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

  • Photo of Accreditations

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

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

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

  • Photo of SWMA

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

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

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

  • 1.8 Emergency Contacts Onsite -Rating Medium

  • Photo of Emergency Contacts

  • 1.9 PPE available and being used -Rating High

  • 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

  • 1.12 Vehicle and Plant Hazard Lights On -Rating Medium

Traffic Controls

2. Traffic Controls

  • 2.1 Traffic Plan is Available Onsite - Rating Medium

  • Photo of Traffic Plan

  • 2.2 Traffic Plan Scenarios

  • Photo of NBN Scenario

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

  • Photo of Site Set Up

  • 2.4 Traffic Plan Evacuation Points - Rating High

  • Photo of Evacuation Plan

  • 2.5 Traffic Controllers have Tickets Onsite -Rating Medium

  • Photo of Accreditations

  • 2.6 Traffic Controllers wearing PPE - Rating Medium

  • 2.7 Traffic Controllers using appropriate Signage -Rating Medium

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

Environmental Controls

3. Environmental Controls

  • 3.1 CCTS Chemical Matrix Onsite -Rating Medium

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

  • 3.3 Erosion and Sediment Controls in place - Rating High

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

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

  • 3.6 Weekly Vehicle Checks Completed - Rating Medium

  • 3.7 Daily Plant Checks Completed - Rating High

  • Photo of Plant Checks

  • 3.8 Loads Covered to prevent spillage - Rating High

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

  • 3.10 Environmental Checklist Completed - Rating High

Work Standards

4. Work Standards

  • 4.1 Materials and Tools used as specified - Rating Medium

  • 4.2 Job Pack, Instructions Onsite - Rating Medium

  • 4.3 Job As Built Information Accurate - Rating High

  • 4.4 Construction to Specifications - Ratings High

Work Standards Technical

4. Work Standards -Technical

  • 4.5 Site Log Book Signed -Rating Medium

  • 4.6 Contractor ID Valid and on display - Rating Medium

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

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

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

  • 4.10 Hard Copy of Detailed Design Onsite - Rating High

  • 4.11 Work Instructions Available - Rating Medium

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.