Personal Protective Equipment Audit

• MIRDF007

• Personnel Protective Equipment Audit

• Operative

• Conducted on

  Date

• Auditor

• Location
  Address

NAME OF OPERATIVE

• Audit Type

  Interview

  Site Visit

• SURNAME

• FIRST NAME

• MOBILE NUMBER

• SENTINEL NO

COMPETENCES HELD

• Competence / Attachments

  Select PTS TRK IND LKT COSS IWA PC ES PS STRAP CC PICOP MC SPICOP SSoWp LLT CRP Level A

  • PTS
  • TRK IND
  • LKT
  • COSS
  • IWA
  • PC
  • ES
  • PS
  • STRAP
  • CC
  • PICOP
  • MC
  • SPICOP
  • SSoWp
  • LLT CRP
  • Level A

LOOKOUT KIT

• Blue Bag

  Yes

  No

  N/A

• Track Circuit Clip (unopened)

  Yes

  No

  N/A

• Horn

  Yes

  No

  N/A

• Whistle

  Yes

  No

  N/A

• Torch

  Yes

  No

  N/A

• Red Aspect Attachment

  Yes

  No

  N/A

• Spare Battery

  Yes

  No

  N/A

• First Aid Kit

  Yes

  No

  N/A

• Red Flag

  Yes

  No

  N/A

• Chequered Flag

  Yes

  No

  N/A

• Site Warden Badge

  Yes

  No

  N/A

• Lookout Badge

  Yes

  No

  N/A

• Detonators

  Yes

  No

  N/A

EQUIPMENT

• Possession Limit Boards

  Yes

  No

  N/A

• Engineering Work Site Boards

  Yes

  No

  N/A

• Live Line Tester

  Yes

  No

  N/A

• Calibration Date

  Date

• Proving Unit

  Yes

  No

  N/A

• Calibration Date

  Date

• Conductor Rail Straps (procedure A)

  Yes

  No

  N/A

• Conductor Rail Straps (procedure B)

  Yes

  No

  N/A

• Short Circuit Bar

  Yes

  No

  N/A

• Hook Switch Pole

  Yes

  No

  N/A

• Wire Brush

  Yes

  No

  N/A

• Shrouds

  Yes

  No

  N/A

PPE and CLOTHING

• Hard Hat (in date)

  Yes

  No

  N/A

• Boots (S3)

  Yes

  No

  N/A

• Class 2 / 3 Hi Visibility Upper Body

  Yes

  No

  N/A

• Rail Approved Hi Visibility Trousers

  Yes

  No

  N/A

• Gauntlet Gloves

  Yes

  No

  N/A

• Expiry Date

  Date

• Protective Gloves

  Yes

  No

  N/A

• Ear Defenders

  Yes

  No

  N/A

• Safety Glasses

  Yes

  No

  N/A

• Head Torch

  Yes

  No

  N/A

• Morson Logo

  Yes

  No

  N/A

• Half Mask (P3)

  Yes

  No

  N/A

Site Documentation

• Safe System of Work Pack (in date, relevant to duty)

  Yes

  No

  N/A

• Sectional Appendix

  Yes

  No

  N/A

• Hazard Directory

  Yes

  No

  N/A

• RT3181 Line Blockage Form completed

  Yes

  No

  N/A

• Appendix C (COSS verification form) complete

  Yes

  No

  N/A

• RT9909 Fully Completed (check workgroup for understanding)

  Yes

  No

  N/A

• Isolation Permit (relevant information)

  Yes

  No

  N/A

COMMENTS / NOTES (auditor / auditee)

• Observations positive/ negative

• Signature of Operative

  Sign

• Signature of Auditor

  Sign