PAIR Form - Site Documents

• Inspection Type: (Site Documents)

• Contractor:

• Team:

• Date:

  Date

• Prepared by:

• Project Title:

• ELR & Mileage:
  Address

• Weather & temp:

Site documents

• Work activities on site:

• Work package plan?

  Yes

  No

  N/A

• SSOW: Mileage and date correct? Cards checked and all signed-in? Safe system suitable for work at site and access to site? Briefed to the team? How is the SSOW maintained? (photos)

• SSOW pack suitable?

  Yes

  No

  N/A

• Task Brief: Mileage and date correct? All tasks on site contained within? Personnel, equipment, and plant correct? Emergency information correct? Signed and briefed? (photos)

• Task brief suitable?

  Yes

  No

  N/A

• Work at Height Form? (ADB/DDD Projects)

  Yes

  No

  N/A

• Line Block Approval Form? (if applicable)

  Yes

  No

  N/A

• Risk Assessments: POWRA completed? Site specific hazards listed with appropriate mitigations? Correct date? Signed and briefed? (photos)

• Risk assessments? (POWRA)

  Yes

  No

  N/A

• ALO form?

  Yes

  No

  N/A

• Daily/weekly work plan?

  Yes

  No

  N/A

• Tool & equipment check sheets?

  Yes

  No

  N/A

• Tool & plant service records?

  Yes

  No

  N/A

• Lift Plans? (if applicable)

  Yes

  No

  N/A

• HAVS forms?

  Yes

  No

  N/A

• Written Third party agreements?

  Yes

  No

  N/A

• Bird nesting form?

  Yes

  No

  N/A

• Ecology recommendations?

• Operative competencies?

  Yes

  No

  N/A

• First aid competency?

• LOLER certificates?

  Yes

  No

  N/A

• Additional comments?

Actions to be entered into CMO:

• Enter an Action, an Action Owner, and an Action Date.
  If N/A, enter “No actions”.

• 1.

• 2.

• 3.

• 4.

• 5.

• 6.

• 7.

• 8.

• All actions have been assigned correctly, and Close Calls recorded where required.

  Sign