NRU Site Inspection V1 - duplicate

• Client/Site
  Address

• Conducted on

  Date

• Prepared by

• Location
  Address
• Site Details (Brief description of work-site and the activities being undertaken)
  Address

• Is there a Covid 19 observer on site?

  Yes

  No

• Name the Covid 19 Observer

• <br>Is the Covid19 register correctly filled out with full names and contact details?

  Safe

  At Risk

  N/A

• Has anyone presented symptoms of potential Covid19 infection or shown any signs of being unwell?

  Safe

  At Risk

  N/A

• <br>Are personnel maintaining physical distance separation between themselves (at least 1m apart at all times)

  Safe

  At Risk

  N/A

• If required to work in closer proximity than 1m of another person, is the correct PPE (mask, gloves and eye protection) being used correctly?

  Safe

  At Risk

  N/A

• Does the site have appropriate hand washing facilities and/or hand sanitiser available?

  Safe

  At Risk

  N/A

• Does the site have adequate information posters displayed that clearly explain the required Covid19 mitigation measures?

  Safe

  At Risk

  N/A

• Is the RPO/SP conforming with the requirements of Special Bulletin 300 (locking on/off)?

  Safe

  At Risk

  N/A

• Is the required cleaning of shared surfaces being undertaken by the designated person?

  Safe

  At Risk

  N/A

• How many people onsite?

• Are workers broken into groups of less than 10 personnel?

  Safe

  At Risk

Permit to Enter

• Is the individual / contractor covered by a Permit to Enter issued by the National Permit Office (applies to non-KiwiRail only)?

  Yes

  No

• Does the Permit accurately reflect the location / site where access is required?

  Yes

  No

• Is the Permit to Enter held on site?

  Yes

  No

• Has the permit been signed by the permits office?

  Yes

  No

General Access

• Is access managed through the Northland Coordination Centre correctly?

  Yes

  No

• Has a SWMS/JSEA or similar been completed for the proposed works?

  Yes

  No

• Has notifiable work been advised to WorkSafe

  Yes

  No

  N/A

• Is there sufficient protection of the site to restrict public access (fencing/gates etc)?

  Safe

  At Risk

  N/A

• Are public safety controls in place?

  Safe

  At Risk

  N/A

• Is traffic management in place?

  Safe

  At Risk

  N/A

• Is there sufficient supervision on site? Name the site Supervisor.

  Yes

  No

  N/A

• Are general well-being issues being adequately managed, D&A testing, hours of work, rest periods and knowledge of employee Welfare Officer/services such as EAP?

  Yes

  No

  N/A

Hazardous Goods and Materials

• <br>Are any Hazardous Goods or materials being used on site?

  Yes

  No

• Are Hazardous goods and materials stored in the correct container and in a safe manner?

  Safe

  At Risk

• Are the Safety Data Sheets Available onsite for the Hazardous materials being used?

  Yes

  No

Personnel

• Do all personnel onsite have either, a valid KiwiRail competency card, Staff 23, or IMC learning app installed on their phone?

  Yes

  No

• Are all the LTOs / Competencies held for the proposed works, are they current and Safety Observations in date?

  Safe

  At Risk

• Has the pre-start briefing been held and site specific hazards identified?

  Safe

  At Risk

• Are trainees being supervised (where applicable)?

  Safe

  At Risk

  N/A

• Do personnel working on track hold the required NRSS/NTC medical clearances (Cat 1, 2, 3 etc)?

  Safe

  At Risk

  N/A

PPE/Emergency Equipment

• Is the following equipment available for each member of the team?<br>a) Hi Viz clothing (ankle to wrist full body coverage)<br>b) Safety boots<br>c) Hard hat<br>d) Safety Glasses<br>e) Covid19 PPE available

  Safe

  At Risk

• Does the team have emergency equipment (as per company policy)?<br>a) First Aid Kit<br>b) Fire Extinguisher<br>c) Personal Locator Beacon<br>d) Means of communication - Sat phone, cellphone, RT<br>e) Torch/light spare batteries?<br>d) Water/food

  Safe

  At Risk

• <br>Are there sufficient emergency plans?<br>a) fire<br>b) tsunami<br>c) earthquake/landslides<br>d) process to evacuate injured person <br>e) medical emergency

  Safe

  At Risk

• Have Fire Extinguishers and First Aid kits been checked within last 6 months?

  Yes

  No

Hi-Rail Vehicles

• Is a HRV involved in the works?

  Yes

  No

• <br>Is there opportunity for conflicting movements or contact between Rail Personnel and the HRV?

  Yes

  No

• Has a work area critical control verification been completed for the operation of HRV's (Form KR_PPI_CCV)?

  Yes

  No

• Has a Mobile Plant Controller (MPC) been appointed for the work area?

  Yes

  No

• MPC to explain the communications plan

• Is the MPC and Worksite Supervisor in agreement with the movement plan?

  Safe

  At Risk

• Are all personnel operating plant correctly briefed and familiar with the movement plan/s?

  Safe

  At Risk

• Has the exclusion zone been established around plant machinery (please provide details of visual indication of exclusion zone as a note)

  Safe

  At Risk

• Do all Hi-Rail vehicles have a current 155b sticker to operate on track?

  Yes

  No

• Is there any evidence of modification to the HRV?

  Yes

  No

• If HRV is modified has this been certified by KiwiRail?

  Yes

  No

• Are the daily safety checks completed on the HRV?

  Yes

  No

• Is the Operator correctly certified and hold the required Cat 1 medical rating?

  Yes

  No

• Does the HRV have an operating manual containing information on the safe operation of the vehicle?

  Yes

  No

• Does the HRV have a fire extinguisher and first aid kit in the vehicle?

  Yes

  No

Track Protection

• Is rail protection required for the work being performed?

  Yes

  No

• <br>Are works closer than 4m to the track have sufficient protection or are they covered by special safe working arrangements?

  Safe

  At Risk

  N/A

• Is the work-site listed on the daily information bulletin?

  Yes

  No

• Does the work team have access to KiwiRail safety information applicable to the work (Track Safety Rules, Bulletins, Codes?)

  Yes

  No

• If working with a Rail Protection Officer or Site Protector, does the RPO/SP have local knowledge and access to S&I diagrams for the area?

  Safe

  At Risk

Tunnels

• Is tunnel work involved?

  Yes

  No

• Has A Tunnel Work Safety Plan been completed?

  Yes

  No

• Are the appropriate TARPs available?

  Yes

  No

• Are Drager Gas Monitors correct type covering all gases (02, C0, N02) being used correctly?<br>a) bump tested<br>b) fresh air calibrated<br>c) in date

  Yes

  No

• When required, is each individual in possession of an SCSR?

  Yes

  No

• If HRV's , EWPs or machines being used in tunnel fire hardened/suppressed?

  Yes

  No

  N/A

• If tunnel access is via an HRV, are there suitable emergency evacuation arrangements in place?

  Yes

  No

  N/A

• Is petrol powered plant being used within the tunnel environment?

  Yes

  No

• Are all the tunnel related LTOs / Competencies held for the proposed works and Safety Observations up to Date?

  Yes

  No

Working at Height

• Is there appropriate fall protection arrangements in place?

  Safe

  At Risk

  N/A

• If using scaffolding, has this been certified and checked weekly?

  Safe

  At Risk

  N/A

• If personnel are using harnesses have they been trained in their safe use?

  Safe

  At Risk

  N/A

• Edge protection in place?

  Safe

  At Risk

  N/A

Cuttings and Embankments

• Are there arrangements in place to address the risk of collapse or other geo-technical issues?

  Safe

  At Risk

  N/A

• Is there a risk of material falling from above? Has the risk been controlled?

  Safe

  At Risk

  N/A

Plant, Machinery and equipment (generators, powered track maintenance tools, excavators etc, compressors, power tools)

• Are pre-start checklists completed for all excavators and plant on site?

  Yes

  No

  N/A

• Are safety interlocks and guards fitted?

  Yes

  No

  N/A

• Are excavators fitted with appropriate operator protection for the site safety risks (ROPS/TOPS/FOPS/COPS/OPS)?

  Yes

  No

  N/A

• Are operators of minor plant trained or instructed in the safe use?

  Yes

  No

  N/A

• Does minor plant have current 155 certification?

  Yes

  No

  N/A

• Are all electrical leads/appliances/generators tested and in date?

  Yes

  No

  N/A

• Do site caravans or portacoms etc have a current electrical WOF?

  Yes

  No

  N/A

• Has all minor plant been checked and safe to use?

  Yes

  No

  N/A

• Are chains and lifting equipment being used on site, are they tested and compliant?

  Yes

  No

  N/A

Site Specific

• Are site facilities tidy and in good condition?

  Yes

  No

• Is there sufficient site hygiene provisions (toilet, handwashing etc)?

  Yes

  No

• Photos of Worksite

  Media

Completion

• Full Name

  Sign