'Out and About'

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Job details

• Location

  Select Road Nature Strip Reserve Private Property Dam/Catchment Other

  • Road
  • Nature Strip
  • Reserve
  • Private Property
  • Dam/Catchment
  • Other

• Asset

  Select Retic Distribution Pumping Station Treatment Other

  • Retic
  • Distribution
  • Pumping Station
  • Treatment
  • Other

• Type

  Water

  Sewer

  Recycled

  Storm Water

  Other

• Proposed Work

• Weather

  Hot

  Cold

  Dry

  Wet

• Work is

  Planned

  Unplanned

• Reason for work

  Failure

  Unplanned maintenance

Safe Job Planning

• Task requires any of the following permits

  Clearance to work

  Hot work

  Confined space

  Isolation

  N/A

• Add media

  Media

• Is this task classified as 'High Risk'

  Yes

  No

  N/A

• Is there a SWMS for this task

  Yes

  No

  N/A

• Were employees required to be logged onto 'Lone Worker'

  Yes

  No

  N/A

• Was a JSA required

  Yes

  No

  N/A

JSA

• Were all staff involved in constructing the JSA

  Yes

  No

  N/A

• Does the JSA identify all the job steps

  Yes

  No

  N/A

• Is the JSA detailed and avoids generic terms

  Yes

  No

  N/A

• Are all staff signed onto the JSA

  Yes

  No

  N/A

• Copy of JSA

  Media

P.P.E

• Are all staff wearing the required P.P.E

  Yes

  No

  N/A

• Were staff required to wear hard hats

  Yes

  No

  N/A

• Did staff have a wide brim or legionnaires flap attached to their hard hat

  Yes

  No

  N/A

• At any stage did you have to remind staff to put on their P.P.E

  Yes

  No

  N/A

Equipment

• Was the equipment used appropriate for the task

  Yes

  No

  N/A

• Do staff have the appropriate level of training

  Yes

  No

  N/A

• Was the equipment inspected prior to use

  Yes

  No

  N/A

• If FIPS gear was used, was the equipment within 10 years of its date of manufacture

  Yes

  No

  N/A

Work Site

• Is the area free from slips, trips & falls

  Yes

  No

  N/A

• Are exclusion zones in place

  Yes

  No

  N/A

• Is signage in place

  Yes

  No

  N/A

Manual handling

• Are staff taking regular rest breaks

  Yes

  No

  N/A

• Are staff job sharing/rotating

  Yes

  No

  N/A

• Are staff utilising 2 man lifts for heavy equipment

  Yes

  No

  N/A

General

• General observations

• Add media

  Media

• Add media

  Media

• Add media

  Media

• Add media

  Media

Recommendations

• Add signature

  Sign