EWP
- Rope Access
- Other
- No current access point
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Name access
- Data Plate
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How many
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Is data plate legible?
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Is all required information on the plate?
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Date of last inspection
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Installation date of system
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Installed by
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Manufactured by
- Sayfa
- Safetylink
- 3M
- BTS
- RIS
- other
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Persons per system
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System load rating
- 15kN
- 12kN
- 1 x 136kg
- 2 x 136kg
- 3 x 136kg
- 4 x 136kg
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System ID number
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Were any new data plates installed
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Photos
Fixed Ladders
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How many?
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Photos
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Is the ladder secured appropriately?
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Are all fixings in place as per Manufacturers installation instructions
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Is there any visible damage to the ladder?
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Is there a fall arrest line on the ladder?
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If fall arrest line present include in static line section of this report
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Does the line have a shock absorber?
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If shock absorber present record details in associated equipment register
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Is the line installed in a compliant manner?
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Is there a cage on the ladder?
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If no lifeline or cage is present would one be recommended?
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Is there any other issues affecting the safe operation of the ladder?
Ladder Brackets
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How many?
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Photos
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Is the bracket installed as per the manufactures specifications?
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Have any modifications been made to the bracket or parent structure?
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With the appropriate ladder can the bracket be used to access the required area safely?
Walkways
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Do they comply to AS1657:2018?
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What type
- Steel
- Alumimium
- Timber
- Fiberglass
- other
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What brand in known
- Sayfa
- Safetylink
- 3M
- BTS
- RIS
- other
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Platforms present
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Are platforms installed correctly
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Is current layout safe to use
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What is required to platform / walkway to make compliant
Are there handrails on-site
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Do they comply to AS1657:2018?
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What brand in known
- Sayfa
- Safetylink
- 3M
- BTS
- RIS
- other
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Is current layout safe to use
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What is required to make compliant
Lanyards / Strops
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undefined
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How many?
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Photo
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Has the lanyard/wire rope been damaged or modified in any way?
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Is there any deterioration in the anchorage/parent structure?
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Is the line the appropriate length for the designated task?
Fixed Anchor Points
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Are all anchors individually tagged?
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Photos of anchor tags
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Abseil (15kN+)
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Are these anchors present onsite?
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Types of anchor present
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Fall Arrest (15kN+)
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Are these anchors present onsite?
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How many
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Types of anchor present
- Surface mount
- Purlin mount
- Concrete
- Clamp mount
- Tri Plate
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What are the anchors fixed to?
- Steel Purlin
- roof sheet & Purlin
- roof sheet
- concrete
- bricks
- bolt through
- multiple
- other
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Please advise
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If the anchor is fixed to concrete or bricks all anchors must be pull tested to 7.5Kn for 2 Minutes. If Tri Plate, please note if each fixing was tested. Tri plate anchors can be direct pulled as per single eyelet.
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Was a testing device used?
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If a testing device was used please provide make model and serial number
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Any signs of deterioration in the anchor or parent structure?
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Any corrosion or rust present in anchor or parent structure?
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Is the anchor damaged or deformed from usage or loading?
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Has the anchor or parent structure been modified in any way?
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Is there any other factors that would prevent the anchor holding its intended load when required?
Static Lines
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undefined
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How many
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Types of lines present
- Sayfa
- Safetylink
- 3M
- BTS
- RIS
- other
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Brand
- Sayfa
- Safetylink
- 3M
- BTS
- RIS
- other
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What are the lines fixed to?
- Steel Purlin
- roof sheet & Purlin
- roof sheet
- concrete
- bricks
- bolt through
- multiple
- other
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If the line is fixed to concrete or bricks all anchors must be pull tested to 7.5Kn for 2 Minuets
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Was a testing device used?
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If a testing device was used please provide make model and serial number
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Is the line tensioned appropriately?
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Are all bolts, rivets, screws and fastenings secure?
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Any corrosion or rust present in system or parent structure?
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Any corrosion or rust present in travel/attachment device?
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Is there any brittleness or fraying in the steel cable?
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Does the travel device operate smoothly along the entire system?
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Does the system have a shock absorbing device?
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Has the shock absorber been deployed or damaged in any way?
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Does the line have a working tension indicator?
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Are all joints and swages secure?
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Is there any visible cuts or dents in the system?
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Is there any other visible damages or modifications that may cause the system to fail?
Fixed Rail Systems?
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undefined
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How many
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Types of rails present
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Brand of rail
- Sayfa
- Safetylink
- 3M
- BTS
- RIS
- other
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What are the rails fixed to?
- Steel Purlin
- roof sheet & Purlin
- roof sheet
- concrete
- bricks
- bolt through
- multiple
- other
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If the rail is fixed to concrete or bricks all anchors must be pull tested to 7.5Kn for 2 Minuets
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Was a testing device used?
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If a testing device was used please provide make model and serial number
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Are all bolts, rivets, screws and fastenings secure?
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Are all joints under the maximum allowable distance of 4mm
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Is the rail mounted as per the manufactures specifications?
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Are any bolts or connectors missing?
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Any corrosion or rust present in system or parent structure?
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Is the rail free from any contaminants?
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Is the rail free from dents, cracks, splitting and other damages?
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Any corrosion or deterioration present in travel/attachment device?
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Does the shuttle/travel device operate smoothly along the entire system?
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Is there any other visible damages or modifications that may cause the system to fail?
Davit Base Systems ?
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How Many
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Types of bases present
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Brand of Davit System
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What are the bases fixed to
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If the base is fixed to concrete or bricks, all anchors must be pull tested to 23kN for 1 minutes
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If a test device was used, please provide make model and serial number
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Are all bolts and fastenings secure?
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Are the bases installed as per the manufactures specifications?
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Are any bolts or connectors missing?
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Any corrosion or rust present in system or parent structure?
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Is the system free from any contaminants
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Is the system free from dents, cracks, splitting and/or other damages?
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Is there any other visible damages or modifications that may cause the system to fail?
Other Structures for Anchoring
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undefined
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Photos
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Is the structure a permanent support of the building?
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Can it be accessed with ease?
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Is the structure free from dirt, grease, insects and other contaminants?
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Does the structure have any sharp edges or burrs?
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Will the structure hold a 15+kN load?
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Could slings or other rigging slip off?
Final Appraisal
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What is the result of the inspection?
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If anything besides safe for use was selected please give details
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Items to be addressed
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Photos
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Will a return visit be required? If yes provide details
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Additional notes from technician
By Submitting this audit, the Technician has confirmed the site / systems are safe and comply to all relevent stardards uneless stated in above report.
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I Agree
Audit. The Contractor needs to demonstrate they are complying with their obligations as an employer, what specific remedial action they propose for this site, and if any overall modifications are required to their Health and Safety Plan / safety procedures / supervision. Prompt corrective action is required to eliminate any agreed deficiencies, and areas of any disagreement need to be further explored in writing. All “failed responses” need to be addressed / Reported to Client and resolved.
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Do you agree?