Power and Gas

• Audit No.

• Auditor:

• Conducted on

  Date
• Location.
  Address

D1.0. Pre Start Meeting. Performance Objective.

• D1.01 Traffic management according to TTM plan and appropriate for site, changes recorded.

  Yes

  No

  N/A

• D1.02. Spill kit on site?

  Yes

  No

  N/A

• D1.03. MSDS sheets on site for all hazardous substances?

  Yes

  No

  N/A

• D1.04. Daily site specific hazard document completed, all hazards identified and appropriate control measures implemented?

  Yes

  No

  N/A

• D1.05. Task objective?

  Yes

  No

  N/A

• D1.06. All paperwork including plans and consents on site?

  Yes

  No

  N/A

• D1.07 No additional hazards identified?

  Yes

  No

  N/A

• D1.08 All operatives signed onto plan confirming acknowledgement of hazards and control measures?

  Yes

  No

  N/A

• D1.09 Worksite supervisor on site?

  Yes

  No

  N/A

• Comments/Recommendations

2.0. Plant and Equipment: Performance Objective.

• D2.01. Are 2 fire extinguishers available?

  Yes

  No

  N/A

• D2.02. First Aid kit - Full and tidy?

  Yes

  No

  N/A

• D2.03. Drinking water available?

  Yes

  No

  N/A

• D2.04. Gas go seekers available and within valid test date?

  Yes

  No

  N/A

• D2.05. Does vehicle have current Registration?

  Yes

  No

  N/A

• D2.06. Does vehicle have current Warrant of Fitness?

  Yes

  No

  N/A

• D2.07. Fire extinguishers, leads, EF welder all have current test certificate?

  Yes

  No

  N/A

• Comments/Recommendations

D3.0. PERSONNEL PROTECTIVE EQUIPMENT. Performance Objective.

• D3.01. Hard Hat (3years)

  Yes

  No

  N/A

• D3.02. Full cover Fire Retardant overalls?

  Yes

  No

  N/A

• D3.03. Safety footwear?

  Yes

  No

  N/A

• D3.04. Anti Static High Vizible Vest?

  Yes

  No

  N/A

• D3.05. Safety Eye Wear?

  Yes

  No

  N/A

• D3.06. General Purpose Gloves?

  Yes

  No

  N/A

• Comments/Recommendations

D4. PERSONNEL COMPETENT.

• D4.01. Individual competent for task?

  Yes

  No

  N/A

• D4.02. Competency Available?

  Yes

  No

  N/A

• D4.03. Competency Card or dispensation display expiry date?

  Yes

  No

  N/A

• D4.04. Operatives not working under influence of alcohol and or drugs?

  Yes

  No

  N/A

• D4.05. No dangerous acts observed likely to cause harm or injury?

  Yes

  No

  N/A

• D4.06. Operatives observed working safely?

  Yes

  No

  N/A

• D4.07. Plant or Equipment left in a safe manner?

  Yes

  No

  N/A

• Comments/Recommendations

D5. GMS METER KIT REPLACEMENT. Performance Objective.

• D5.01. Is the base of the meter and the cover above finished ground level?

  Yes

  No

  N/A

• D5.02. Is the service valve installed between 150mm and 300mm above finished ground level and in an operable location?

  Yes

  No

  N/A

• D5.03. Is there an exclusion zone around each installation?

  Yes

  No

  N/A

• D5.04. Tracer wire taped and terminated below riser as per standard?

  Yes

  No

  N/A

• D5.05. Installation leak free

  Yes

  No

  N/A

• D5.06. Has the GMS bracket been fixed to the dwelling using type 316 stainless steel fittings?

  Yes

  No

  N/A

• D5.07. Has the GMS been vertically and horizontally levelled?

  Yes

  No

  N/A

• D5.08. Are all the open ends on fittings either plugged or capped and gas tight to prevent any unwanted material entering the components?

  Yes

  No

  N/A

• D5.09. Location compliant.

  Yes

  No

  N/A

• D5.10. Meter sealed.

  Yes

  No

  N/A

• D5.11. Regulator sealed.

  Yes

  No

  N/A

• Comments/Recommendations

D6.0. Work Area / General Quality. Performance Objective.

• D6.01. Is the road berm area adequately reinstated?

  Yes

  No

  N/A

• D6.02. Is the customers property adequately reinstated?

  Yes

  No

  N/A

• D6.03. Roadway/footpath reinstated to standard?

  Yes

  No

  N/A

• Comments/Recommendations

D7.0. WORK PROCEDURES BEING FOLLOWED. Auditor observed the following.

• D7.01. Test and or purge procedure on main or service pipe

  Yes

  No

  N/A

• D7.02. Operated gas detector to locate leak or check gas concentration

  Yes

  No

  N/A

• D7.03. Correct depth of pipe as per Powerco standard

  Yes

  No

  N/A

• D7.04. Conduct EF welding

  Yes

  No

  N/A

• D7.05. Pipe laying and backfilling (thrusting or open trench)

  Yes

  No

  N/A

• Comments/Recommendations

NON COMPLIANCE REPORT.

• Add media

  Media

Site Address.

Operative Name.

NCR To Be Completed By.

• Select date

  Date

NCR COMPLETED.

• Select date

  Date

Completed by.

• Name =

Manager comments.

PREVENTATIVE ACTION PLAN (action taken to prevent a reoccurrence).