Title Page

  • Project Name / Number

  • Conducted on

  • Recorded By

  • Names of Contractor Representatives

  • Names of Superintendent Representatives

  • Names of EGW Representatives

  • Site Address


  • Has an HSE Inspection been completed this week? Refer EGW Form CSEM 5.1 Worksite Inspection Checklist

  • List outstanding items arising from the most recent HSE Inspection

  • Are there any uncontrolled HSE hazards evident?

  • Please include photos showing HSE hazard controls (traffic management, fencing, trench shields, sedimentation control, PPE in use, etc.) and/or photos of areas where HSE improvements could be made

  • Provide information on any uncontrolled HSE hazards or areas for improvement


  • Has an updated construction program been submitted this week?

  • Are works on track with the updated construction program?

  • Provide details of any delays including causes and how these delays may be recovered to minimise impacts on the overall program

  • List works expected to occur in the next week

  • Are any water service interruptions required within the next 2 weeks?

  • Details of any water service interruptions proposed for the next 2 weeks.

  • Please include photos of progress - works underway and/or recently completed.

  • Where relevant, sketch any details of existing or proposed new infrastructure (water main intersections, valve arrangements, offsets from boundaries or other services, etc.)


  • Have there been any recent changes to the works that may result in a variation or extension of time? (Site conditions, directions from Superintendent, weather, design changes, etc.)

  • Please provide photos of any conditions of the works that have changed compared to the latest design.

  • Provide details of any changed conditions or new variations


  • Has a payment claim been submitted for the current month?

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