Surveillance Report Information

OHS Worksite Surveillance Report

  • Job Number

  • Address / Reference Number

  • Client

  • Date

  • Inspected By:

  • Location
  • Team Name

  • Non Conformances that are (H = High Risk) must be acted on as soon as possible.
    (M = Medium Risk) actions can be programmed for rectification.

OHS Controls

1. OHS Controls

  • 1.1 Staff and Contractors have Work Cover Card and Drivers Licence- Rating High

  • Comment / Actions Taken and Date

  • 1.2 Staff and Contractors have inducted to Site or signed into Building - Rating Medium

  • Comment / Actions Taken and Date

  • 1.3 Visitor Log Book Signed. (Buildings) - Rating Medium

  • Comment / Actions Taken and Date

  • 1.4 SWMA, SWMS and Safety Folder available on site - Rating High

  • Comment / Actions Taken and Date

  • 1.5 all Site Specific Hazards have been Identified and Controlled - Rating High

  • Comment / Actions Taken and Date

  • 1.6 On Larger Projects are Toolbox Talks available - Rating Medium

  • Comment / Actions Taken and Date

  • 1.7 On Larger Projects Site Specific OHS Management Plan Onsite - Rating Medium

  • Comment / Actions Taken and Date

  • 1.8 Emergency Contacts Onsite -Rating Medium

  • Comment / Actions Taken and Date

  • 1.9 PPE available and being used -Rating High

  • Comment / Actions Taken and Date

  • 1.10 First Aid Kit Class B for up to 25 Staff. See checklist in Safety Folder Section 8 - Rating High

  • Comment / Actions Taken and Date

  • 1.11 Sharps Kit Contents Onsite -Rating High

  • Comment / Actions Taken and Date

  • 1.12 Vehicle and Plant Hazard Lights On -Rating Medium

  • Comment / Actions Taken and Date

Traffic Controls

2. Traffic Controls

  • 2.1 Traffic Plan is Available Onsite - Rating Medium

  • Comments / Action Taken and Date - Rating Medium

  • 2.2 Traffic Plan Scenarios

  • Comments / Action Taken and Date

  • 2.3 Does Traffic Plan adequately control Pedestrians and Vehicles - Rating High

  • Comments / Action Taken and Date

  • 2.4 Traffic Plan Evacuation Points - Rating High

  • Comments / Action Taken and Date

  • 2.5 Traffic Controllers have Tickets Onsite -Rating Medium

  • Comments / Action Taken and Date

  • 2.6 Traffic Controllers wearing PPE - Rating Medium

  • Comments / Action Taken and Date

  • 2.7 Traffic Controllers using appropriate Signage -Rating Medium

  • Comments / Action Taken and Date

  • 2.8 Are Staff regularly inspecting traffic control setup - Rating Medium

  • Comments / Action Taken and Date

Environmental Controls

3. Environmental Controls

  • 3.1 CCTS Chemical Matrix Onsite -Rating Medium

  • Comments / Action Taken and Date

  • 3.2 Spill Kits Onsite (Heavy Vehicles and Plant) - Rating High

  • Comments / Action Taken and Date

  • 3.3 Erosion and Sediment Controls in place - Rating High

  • Comments / Action Taken and Date

  • 3.4 Dust Controls (Refer to Dust SWMS) -Rating Medium

  • Comments / Action Taken and Date

  • 3.5 Noise Controlled (Refer to Noise SWMS) -Rating Medium

  • Comments / Action Taken and Date

  • 3.6 Weekly Vehicle Checks Completed - Rating Medium

  • Comments / Action Taken and Date

  • 3.7 Daily Plant Checks Completed - Rating High

  • Comments / Action Taken and Date

  • 3.8 Loads Covered to prevent spillage - Rating High

  • Comments / Action Taken and Date

  • 3.9 Site Clear of Waste, Rubbish and Debris - Rating High

  • Comments / Action Taken and Date

  • 3.10 Environmental Checklist Completed - Rating High

  • Comments / Action Taken and Date

Work Standards

4. Work Standards

  • 4.1 Materials and Tools used as specified - Rating Medium

  • Comments / Action Taken and Date

  • 4.2 Job Pack, Instructions Onsite - Rating Medium

  • Comments / Action Taken and Date

  • 4.3 Job As Built Information Accurate - Rating High

  • Comments / Action Taken and Date

  • 4.4 Construction to Specifications - Ratings High

  • Comments / Action Taken and Date

Work Standards Technical

4. Work Standards -Technical

  • 4.5 Site Log Book Signed -Rating Medium

  • Comment / Action Taken and Date

  • 4.6 Contractor ID Valid and on display - Rating Medium

  • Comment / Action Taken and Date

  • 4.7 Contractors Telstra Site Induction Certification Number available Onsite - Rating Medium

  • Comment / Action Taken and Date

  • 4.8 Contract Product Quality and OHS Plan Onsite -Rating Medium

  • Comment / Action Taken and Date

  • 4.9 Contract / Product Risk Assessment Plan Onsite - Rating High

  • Comment / Action Taken and Date

  • 4.10 Hard Copy of Detailed Design Onsite - Rating High

  • Comment / Action Taken and Date

  • 4.11 Work Instructions Available - Rating Medium

  • Comment / Action Taken and Date

Others

5. Others

    Others
  • Others

  • Rating

  • Conforms, Non Conforms, N/A

  • Comments / Action Taken and Date

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.