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
SECTION 1 : GENERAL
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Site Location e.g. Pole / Tower No. / Feeder
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Work Activity / Task Description
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What is the Line Voltage being worked on
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Safe Approach Distance for Authorised Person
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Safe Approach Distance for Plant
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Safe Approach Distance for Live Line
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SWMS / SWP / WI Numbers used on site
SECTION 2 : SITE PRE-START CHECKS
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Where is the Nearest First Aid equipment
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Where is the Emergency Evacuation Area
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Have all personal completed a Site Induction
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Do Personal hold the relevant tickets / Cert. for the task being done e.g. High Risk / Electrical Linesperson / White Card
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Has all equipment been inspected prior to use e.g. Tagged and in test date and visually look at
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Are weather conditions going to impact on the job and is it SAFE to start
SECTION 3 : PERMITS
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Is a EPA / VA required for this Task
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Is a Working at heights / Confined spaces / Hotworks required for the task
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Have you identified the correct Circuit before you Test and prove DEAD the line before applying work earths
SECTION 4 : PERSONAL PROTECTIVE EQUIPMENT
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Are personal wearing the Mandatory PPE, e.g. Hard hat, eye protection, steel cap footwear, gloves, full body Hi Vis coveralls and as required safety harness, ear protection.
SECTION 5 : HAZARD AND CONTROLS
1. WORKING AT HEIGHTS
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1.1 Is there a RISK of Falls of 2m or more? (including pits and trenches, holes, Working out of an EWP, Crane cage, climbing)
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1.2 Is there a RISK that personal are not trained e.g. Rescue, working at heights Electrical shock
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1.3 Is there a RISK of Plant e.g. Tipping, crushing, falling out of basket, Electrical shock
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1.4 Can safe Approach Distances be Maintained at all times or is a Safety Observer required and Name
2. PLANT AND EQUIPMENT
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2.1 Is there a RISK of Break down, crushing, tipping, uneven ground conditions, High winds, etc.
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2.2 Is there a RISK of Equipment failure e.g. Not in test date, has not been inspected prior to use
3. LADDERS
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3.1 Is there a RISK of Ladder breaking, crushing, manual handling, Not inspected, Electrical shock
4. SCAFFOLDS
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4.1 Is there a RISK of scaffolds tipping, crushing, manual handling, Incomplete, exceeding SWL limits
5. MANUAL HANDLING
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5.1 Is there a RISK of Personal injury, crushing, plant.
6. HAZARDOUS CHEMICAL (INCLUDING FUEL AND OIL)
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6.1 Is there a RISK to Personal, other work groups
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6.2 Are MSDS sheets accessible, is there enough storage
7. TRAFFIC MANAGEMENT
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7.1 Is there a RISK of getting run over by other vehicles. The public
8. WORK ENVIRONMENT
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8.1 Is there a RISK of slips, trips and falls
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8.2 Are there any house keeping issues, block emergency exits, plant and equipment in the way
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8.3 Is there a RISK of working in the dark
9. ELECTRICAL HAZARDS
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6.1 Is there a RISK of electrical shock from RCD, leads, lack of Lock-out/ tag
10. ENVIRONMENTAL
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10.1 Is there a RISK to the environment, Oil spills, Wildlife, Vegetation, Farmers Land, etc
11. OTHER RISK / HAZARDS
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11.1
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11.2
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11.3
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11.4
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11.5
SECTION 6 : WORK PARTY SIGN AFTER PRE-START TALK
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Name and Company
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Name and Company
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Name and Company
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Name and Company
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Name and Company
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Name and Company
SECTION 7 : VISITORS / CONTRACTORS SIGN OFF
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Name and Company
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Name and Company
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Name and Company
