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  • This audit and self inspection tool is designed to guide you through a number of steps for ensuring you personal safety and that of your work colleagues. We each have a responsibility for safety and health in the workplace and the NZRB can only succeed in helping you to get home safely if you help us in making sure the correct checks are done as part of your workplace activities. If you have difficulties in using this equipment due to a error or recording of the information please speak to your team leader or contact healthandsafety@nzrb.co.nz.

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  • Venue Name (i.e. Race Course, Office etc)

  • Operational Group (select from drop down)

  • Date of inspection / audit conducted

  • Prepared by (Name of person conducting)

  • Location Address (enter location address)

Audit / Inspection type (please select from drop down list)

  • Select type of inspection / audit

  • Current BWoF displayed

  • There is a visitor register at reception

  • Visitor register shows evidence of use

  • Frontage of building is clean and tidy in appearance

  • Contact property and Procurement to notify the front should be cleaned to ensure proper standards of presentation are maintained

  • Reception area is tidy

  • Staff are reminded they need to maintain the reception area in a clean and fit state for presentation to visitors and the organisations standards.

  • Fire doors clearly labelled

  • Please make arrangements for correct signage to be placed through property and procurement or through Bayleys Property Services Ltd.

  • Fire exits are clear of potential blockages and obstructions I.e nothing with 1 square metre of the dorrway

  • All staff are reminded to keep emergency and other exits clear of potential obstructions - Manager is to ensure they remove this material and remind staff of the need to maintain these requirements.

  • Appropriate fire suppression equipment present

  • Please ensure you have the appropriate fire extinguishers (ABE, CO2) available

    Flamefighter-Extinguisher_ABE_9_0-e1415570583130.jpg
  • Fire suppressant equipment is in current test and inspection - check the yellow tag

  • Please contact Property and Procurement or Bayleys to have the fire suppressant equipment serviced.

  • Access ways are clear of obstructions

  • Staff are reminded they keep all access ways clear of obstructions and Manager is follow up an ensure this issue is dealt with.

  • Lighting is free form outages, failed units, flickering, poor levels

  • Notify property management

  • Air quality - free from odours, visible dust etc.

  • Refer property management

  • Thermal comfort - the temperature range is between 18-22 degrees (average) or in general is comfortable

  • Notify property management

  • Toilets - are clean, free from leaks, damage, cracked flooring or waste. Toilets are presentable and stocked for hygiene supplies required.

  • Staff are reminded the toilets should be maintained in a clean fit state for basic hygiene requirements - If leaks or other issues identified please notify property management

  • Work Stations - are in good condition - i.e. free from damage or heavy wear.

  • Please notify property management

  • Choose specific warehouse location

  • The warehouse is tidy and free of rubbish?

  • Fire exit doors free of obstructions?<br>

  • Rubbish has been removed or is in proper waste storage bins?

  • Sufficient lighting an lighting is in working order? Please note any lights which may require replacement or repair.

  • Access ways for safe pedestrian access clearly marked?

  • Heavy items on shelves are secured and stable?

  • Shelving is load rated and marked to show max loads possible?

  • There is a forklift on location?

  • Seat belt fitted and working?

  • Stowed with forks on the ground?

  • Reversing beacon works (sounds when reversing)?

  • Holds current test or inspection certificate?

  • Appropriate safety signage displayed on the forklift?<br>1 - authorised operators only.<br>2 - seat belt must be worn when in use?<br>3 - maximum loading signage displayed?<br>

  • Current F-Endorsement held by operator?

  • Free of leaks on hydraulic lines or fuel source?

  • Tyres in good condition? I.e. Sufficient tread depth (minimum 1.5 mm deth, or passes the 20 cent coin test depth).

  • Select type of equipment being inspected

You have selected Personal Protective Equipment please complete the following checks and net your observations.

  • Safety foot wear is free of damage (I.e. No exposed steel cars, upper sole in good condition, sole is not worn, laces are in good condition)? Slip on boots are not permitted.

  • Harness - full body is in good condition?

  • Webbing in good condition I.e free of feathering, tears, cuts, and abrasions?

  • Equipment certificate of fitness is current?

  • Quick release units work correctly - I.e. Free release, and lock properly when engaged?

  • No paint or solvent marks on the webbing?

  • nano lock or PFAS system attached?

  • Nano lock system works I.e. Retracts properly when released?

  • D-links or carabeeners load rated to a minimum of 15kN and working? I.e. Twist gate double action secures and works as required.

  • Double action scaff-it hooks work when tested and close and open smoothly?

  • Hung properly for safe storage?

  • Climbing hard hat

  • Current to within 5 years of issue or manufacture

  • Chin strap connectors work properly

  • Free of damage to shell

  • Free of paint marks or marker pen labelling or unapproved stickers / labels

  • Gloves

  • Gloves are fit for purpose free of holes and heavy wear

  • Gloves are suitable type or as approved by NZRB

You have selected electrical equipment inspection please complete the following checks and note your observations

  • Current electrical test and tag? (Check the tag is attached to the main power lead and is within date)

  • The item is free of damage? I.e. Squashed cabling, crimping, broken outer sheath, exposed colour coded wires (inner sheath) or exposed wires, or general damage such as cracked outer casings.<br>

  • The cable leading to the main unit is connected to a mains outlet or commercial rated power multi box?

  • The plug cable is not exposed to general foot or equipment traffic? I.e. Has a coverage or is stowed safely out of the way of such.

  • Select sub category of the venue item being inspected

  • This section will guide you through the checks you should perform on the EWP prior to use and should you identify any specific issues regarding the potential safe performance or condition of the EWP you must notify your Team Leader immediately to ensure it is resolved before operating the equipment.

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  • The EWP has a current inspection (i.e. within 6 months of last inspection and not expired

  • The EWP should not be used as the regular inspection is a legal requirement for ensuring the safety or the equipment for general activities and operation. The Matter should be referred to the team Leader for action by the Club and Supplier.

  • The EWP tyres are in good condition

  • The EWP should not be used as poor tyre condition can lead to instability during operation. The issue should be referred back the Club for resolving by the supplier.

  • Tyres are suited to rough terraine and outdoor use

  • The EWP should not be used in an outdoor environment

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  • The EWP is free of structural issues and potential damage i.e. corrosion, bends, warps etc.

  • The EWP must not be used and should be referred back the supplier through the Club PoC.

  • Free of hydraulic leaks or loss

  • The EWP should not be used until the fluid leak is repaired - this may cause the scissor lift to fail in operation

  • EWP controls show written visually clear instructions

  • Please review the operating manual and familiarise yourself with the controls - team leader should also notify the Club of the issue for the supplier to rectify going forward.

  • The EWP is fitted with outriggers

  • The EWP must not be used - all outriggers must deploy equally to provide proper stability

  • Outriggers are functioning correctly

  • Is the unit set on compacted hardseal? I.e. concrete or asphalt etc.

  • Ensure load spreaders are used for the operation - this will help to minimise the risk of ground subsidence during operation of the Scissor lift and provide stability.

  • The EWP cannot be used in an outside environment as the lack of outriggers makes this unstable in these environments.

  • There is a deadman control located in the caged area for the operator

  • There must be a dead-man control for the operator in case of emergemency fitted to the EWP

  • The caged area contains a rated anchor point for your attachment

  • Ensure you Do NOT attempt to clip onto the cage this is not rated, you should ensure you use a temporary anchor point strop for the attachment to a key structural feature.

  • The man cage gate locks to eliminate the potential for a fall by the operator

  • The EWP cannot be used - refer the matter back to your Team Leader who will notify the Club to address with the supplier of the EWP.

  • All start up alarms work as required (Audible)

  • The EWP cannot be used as this indicates there is a potential fault in the system that may affect the safe operation of the equipment.

  • The immediate area around the EWP is isolated from other work parties

  • The immediate work area of the EWP must be isolated from other people to within 1.5 times the working height of the platform.

  • Access ways clear and free of obstructions

  • Plug outlets in good condition, no exposed wiring and working

  • Work area is free of waste and rubbish including animal waste

  • Seating is in good condition and safe

  • Lighting is good

  • Please identify type of Tower

  • Safe access to the tower I.e ground condition is safe and not inhibitive.<br>

  • Tower access issues should be notified to the race club person via their point of contact person (PoC) through your Health and Safety Advocate and notified to the team lead. The race club will arrange to have the specific issues addressed prior to the next meet.

  • Ladder appears to be in good condition I.e free from corrosion bending, warping, or fatigue?<br>

  • Ladder should not be used and the issue must be referred back the club for further repair and action - alternative coverage arrangements should be made such as an EWP. Notify through the Team Leader or Director to the PoC person at the Club.

  • Tower appears to be in good condition by appearance?

  • Tower should not be used and the Club will need to provide repair beofre it can be used, discuss requirement with Team Leader for club to resolve.

  • Access to the tower is restricted? i.e.general public cannot reasonably gain access<br>

  • This does not affect your immediate ability to use the tower however the club must ensure this is resolved for general public safety requirements

  • Trap door / door to tower closes and opens freely without difficulty?

  • Issue must be resolved and actioned by the Club, this should be notified to the Club PoC Person through the Team Leader.

  • Tower interior is clean and hygienic?

  • Issue must be notified to the Club, if NZRB waste this must be removed by NZRB at the end of working day.

  • There is a permanent or temporary anchor point available within the tower?

  • Remember to use the temporary anchor slings provided as part of the safe working at heights kits during the climb.

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  • Safe access to the tower I.e ground condition is safe and not inhibitive.

  • Trap door / door to tower closes and opens freely without difficulty?

  • Ladder appears to be in good condition I.e free from corrosion bending, warping, rot, or fatigue?

  • Tower appears to be in good condition by appearance? i.e. not leaning, moving etc.

  • Access to the tower is restricted? i.e.general public cannot reasonably gain access

  • There is a permanent or temporary anchor point available within the tower?

  • Remember to use the temporary anchor slings provided as part of the safe working at heights kits during the climb.

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  • Tower interior is clean and hygienic?

  • Access to the tower is restricted? i.e. to prevent general public access

  • Please record and image of the specific issue

  • The club is required to ensure appropriate barriers are in place to prevent unauthorised entry being gained to the tower by the general public.

  • Tower structure appears free from dry/wet rot?

  • Please record an image of the specific issue and concern sighted.

  • Rot presents a significant hazard and risk to persons climbing the tower and the structural integrity of the tower, please ensure the PoC person at the club is notified via your health and safety advocate or the Team Lead. Rot must be dealt with by the club to correct - if the rot is a structural beam or member please tag the tower out and arrange an EWP with the club.

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  • No loose members of timber apparent on the tower

  • Record image of the specific issue identified

  • Loose members and timber present both a structural and dropped items risk to persons working on and in the vicinity of the tower. Notify the PoC person at the club through your team leader to have this repaired.

  • Tower ladder is secure and free from unusual movement

  • Record image of the ladder of concern.

  • This tower should not be used until the issue has been resolved - notify your team leader immediately to allow the Race Club to organise an EWP as per safe working requirements.

  • Rungs are free from warps, bending, cracking, rot, or fatigue?

  • Record image of the specific issues of concern

  • Ladder should not used - the issue must be referred to the Race Club through the Team Lead - the Club is required to provide and EWP or other arrangements with your team

  • Tower is free or rubbish and waste

  • Please record an image of the specific issue

  • Please ensure any waste generated by the NZRB is removed, if other waste this should be referred back the club to have the tower cleaned more regularly

  • Tower is clean inside the box?

  • Please record an image of the specific issue identified

  • Towers should be maintained free of any bird waste or general rubbish, please refer all non-NZRB waste issue to the club - bird waste poses a significant health risk to all persons and should be removed regularly. NZRB staff are reminded to ensure they remove any waste related with their work at the end of each race day.

  • Box access door is working correctly and not loose or containing rot?

  • Please record and image of any potential issues

  • notes of any specific issues identified or additional information for the Club

  • There are anchor points or suitable locations for the temporary anchor points available

  • Remember to use the temporary anchor slings provided as part of the safe working at heights kits during the climb.

    TAS M&C.jpg
  • Platform location

  • Platform is safe and stable i.e. free from movement or rot

  • Platform is not to be used. Please communicate with the Team Leader and or Director to arrange an alternative

  • Platform has safe access?

  • Relay requirements to the Club for resolution through the Team Leader and or Director

  • Is the platform over 1 metre in height?

  • Platform is fitted with a secure handrail and suitable access?

  • Refer issue to the Club for action through NZRB representative, team leader, or director for action;
    Note: The it is a building code requirement for items constructed with a fall potential greater than 1 metre to have appropriate fall prevention in place when constructed (Building Code NZ).

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  • You have good field of view for the camera

  • Notify the team leader and or Director to allow for the issue to be referred back to the club.

  • Is the last platform above 1 metre?

  • Suitable guard rail in place (max height should be 1100 mm and not less than 900 mm (waist height).

  • Ensure the issue is referred back to the Club for action - Building Code requires that all platforms and decks with a fall potential of 1 metre or greater to have suitable guard rails and barriers in place to prevent person falling.

  • Area is free of rubbish and waste?

  • Please record issue image

  • If rubbish is related to the NZRB operations this should be removed immediately and disposed properly, if the issue is non-NZRB please refer the matter back to the club for further action and for the waste to be removed.

  • Choose type of vehicle unit being inspected from drop down list

  • Trailer rego.

  • Trailer has maximum load rating displayed

  • Tyre tread depth is good I.e. 1.5mm or greater

  • Tow hitch coupling is free of any damage or defect

  • Tow hitch grease point is freshly greased

  • Storage unit compartment free of damage and closes securely

  • Current registration

  • Current trailer warrant of fitness displayed

  • Pin connector free of defects or exposed wiring

  • Trailer stop lights working

  • Jockey wheel functions correctly and free of defects

  • Trailer indicators working correctly as do hazards

  • Coupling works correctly and seats correctly on tow bar of vehicle

  • Brake unit hydraulic reservoir topped up with fresh (dark green) fluid

  • When closed the hydraulic brakes work properly

  • Trailer unit is free of damage

  • The trailer has a current registration

  • Vehicle rego.

  • Trailer has a current warrant of fitness

  • The trailer has a maximum load rating displayed

  • The trailer structure appears in good condition

  • The trailer stop lights function correctly

  • The trailer indicator lights function correctly

  • Check your indicators beofre operating the vehicle in tow

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  • The trailer coupling is free of defects

  • Image of trailer coupling

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  • The trailer unit draw bar chain is in good condition and connected properly with the correct load

  • Ensure the correct loading is stated for the chain

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  • Ensure the chain is correctly attached to the trailer

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  • The trailer Pin Connector is in good condition and free of exposed wires

  • Image of pin connector - check this is free of damage or exposed wires

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  • Current registration

  • Vehicle rego

  • Current warrant of fitness

  • Tyres have good tread depth 1.5mm or greater

  • Spare tyre is in good condition

  • Stop lights work properly

  • Indicators work properly

  • Coupling seats correctly and securely

  • Wiring pin connector in good condition I.e. Connects properly and free of exposed wiring

  • Trailer chain present and in good condition

  • Record mileage

  • Vehicle rego.

  • Current registration

  • Current vehicle warrant of fitness

  • If diesel the vehicle has current RUC (road user charges)

  • Indicators working correctly

  • Stop lights work correctly

  • Vehicle windscreen free of damage

  • Vehicle interior and exterior are clean and tidy

  • Vehicle is free of damage

  • Current first aid kit

  • Current fire extinguisher (ABE Dry Powder 1.5 kg minimum)

  • Record current mileage

  • Vehicle rego.

  • The vehicle has a current certificate of fitness

  • The vehicle mileage is within the RUC displayed

  • Seatbelts function and retract as designed.

  • Interior is clean and tidy

  • Exterior is free of damage

  • Tyres are in good condition I.e. A minimum of 1.5mm tread depth uniform ally across the tyres on all tyres.

  • Tyre is inflated to the correct PSi and has a good tread

  • There is a spare tyre fitted?

  • The tare changing equipment is present and able to be accessed easily

  • Head lights work both low beam and high beam.

  • Indicators work

  • Stop lights work

  • Reversing beacon operates when revering gear engaged

  • Water (windscreen) topped up

  • Window wipers work and function properly I.e. No streams on working

  • Oil is correctly topped

  • Vehicle has a first aid kit

  • Vehicle has a fire extinguisher fitted (minimum of ABE Dry powder 1.5kg)

  • Vehicle is fitted with a hydraulic ramp?

  • Grease nibs have been greased for hydraulic pins with fresh MP Grease

  • Correct safety signage is displayed on the outside of the ramp I.e. Max loading and distance for following vehicles and parking vehicles

  • Vehicle is OB (Broadcasting Truck)?

  • Ram pins properly engage on retractable steps

  • Manual pins properly engage when retractable steps stowed

  • Door latches operate properly and able to be secured for transit

  • Electrics tagged and tested within last 12 months

  • Appropriate safety signage is displayed

Report completion

  • Please record any general observations you have made in addition to the findings listed in this report.

  • Name and signature of the person conducting this inspection / audit

  • Once completed please save the inspection / audit to the ES file under the title of the inspection as a PDF.
    Store in the inspection file, or
    log onto your work gmail if you have internet access and email to the relevant email account - i.e. hscentral@nzrb.co.nz; hsnorthern@nzrb.co.nz; hssouthern@nzrb.co.nz

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The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.