Information
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Prepared by
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Conducted on
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Location of Works
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Name of Contractor
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Service Request Number
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This Inspection Report is intended for use by City West Water (CWW) employees to ensure contractors are meeting OH&S requirements and undertaking works in accordance with current industry standards.
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Type of Work
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Description of Works
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Current Weather Conditions
Occupational Health and Safety
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Has a JSEA/SWMS been completed with all associated risks identified?
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Has the JSEA/SWMS been signed by all personnel at the site?
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Are all personnel on site carrying appropriate licences for the tasks being performed?
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Has a DBYD/MOCS enquiry been made to identify all other services in the vicinity of the works? (Planned works)
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Is the appropriate PPE being worn for the activities being undertaken?
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Is the PPE in proper condition and being worn correctly?
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Are correct manual handling techniques being used by all personnel on site?
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Is there a sufficiently stocked First-Aid kit available on site?
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Is an Abnormal Voltage Detection Device (AVDD) being used for this task?
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Is the AVDD being used correctly and is it within the required calibration period?
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Please enter the calibration/service date and unit identification number.
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Comments
Traffic and Pedestrian Management
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Is appropriate traffic and pedestrian management being implemented?
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Is a copy of the Traffic Management Plan available on site?
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Has the worksite been isolated (e.g. Para-webbing, barriers) to protect the public and prevent unauthorized entry?
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Are all safety signs and equipment being used in good condition?
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Comments
Confined Space Entry
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Does this activity involve Confined Space Entry (CSE)?
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Have Confined Space Entry permits been obtained and filled out correctly?
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Do all personnel performing the Confined Space Entry have the appropriate training and licenses?
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Has the Operational Control Centre (OCC) been notified of the Confined Space Entry?
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Is the Confined Space Entry being undertaken as per the Confined Space Entry Plan?
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Is a copy of CWW's 'Confined Space Entry & Associated Work Procedures' (PRO-69) available/accessible on site?
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Is all PPE being used for the Confined Space Entry in service and in proper condition for its use?
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Comments
Vehicles, Plant and Equipment
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Are all vehicles, plant and equipment clean and in good working order?
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Are vehicle and plant log-books correctly filled out and up to date?
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Does all plant and equipment have the required safety mechanisms and silencing tools in place?
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Is there an 'in-service' Fire-Extinguisher available on site?
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Comments
Asbestos Tasks
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Is asbestos removal or repairs involved in this task?
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Is the contractor suitably licensed (e.g. Class B licence) to undertake asbestos related activities?
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Has an Asbestos Plan been completed and a Supervisor nominated?
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Are all personnel involved in the task appropriately trained and certified to carry out asbestos related tasks?
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Is the appropriate PPE for asbestos related tasks being worn by all workers on site?
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Is the appropriate signage being displayed correctly on site?
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Has all waste been removed as per current industry standards (i.e. double-bagged with SR number written on outer bag)?
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Comments
Environmental Aspects
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Are silt traps in place to prevent excessive sediment entry into storm water drains?
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Are measures in place to protect Flora and Fauna from being damaged as a result of works?
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Are all hazardous substances and/or dangerous goods stored safely on site and correctly labelled?
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Are MSDS's available and/or accessible to workers on site?
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Are waste stockpiles watered down to prevent excessive dust and contaminants from entering the atmosphere?
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Comments
Customer Focus
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Have customers been given the required notification of the activities being undertaken?
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Has the water supply been shut down?
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Please enter the time that water was called off.
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Is the contractor aware of CWW's timeframe for water supply interruptions (i.e. 146 minutes)?
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Has there been any consequential damage caused to customers property or other assets?
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If damage has been caused, have all of the relevant details been recorded and reported?
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Comments
Excavation
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Is the excavation size appropriate for the activities being undertaken?
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Is the correct equipment being used for the excavation?
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Is the excavation greater than 1.5m in depth?
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Has the contractor sent a notification to commence trenching to WorkSafe?
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Are proper shoring devices safely in place?
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Is backfilling and compaction being undertaken in accordance with CWW and/or council/VicRoads requirements?
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Comments
Mechanical and Electrical - Sewer
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Has the wet-well and site been cleaned as per CWW standard procedures?
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Are all covers correctly re-fitted and in good condition?
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Are 'fall from heights' barriers and protection measures in place?
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Are all alarm inhibit over-rides reset?
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Are log-book details entered and station locked up?
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Comments
Opportunity for Improvement
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Were any opportunities for improvement identified during this inspection?
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Please enter details below and ensure they are recorded, reported and followed up.
Sign off
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Auditor's Signature
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Once you have selected 'Finish' below, please export this document via email to auditsnetops@citywestwater.com.au