Programmed CWW - Confined Spaces Audit

• Audit Title SR Number

• Location
  Address

• Inspection Date:

  Date

Crew/Contractor Information

• Select the crew/s from the drop down box. Multiple selections can be made.

  Select A1 Groundforce Allabout Excavations ATMS Citywide Donnaz Evolution Traffic Global Traffic Gramac IV Plumbing Jetstream JMH Excavations L&K Earthworks LMF Maintech McLean Civil Meiss Plumbing Metro Utilities Traffic MRB Excavations Other P&B Plumbing PFM M&E PFM SEWER PFM TRAFFIC PFM WATER Rangedale Rangedale Traffic Management (RTM) RBM Sewer Sunny Excavations Taylord Plumbing Toxfree The Blockage Bloke Underground Logistics 30XY

  • A1 Groundforce
  • Allabout Excavations
  • ATMS
  • Citywide
  • Donnaz
  • Evolution Traffic
  • Global Traffic
  • Gramac
  • IV Plumbing
  • Jetstream
  • JMH Excavations
  • L&K Earthworks
  • LMF
  • Maintech
  • McLean Civil
  • Meiss Plumbing
  • Metro Utilities Traffic
  • MRB Excavations
  • Other
  • P&B Plumbing
  • PFM M&E
  • PFM SEWER
  • PFM TRAFFIC
  • PFM WATER
  • Rangedale
  • Rangedale Traffic Management (RTM)
  • RBM Sewer
  • Sunny Excavations
  • Taylord Plumbing
  • Toxfree
  • The Blockage Bloke
  • Underground Logistics
  • 30XY

• List the names of the crew/s

  Yes

  No

  N/A

• Are all personnel on site carrying their current CWW ID cards?

  Yes

  No

  N/A
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Section 1.0 HSEQ Considerations

• 1.1 Has the pre start JSEA been completed correctly with all risks identified? Has the JSEA been signed by all personnel on site? Please take a photo.

  Yes

  No

  N/A
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• 1.2 Have all controls identified on the JSEA been implemented appropriately?

  Yes

  No

  N/A
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• 1.3 Is the proper PPE being worn and in good condition? i.e. long long uniform, hard hats, safety glasses, vests, gloves, etc.

  Yes

  No

  N/A
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• 1.4 Is the AVDD unit being used for this task? If so, is the AVDD unit within calibration date?

  Yes

  No

  N/A
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• 1.5 Are the AVDD cables, earth leads and gloves in good condition? i.e. gloves not torn or have holes, cables do not have bare wires exposed or damaged insulation, earth leads dated and tagged.

  Yes

  No

  N/A
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• 1.6 Are the Main to Meter tickets current? Please take a photo.

  Yes

  No

  N/A

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• 1.7 Is there a first aid kit available and is it appropriately stocked for the activity being carried out?

  Yes

  No

  N/A
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• 1.8 Are all hazardous substances correctly labeled and stored correctly in spill trays?

  Yes

  No

  N/A
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• 1.9 is there a refuelling container available, is it fitted with a transfer nozzle and if a plastic fuel container, is it less than 5 years old? (date of manufacture is stamped on the bottom of plastic fuel containers)

  Yes

  No

  N/A
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• 1.10 Are gas offsets available? If planned or scheduled works, are DBYD plans available, including permits (if required by the DBYD plans)?

  Yes

  No

  N/A
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• 1.11 Is there a pipe locator available and was it used to locate services? Have all other services in the vicinity been located and marked to alleviate accidental strikes?

  Yes

  No

  N/A
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Section 6.0: Confined Space Entry

• 6.1 Does this activity involve "Confined Space" entry?

  Yes

  No

  N/A
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• 6.2 Has the OCC been notified of the Confined Space Entry?

  Yes

  No

  N/A
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• 6.3 Does all of the personnel involved in the Confined Space entry have the appropriate training, qualifications and tickets? Confined Space ticket valid for 12 months only. Please take a photo.

  Yes

  No

  N/A
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• 6.4 Have the correct Confined Space permit/s been obtained and filled out correctly? Take specific notice of the rescue plan and make comments.

  Yes

  No

  N/A
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• 6.5 Is the Confined Space entry being conducted to the Confined Space Entry Plan?

  Yes

  No

  N/A
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• 6.6 Is all PPE used for the Confined Space entry in service and in proper condition for it's use?

  Yes

  No

  N/A
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Section 7.0: Asbestos tasks

• 7.1 Is there Asbestos Removals or Repairs involved in the task?

  Yes

  No

  N/A
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• 7.2 If Asbestos removal is required, is a copy of the contractors Asbestos Removal Licence onsite? Note: PFM Asbestos Removal licence cannot be used by a contractor or vice versa.

  Yes

  No

  N/A

• 7.3 Are all personnel involved in the task appropriately trained and ticketed to carry out asbestos tasks? Asbestos removal ticket must be renewed every 24 months. Provide photo of tickets.

  Yes

  No

  N/A
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• 7.4 Has the Asbestos Control Plan been completed, company name specified and the supervisor nominated? Note: take specific notice of names and signatures, the nominated supervisor must be from the list of supervisors detailed on the licence. Provide photo of the Asbestos Control Plan.

  Yes

  No

  N/A
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• 7.5 Is the correct PPE available for use/being worn? at least P2 dust mask, coveralls, gloves, safety glasses, safety gumboots, etc.

  Yes

  No

  N/A

• 7.6 Has all waste been removed as per the requirements, i.e. double bagged, SR number written on the outer bag.

  Yes

  No

  N/A
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Section 8.0: Excavation

• 8.1 Is the excavation over 1.5 mt. deep? If so, are the correct shoring devices being used or is the excavation "battered back", are appropriate barricades in place, is an access/egress ladders in place, has the excavation been reported to WorkSafe? NB: Notification to WorkSafe not required for emergency works.

  Yes

  No

  N/A
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• 8.2 Does the operator of the excavator have the appropriate licence? Who is the appointed operator? Who is acting as the Spotter and do they hold a current ESV spotter ticket?

  Yes

  No

  N/A
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• 8.3 Has the excavation been backfilled correctly and compacted?

  Yes

  No

  N/A
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Section 12.0: Opportunities for Improvement

• Are there any Opportunities for Improvement identified in the audit?

  Yes

  No
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• Enter the details of the identified opportunities.

Section 13.0: Signatures and sign off.

• Signature of Auditor/Supervisor/Manager

  Sign

• Signature of Additional Auditor/Supervisor/Manager

  Sign