Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Worksite setup

  • Pedestrian management assessed

  • Traffic management assessed

  • Appropriate signage and guarding utilised

Assess/review the job and it's surrounds

  • Presence of snakes, spiders and sharps assessed

  • Sufficient traffic and pedestrian access

  • All appropriate PPE on site

  • Weather conditions suitable

  • Light sufficient for all tasks

Accessing underground plant

  • Correct manual handling tools used

  • Manholes double guarded

  • Pits guarded

  • Gas detector used and nil gas present

  • Trip hazards, slippery ground assessed near open plant

  • Presence of snakes, spiders and sharps assessed

  • Plant under 1.5m deep

  • Spotter present for plant over 1.5m

  • Obstructions cleared to allow egress from plant

  • Sufficient light

  • Asbestos risk assessed

  • Unattended plant able to be guarded and safe

Accessing customers premises

  • Ground surfaces assessed for trips and slips

  • Noise, electrical and chemical hazards assessed

  • Presence of dogs,snakes, gases assessed

  • Exposed asbestos assessed

  • Breathing protection used in concealed/confined spaces

  • isolation of electrical hazards assessed

  • Underground/overhead services assessed

  • 3rd party present for concealed/confined space access

  • Faulty CLP assessed

  • Working at height assessed

  • CPE assessed as safe

Cable flash testing, heat shrinking

  • Burns, lead-poisoning and explosions assessed

  • Fire extinguisher present and accessible

  • Emergency contact possible

Hauling and jointing

  • Correct manual handling tools available

  • Fluid hazard assessed

  • Sharp tooling used with guards and away from body

  • All combustibles removed from work area

Pit and pipe trenching and repair

  • Public utilities identified

  • Hazardous materials assessed

  • Asbestos handling assessed

  • Appropriate guarding present

Aerial cable installation

  • Pole integrity assessed

  • Clearance from power assessed

  • Clear fall area assessed

  • Ground surface level and clear for ladder footing

  • Sufficient lean possible for 4:1 ladder angle

Additional comments

  • Additional comments

  • Add signature

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.