PoM During Site Work Check

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Site Work Review

• Is a copy of the Health and Safety Plan (HASP) on site and available to all field staff?

  Yes

  No

  N/A

• Has the HASP Personnel Register been signed by each field staff?

  Yes

  No

  N/A

• Are JSA's available and initialled by all involved in each activity?

  Yes

  No

  N/A

• Has a work area perimeter been identified and delineated?

  Yes

  No

  N/A

• Have all individual field staff completed the PoMC Online Induction?

  Yes

  No

  N/A

• Are any other works planned in the area, if so have risks been managed?

  Yes

  No

  N/A

• Have individual field staff got an OHS Construction Induction Card?

  Yes

  No

  N/A

• Do all individual field staff have an MSIC (or have applied for one)?

  Yes

  No

  N/A

• Has a PoMC site safety induction checklist been completed and signed for each field staff member?

  Yes

  No

  N/A

• For tenanted sites, have all staff satisfied tenant site induction and any other tenant requirements?

  Yes

  No

  N/A

• Have PoMC and/or tenant loading charts been considered and confirmed that any time loading will be within acceptable limits (factor of safety)?

  Yes

  No

  N/A

• If job is longer than 1 day, are Tool Box meetings held and are records available?

  Yes

  No

  N/A

• Is the following PPE being worn in accordance with HASP/JSAs (tick as appropriate)?

  Yes

  No

  N/A

• Full length clothing

  Yes

  No

  N/A

• Safety boots

  Yes

  No

  N/A

• Hi-vis vest

  Yes

  No

  N/A

• Hard hat

  Yes

  No

  N/A

• Safety glasses

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A

• Other PPE (specify in comment line)

  Yes

  No

  N/A

• Is the Site being maintained and monitored (tick as appropriate)?

  Yes

  No

  N/A

• Is the site being maintained appropriately and are the work areas tidy?

  Yes

  No

  N/A

• Is there designated areas for waste disposal (e.g. drums/bins)?

  Yes

  No

  N/A

• Are drums at least 2m away from site perimeter fence lines and are they labelled with relevant details?

  Yes

  No

  N/A

• Is waste soil, waste water and general rubbish being disposed of appropriately?

  Yes

  No

  N/A

• Is any monitoring underway during the works (e.g. workspace PID, LEL, runoff, odours, dust)?

  Yes

  No

  N/A

• Are intrusive activities occurring/planned (tick as appropriate)?

  Yes

  No

  N/A

• Has a pre-site work review of principal contractor documentation been completed?

  Yes

  No

  N/A

• Are Dial-B4-You-Dig plans on-site and available?

  Yes

  No

  N/A

• Is the same Principal Contractor personnel from service clearance present?

  Yes

  No

  N/A

• Is a Pre-Drilling Protocol (e.g. hand augering/air knifing) being followed?

  Yes

  No

  N/A

• Are there rotating drilling mechanisms, if so is a protective cage in place?

  Yes

  No

  N/A

• Is there a 'kill'/shutoff switch, if so are all field staff aware of location(s)?

  Yes

  No

  N/A

• Are subcontractor JSAs available (e.g. driller)?

  Yes

  No

  N/A

• Have all OHS incidents or near misses been reported to PoMC?

  Yes

  No

  N/A

• Has critical infrastructure (e.g. pipelines, berths) been considered?

  Yes

  No

  N/A

• Other?

• Actions arising from check (if any):

• Signed PoMC Representative:

  Sign

• Signed Principal Contractor Representative:

  Sign