Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
More than one auditor?
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Additional auditors
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Can the work be undertaken from the ground or from a solid construction?
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If not can the work be undertaken using a passive fall prevention device? (Tick applicable)
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Scaffolds
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Perimeter screens
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Step platforms
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Perimeter guard railing
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Elevating work platforms
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Guard railing edges of roofs
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Mast climbing work platforms
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Protection for trenching works
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Work boxes
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Safety mesh
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Can the work be undertaken using a fall arrest system? Tick applicable
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Travel restraint systems
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Industrial rope-access systems
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Can the work be undertaken using a fall-arrest system?
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Safety harness systems (other than travel-resistant systems)
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Catch platforms
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Working at Heights (WAH) permit, SWMS / JSEA in place
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WAH permit, SWMS / JSEA reviewed and signed by all involved in the task
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Fall prevention equipment inspected and suitable for task
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Fall prevention systems insatlled and inspected by a competent person
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Personnel trained in the use of equipment
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Tools and equipment secured by lanyards (hard hats secured by chinstraps)
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Spotter being used for all WAH activities at all times
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Exclusion areas (below) defined and controlled by barricading, signange and spotter
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Wind speed is acknowledged and operations are halted during strong winds as determined by risk assessment and/or plant (EWP) manufacturer's operations manual?
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Rescue plan in place and adequate
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Have the following common WAH hazards been assessed?
- surfaces (slips, stability, strength and slope)
- level changes
- stability of structures (temporary or permanent)
- the ground (stability and evenness of the ground for scaffold or work platforms)
- edge protection (including protection around open edges of floors)
- openings and holes (guarding in place)
- any loads on elevated work areas above workers
- hazards below (star pickets, reo bars)
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Signed PoMC Representative:
Action required?
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Action
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Allocated to
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Action due
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Signed Principal Contractor Representative (optional):