Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Select date

1 EMERGENCY RESPONSE

  • 1.1 Current Emergency Evacuation Plan & Procedure displayed in appropriate positions around site?

  • 1.2 Fire Extinguishers are marked correctly on evacuation plan?

  • 1.3 Emergency assembly & Muster points are highlighted on the evacuation plan?

  • 1.4 Location of First Aid kits are marked on the evacuation plan?

  • 1.5 Emergency Exits are marked correctly on evacuation plan

  • 1.6 Emergency Numbers displayed on evacuation plan?

  • Tick if the emergency numbers displayed on evacuation plan include:

  • Local Police Station

  • Local Fire Brigade

  • Local Hospital

  • Power or electricity source

  • Gas

  • Chemwatch

  • Water & Sewerage

  • Site Managers phone number

  • 1.7 Firefighting equipment in place and in good condition?

  • 1.8 Fire extinguishers are correct type for the area?

  • 1.9 Fire extinguisher signage is in place and correct?

  • 1.10 Fire extinguishers are serviced every 12 months and fitted with anti-tamper tags?

  • 1.11 One metre clearance maintained around fire fighting equipment?

  • 1.12 Access to fire fighting equipment is clear?

  • 1.13 Fire Breaks in place and adequate?

  • 1.14 Access to switchboards is clear and unobstructed?

  • 1.15 Smoke alarms fitted in nominated locations?

  • 1.16 Emergency assembly / muster area(s) sign posted?

  • 1.17 Emergency assembly / muster area(s) have a clear path to them and are free of debris?

  • 1.18 First Aid kits are available with correct signage displayed?

  • 1.19 First Aid kits in good condition and fully stocked (contents list is located on inside of kit - check)?

  • 1.20 Are names of first aiders on site located on the first aid kit?

  • 1.21 Sign in sheets accurate?

  • 1.22 Emergency 'exit' signs present and illuminates (above fire doors and directing exits)?

  • 1.23 Exits and stairs clear and unobstructed?

2 House Keeping

  • 2.1 Access / Egress to work sites up to standard?

  • 2.2 Caps on star pickets & rebar?

  • 2.3 Rubbish bins provided and used?

  • 2.4 Materials neatly stacked?

  • 2.5 Work platforms clear?

  • 2.6 Adequate lighting for night work?

  • 2.7 All hoses off ground?

  • 2.8 Correct signage in place & readable?

  • 2.9 Hazardous Sub's labeling & storage?

  • 2.10 Waste stored / removed correctly?

  • 2.11 Recycling is occurring?

  • 2.12 Do employees pick up stock / litter / spillages off floor & site area?

3 Offices and Ablutions

  • 3.1 Crib room clean, tidy and hygienic?

  • 3.2 Floors are clean, clear with a safe path of travel throughout area?

  • 3.3 Floor coverings / surfaces in good condition?

  • 3.4 Toilets clean and hygienic?

  • 3.5 No evidence of sewage spills or overflows?

  • 3.6 Barricading / signs in place where required?

  • 3.7 Access and Egress; trip hazards, condition of flooring, anti-slip, handrails?

  • 3.8 Emergency Evacuation Plan?

  • 3.9 Air conditioning & Ventilation adequate?

  • 3.10 Filing Cabinets / Shelving - not overloaded?

  • 3.11 Leads, Lighting, Emergency Lighting?

  • 3.12 Housekeeping, cleanliness, food / rubbish disposal, hygienic?

  • 3.13 Individuals Work Stations clean and tidy?

  • 3.14 Office equipment; Shredder protected, good height, ventilation, noise - all adequate?

  • 3.15 Equipment such as chairs, desks, computers, etc. are in good working condition?

  • 3.16 Lights are working, covers in place where required and adequate for the job?

  • 3.17 Double adaptors are not being used?

  • 3.18 Electrically operated machines have current testing and tagging (includes kitchen appliances older than 12 months)?

  • 3.19 Power points and power leads are good condition (no leads across floors or on wet surfaces)?

  • 3.20 First Aid Kit available?

  • 3.21 MSDS available?

4 Personal Protective Equipment (PPE)

  • 4.1 PPE available at the worksite?

  • 4.2 All appropriate PPE being worn?

5 Mechanical / Workshop

  • 5.1 9" grinders not in use?

  • 5.2 Clips fitted to all hoses?

  • 5.3 Correct discs used in grinders?

  • 5.4 Ladders secured and tagged?

  • 5.5 guards fitted to machinery/ tools?

  • 5.6 All power tools fitted with dead man?

  • 5.7 Portable electrical equipment Tagged and current?

  • 5.8 Wheel chocks in use / available?

  • 5.9 Hand held tools are in good condition and stored appropriately?

  • 5.10 Are sufficient stocks of PPE kept?

  • 5.11 Manual handling aids available?

  • 5.12 Gas bottles secured / protected from damage or falling over ( e.g strapped or chained to secured fixture)?

  • 5.13 Ladders used are in good working condition?

  • 5.14 Safety warning signs present including:

  • Manual Handling

  • Eye protection

  • Keep out - Authorised Personnel Only

  • Visitors report to the Office

  • Chemicals

  • 5.15 A register of authorised employees to operate plant / equipment is available?

  • 5.18 Stacked items are safe - not overhanging or leaning?

  • 5.19 Are pallets in good condition?

6 Electrical

  • 6.1 Condition of leads, plugs etc - adequate upon assessment?

  • 6.2 ELCB / RCD used for portable tools - adequate upon assessment?

  • 6.3 All equipment tagged correctly?

  • 6.4 Leads off ground not near water?

  • 6.5 Isolations appropriate & completed?

  • 6.6 Earth leads on welders good condition?

7 Vehicles and Mobile Equipment

  • 7.1 All vehicles parked according to parking rules?

  • 7.2 Road rules are being followed?

  • 7.3 Vehicles meet Minepower requirements?

  • 7.4 Weekly pre-start inspection completed and logged on all light vehicle?<br>Refer to Daily Re-start Inspection Checklist

  • 7.5 Daily Pre-start inspection completed and logged on all machinery?<br>Refer to Daily Pre-start inspection checklist

  • 7.6 Flashing lights & headlights working and being used?

  • 7.7 Are vehicles and equipment clean / no loose debris?

  • 7.12 Radio procedures being followed?

8 Traffic Management

  • 8.1 Full segregation of Light Vehicle & Surface Mining Equipment is in place?

  • 8.2 Park up areas are correct?

  • 8.3 Traffic management plans are in place?

  • 8.4 Speed limits are marked correctly?

9 Roads and Surfaces

  • 9.1 Windrows at correct height?

  • 9.2 Surfaces firm and safe?

  • 9.3 Roads have adequate width?

  • 9.4 Delineators are in place?

10 Excavations and Mining

  • 10.1 Battered back?

  • 10.2 Barricaded correctly?

  • 10.3 Easy entry and exit to Digger?

  • 10.4 Loading of Trucks sequenced?

  • 10.5 Correct method of digging is being used?

  • 10.6 Dumpy park up defined?

  • 10.7 All signals appropriate?

11 Job Start

  • 11.1 Job Hazard Analysis (JHA) appropriate & completed?<br>Refer to JHA checklist

  • 11.2 JHA on the job and understood?

  • 11.3 Field Level Risk Assessments (FLRA) have been undertaken?<br>Refer to FLRA cheklist

  • 11.4 Permits appropriate & completed?

  • 11.5 Isolations appropriate & completed?

  • 11.6 Work area de-marked and sign posted?

  • 11.7 Material Safety Data Sheets (MSDS) for chemicals at the workplace?

  • 11.8 Access/egress to work area appropriate?

12 Occupational Health

  • 12.1 Dust levels low and controlled?

  • 12.2 Noise levels acceptable?

  • 12.3 Fibrous Material is being controlled?

  • 12.4 Vibration is being controlled?

13 Hot Work

  • 13.1 Permit in place?

  • 13.2 Flashback arresters on cylinders and hand pieces?

  • 13.3 All equip (hoses, etc) in good condition?

  • 13.4 Fire extinguishers available for all Hot Work?

  • 13.5 Earth clamps in correct location?

14 Working at Heights

  • 14.1 WAH is being eliminated?

  • 14.2 Fall arrest equipment used?

  • 14.3 Permit to work at Height in place?

  • 14.4 Spotters in place as required?

  • 14.5 ECO barricading in place?

  • 14.6 Drop zone barricading in place?

  • 14.7 Dropped objects prevention is in place?

15 Craneage Operations

  • 15.1 Crane log books and documentation in place in the crane?

  • 15.2 Cranes set up correctly?

  • 15.3 Crane operator competent?

  • 15.4 Crane lift risk assessment form in place?

  • 15.5 Crane suitable for the task?

16 Confined Space

  • 16.1 Confined space permit in place?

  • 16.2 Sentry space permit in place?

  • 16.3 Procedure being followed?

  • 16.4 Space safe?

17 Hydrocarbon Storage

  • 17.1 All hydrocarbon materials inside bunds?

  • 17.2 Oil spill equipment available, status?

  • 17.3 No evidence of stains / spillage?

  • 17.4 Bunds fully effective?

  • 17.5 Fuel-containing equipment and plant in trays or provided with other bunding?

18 Flora and Fauna

  • 18.1 All clearing approved?

  • 18.2 VDAs in place for all activities?

  • 18.3 Priority flora is identified and fenced?

  • 18.4 Topsoil stockpiled and signposted?

  • 18.5 Easy exit for fauna from trenches & pits?

  • 18.6 Bore caps in place & conduit ends taped?

  • 18.10 No weeds growing in project areas?

19 Water Management

  • 19.1 Flow meters / volumes recording in place?

  • 19.2 Water holding facilities appropriately constructed (drainage of standpipes, depth)?

  • 19.3 Water holding facilities stock fenced & have exit ropes?

20 Erosion

  • 20.1 No erosion from stockpiles?

  • 20.2 No erosion of gullies and streams?

21 Sewerage Treatment

  • 21.1 Facility approved & permits in place?

  • 21.2 Alarms/warning devices in place for clearing capacity?

  • 21.3 Receiving effluent tank higher capacity then freshwater input tank?

22 Occupational Health and Safety Administration

  • 22.1 Is there a procedure for personnel to refuse working where they feel that injury or harm could occur to themselves or to other people?

  • 22.2 Has a register of Hazardous Materials been developed?

  • 22.3 Names of OH&S Reps Displayed on Notice Board?

  • 22.4 Incident / Accident Recording, Reporting & Investigation Folder is available and current?

  • 22.5 Danger Tags are available and being used correctly site wide?

  • 22.6 Current Company OHS Policies are on display in a prominent position?

  • 22.7 Review Toolbox Minutes from last six meetings?

  • 22.8 Have Site Specific Risk Assessments been completed on contractors?<br>Refer to Site Specific Risk Assessment Checklist

  • 22.9 Is the Site Specific Risk Assessment Current? (Risk Assessment must be no older than 2 years old.)

  • 22.10 Have controls been put in place to control hazards identified? (review site specific risk assessment)

  • 22.11 Does the Site conduct regular evacuation drills? Did the employees participate (Review the last few Fire Drill Records)

  • 22.11(1) When was the last one (Last evacuation drill not to be more than 6 months)

  • 22.12 Has the employee completed Specific Training (review on the job training records)

  • 22.13 Has the employee received / or has the ability to access Safe Work Procedures? (review employee file for sign off)

  • 22.14 Has each crew been established with a First Aider?

  • 22.15 Employees who conduct specialist tasks have received appropriate training in OH&S Related Matters? (check employee personnel files for record of training (certificate or attendance registers)

  • 22.16 Employees have received appropriate training in return to work? (check training matrix)

  • 22.37 Has OH&S Training been conducted for OH&S Representatives within 12 months of accepting the position? (review personnel files or training matrix)

23 Chemicals

  • 23.1 Are only approved chemicals being used as per the Approved Chemical Register?

  • 23.2 Chemicals stored on site are not expired or obsolete?

  • 23.3 Chemicals are not decanted? (substances must be in original containers with original labels)

  • 23.4 Are all the chemicals clearly labelled?

  • 23.5 Material Safety Data Sheets present at location where Chemicals are kept and easily accessible?

  • 23.6 Containers in which chemicals are stored are in good condition and are not leaking?

  • 23.7 Nominated area in which chemicals are stored is locked allowing only restricted access and bundled?

  • 23.8 Gas bottles secured/ protected from damage or falling over? (e.g strapped or chained to secured fixture)

  • 23.9 Is there adequate ventilation where chemicals are stored?

  • 23.10 Spill kits available and fully stocked?

  • 23.11 Are emergency showers or eye wash stations available & easily assessable?

Review

  • Remarks

  • Person completing form

  • Witness/Participant

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