Title Page

  • Conducted on

  • Prepared by

  • Location

Safety and Environment System and Records

  • Have all staff on site undertaken Gippsland Water's corporate and site-specific inductions - where applicable?

  • Have risks associated with work been adequately considered and controlled?

  • Is documentation of the process present on site? e.g. current JSEAs, Risk Assessments etc.

  • Have risks and controls been adequately communicated to all staff working on site?

  • Have all safety hazards been addressed / controlled?

  • What is being done to avoid incident?

  • Are there adequate provisions on site to deal with a safety incident? i.e. first aid kit, mobile phone coverage, radio etc.

Chemical use

  • Are copies of SDSs for chemicals being used available on site?

  • Are chemicals being decanted in a safe way?

  • Is appropriate PPE being worn in line with the site JSEA or SOP?

  • Are chemicals being decanted in an environmentally appropriate location (i.e. away from waterways, spills cleaned up or contained, etc.)

  • Are spill kits available on site and placed logically where spills may occur?

  • Are adequate precautions being taken to avoid off-target damage?

  • Are weather conditions appropriate for chemical use?

Plant and equipment

  • Has all plant equipment been maintained in accordance with scheduled requirements?

  • Are all staff operating plant and equipment adequately trained or licenced to do so?

  • Are plant and equipment fitted with necessary guards, brakes and other safety controls?

  • Is appropriate PPE available and being used by staff operating and in the vicinity of plant and equipment?

Quality Management

  • Are staff adequately trained and / or experienced to deliver the service they are engaged to perform?

  • Is quality of work up to expected standard? i.e. minimal off-target damage from weed control, stakes and guards adequately secured, minimal disturbance from vehicles and foot-traffic on site, etc.

  • Are vehicles, plant and equipment free from soil, plant matter and other potential environmental contaminants?

  • Are recycling and waste options available and are they being used?

  • Are all permits for work (i.e. planning permits, FFG permits etc.) being complied with?

  • Does the work being conducted match the instructions given to staff for the particular job? i.e. are plantings being conducted in accordance with plans? Are all weeds intended to be targeted, being targeted?

  • Are all areas of the site requiring works, receiving works?

Opportunity for Improvements

  • Do you have any concerns with site safety that you wish Gippsland Water to address? If yes, please specify.

  • Are you aware of the process to report a safety hazard to Gippsland Water?

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.