Title Page
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Site conducted
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Contractor / QAL Department
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Location
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Conducted on
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Prepared by
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Personnel
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If "NO' is selected, works must stop immediately and the control put in place and verified
CONTROL: Well maintained and appropriate mobile plant PURPOSE: To prevent the use of mobile plant; in unsuitable conditions or outside its operational limits
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Tick "Yes" if applicable
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The plant is free of any unauthorised modifications?
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The plant is free from any indication of being overloaded?
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Safety devices are being used as designed?
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All guarding is in place and has not been tampered with?
CONTROL: All roadside work has controls implemented; Physical barriers, buffer zones, traffic control in place? PURPOSE: To prevent interaction between mobile plant and pedestrians
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Tick "Yes" if applicable
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Clear warning signage in place?
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Flashing lights are being utilised on stopped roadside vehicles?
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Traffic Management Plan is in place and effective? i.e. TCMP
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Physical barriers are in place?
CONTROL: No person in the slew radius of mobile plant during operation PURPOSE: To prevent interaction between mobile plant and pedestrians
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Tick "Yes" if applicable
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No persons in the slew radius of mobile plant without a formalised /positive communication method with the operator?
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There are well maintained clear areas where plant is used?
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Well defined marking / delineation of permanent exclusion zones?
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Spotter in place and effective when required/in place?
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No persons within 3m of operating mobile plant without a formalised positive communication method established?
- Yes
- No
- N/A
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Delineated walkways and pedestrian crossings clearly defined?
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People using the walkways and crossing (no shortcutting)?
CONTROL: Mobile Plant operated to conditions, manufacturer’s instructions, QAL site requirements and within specified limits PURPOSE: To ensure mobile plant is operated to conditions and manufacturer’s instructions / limits
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Tick "Yes" if applicable
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Operators have considered dynamic conditions that may affect operation of mobile plant?
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Mobile plant operated within manufacturers specifications and limits
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Is the plant free of visible damage?
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Communication available?
Additional Information
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