Proform SMR Performance

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• UEA Crew Name or Subcontractor

• Job Number

Mandatory Pre-start Requirements

• Daily HAC or JSEA completed

  Yes

  No

  N/A

• Mandatory PPE as defined by SWMS being worn by personnel

  Yes

  No

  N/A

General Site Safety

• Drop Zones defined and marked with witches hats

  Yes

  No

  N/A

• Appropriate Traffic and Pedestrian Management in place supplemented with Traffic / Pedestrian Management Plan

  Yes

  No

  N/A

• Appropriate signage in place defining pedestrian and traffic access around work site

  Yes

  No

  N/A

Supply Authority Mandatory Requirements

• LV Rescue and / or Pole Top Rescue Kit checked and in place as required

  Yes

  No

  N/A

EWP & Equipment

• Daily inspection of EWP and equipment completed and record exists.

  Yes

  No

  N/A

• Operators reversing are looking in direction of travel. Operators slow down or stop in places where pedestrians could be. Plant is driven safely (walking pace)

  Yes

  No

  N/A

• Mobile phones not used whilst operating any plant.

  Yes

  No

  N/A

Work at Heights

• Ladders are not used to work from when a person could fall 1.8 metres or more (eg, like next to penetrations) unless 1 metre back from edge for every 1 metre of height on the ladder.

  Yes

  No

  N/A

• People are not stepping above third highest rung and have 3 points of contact (2 feet and one hand, or 2 hands and 1 foot) during going up or coming down the ladder.

  Yes

  No

  N/A

• Person on ladders is carrying tools and equipment in a belt or bag or use a hand lanyard.

  Yes

  No

  N/A

• Builders or extension ladders are securely fixed at top.

  Yes

  No

  N/A

• Pole top rescue kit in place for work above 2m

  Yes

  No

  N/A

Work Near Overhead Power Lines

• Minimum distance is maintained to overhead powerlines. Voltage up to 132kV - min 3m, 132 to 330kV - min 6m, Greater than 330kV - min 8m. Advisory stickers in Plant.

  Yes

  No

  N/A

• An observer is used for all work near overhead power lines.

  Yes

  No

  N/A

SMR Crew Assessment

• Tasks allocated and identified as per roles and responsibilites

  Yes

  No

  N/A

• Coloured brims assigned as per work roles

  Yes

  No

  N/A

• Communication channels established and adequate

  Yes

  No

  N/A

• Daily role rotations established

  Yes

  No

  N/A

• Has the NOSMR drawings been drawn corectly

  Yes

  No

  N/A

• Is the attitude of all crew members adequate and suitable for a successful team performance

  Yes

  No

  N/A

• Is the use of mobile phones restricted to company use and break time unless in case of emergency

  Yes

  No

  N/A

• Are Non electrically qualified workers ensuring they are out of clearances whilst service is strung

  Yes

  No

  N/A

SMR Groundie

• No other tasks to be done while watching EWP Operator

  Yes

  No

  N/A

• Communicating well with EWP Operator

  Yes

  No

  N/A

• Worksite kept clean and footpaths kept clear

  Yes

  No

  N/A

• Controls dropzone and immediate worksite

  Yes

  No

  N/A

• Can groundworker clearly demonstrate current overhead work principles?

  Yes

  No

  N/A

Network Worker

• Is Network worker ensuring enough time is allowed for site set up prior to starting each job. I.e running out cables etcI

  Yes

  No

  N/A

• Is network worker ensuring they position themselves in suitable location to minimise time lost due to repositioning

  Yes

  No

  N/A

• Was a Pre Work inspection on the structure performed prior to working aloft?

  Yes

  No

  N/A

• Rubber mats installed on any conductors and earthed situations within clearances

  Yes

  No

  N/A

• Services raised and tensioned to approved procedures and standards

  Yes

  No

  N/A

• Safe working practices adhered to? Eg. Control of tails, live work practices

  Yes

  No

  N/A

POA Workers

• Are POA workers ensuring workload is not shed to groundsmen unless necessary

  Yes

  No

  N/A

• Pole top rescue kit in place for work above 2m

  Yes

  No

  N/A

• Ladders lashed at top to POA

  Yes

  No

  N/A

• Harness worn when working over 2m

  Yes

  No

  N/A

• Visual conformation of phase rotation meter where applicable

  Yes

  No

  N/A

• Pole strap used to appropriate fixing point when working over 2m

  Yes

  No

  N/A

Environment

• Worksite clean up after work has been completed

  Yes

  No

  N/A

Lifting

• Comments and Corrective Actions

• Auditor Signature

  Sign

• Crew Leader Signature

  Sign