PWC - HHSM Checklist V1.1

• Audit Title

• Field Audit #

• Client / Site

• Location
  Address

• Prepared by

• Conducted on

  Date

• Maximum Temperature

• Maximum Humidity or range

• Work Rate

  High

  Medium

  Low

• Number of workers

Strategies for Hydration and Heat Stress Management

HHSM discussed at Pre-start and in JSEA/SWMS referred to

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/5 1/5 2/5 3/5 4/5 5/5

  • 0/5
  • 1/5
  • 2/5
  • 3/5
  • 4/5
  • 5/5

Cooling Refuge identified

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/5 1/5 2/5 3/5 4/5 5/5

  • 0/5
  • 1/5
  • 2/5
  • 3/5
  • 4/5
  • 5/5

5 to 10 litres of water per person

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/10 1/10 2/10 3/10 4/10 5/10 6/10 7/10 8/10 9/10 10/10

  • 0/10
  • 1/10
  • 2/10
  • 3/10
  • 4/10
  • 5/10
  • 6/10
  • 7/10
  • 8/10
  • 9/10
  • 10/10

Ice Available

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/10 1/10 2/10 3/10 4/10 5/10 6/10 7/10 8/10 9/10 10/10

  • 0/10
  • 1/10
  • 2/10
  • 3/10
  • 4/10
  • 5/10
  • 6/10
  • 7/10
  • 8/10
  • 9/10
  • 10/10

Shade structure or shade area identified

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/10 1/10 2/10 3/10 4/10 5/10 6/10 7/10 8/10 9/10 10/10

  • 0/10
  • 1/10
  • 2/10
  • 3/10
  • 4/10
  • 5/10
  • 6/10
  • 7/10
  • 8/10
  • 9/10
  • 10/10

Fans Available

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/10 1/10 2/10 3/10 4/10 5/10 6/10 7/10 8/10 9/10 10/10

  • 0/10
  • 1/10
  • 2/10
  • 3/10
  • 4/10
  • 5/10
  • 6/10
  • 7/10
  • 8/10
  • 9/10
  • 10/10

Slushy machine & Inverter (power source) available

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/10 1/10 2/10 3/10 4/10 5/10 6/10 7/10 8/10 9/10 10/10

  • 0/10
  • 1/10
  • 2/10
  • 3/10
  • 4/10
  • 5/10
  • 6/10
  • 7/10
  • 8/10
  • 9/10
  • 10/10

Electrolyte Available

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/5 1/5 2/5 3/5 4/5 5/5

  • 0/5
  • 1/5
  • 2/5
  • 3/5
  • 4/5
  • 5/5

Workers weighed in pre-start

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/5 1/5 2/5 3/5 4/5 5/5

  • 0/5
  • 1/5
  • 2/5
  • 3/5
  • 4/5
  • 5/5

Meal breaks and food taken

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/10 1/10 2/10 3/10 4/10 5/10 6/10 7/10 8/10 9/10 10/10

  • 0/10
  • 1/10
  • 2/10
  • 3/10
  • 4/10
  • 5/10
  • 6/10
  • 7/10
  • 8/10
  • 9/10
  • 10/10

Personal water bottles in use at arm’s reach

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/10 1/10 2/10 3/10 4/10 5/10 6/10 7/10 8/10 9/10 10/10

  • 0/10
  • 1/10
  • 2/10
  • 3/10
  • 4/10
  • 5/10
  • 6/10
  • 7/10
  • 8/10
  • 9/10
  • 10/10

Snap brims, 50+ Sunscreen available

• On site &/or included in planning

  Yes

  No

  N/A

• Needed

• Used

• Notes

• Score

  Select 0/10 1/10 2/10 3/10 4/10 5/10 6/10 7/10 8/10 9/10 10/10

  • 0/10
  • 1/10
  • 2/10
  • 3/10
  • 4/10
  • 5/10
  • 6/10
  • 7/10
  • 8/10
  • 9/10
  • 10/10

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