Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
General
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Permit valid. From Date: Time: To Date: Time:
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Site Induction complete
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JPH Approved Contractor
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SWMS have been received
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Company
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Brief description of works
Work Permits - are any of the following work permits required?
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Hot Works
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Energy isolations
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Confined space
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Working at heights
Working Area
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Location
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Number of workers
Personal Protective Equipment
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Is there any requirement for PPE
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Does the worker have all required PPE to complete the works
Hot Works Requirements - to be completed by Key Services
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CO2 fire extinguisher provided
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Barricades, warning, signs & spark/flash screens provided
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Work area, trenches, pits clear of flammable liquids, gases or vapours
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Combustibles located within 15m removed or protected with non combustible curtains, metal guards or flame proof covers
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All floor and wall openings within 15m have been covered to prevent the transmission of sparks
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The work area and all adjacent areas have been inspected at the completion of works ensuring no fire conditions were present
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The hot work area and any adjoining areas must be patrolled from the start of the work until 60 minutes after the work is completed
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The work area has been cleaned and clear to prevent any trip or slip hazards
Hot Works Requirements - to be completed by Building Managment / Security
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Fire Sprinklers and / or thermal detectors must be confirmed operational where installed
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Smoke detectors must be isolated in the work area
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The work area and all adjacent areas where sparks may spread were inspected after works complete, ensuring no fire conditions were present
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De-isolation of the smoke detectors within hot works area within 40 mins of the completion of the works
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Building Managment / Security
Energy Isolations
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Has approval been given for the isolation
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Testing equipment is in good working order
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Locks and/or tags have been installed
Confined Space
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Has the worker completed confined space training
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Confined space permit completed.
Working at Heights
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Has the worker completed working at heights training
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Has the worker been trained in the use of fall restraint equipment
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Fall restraint system required
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Fall restraint equipment is in good working order and in date
Completion of Work
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Has the work area been restored to normal safety / housekeeping requirements
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Have all Isolations and alarms been reactivated
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Signed Key Services
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Signed Subcontractor