QTS Group - SWP Audit - duplicate

• Document No.

• Auditor

• Sentinel Card No

• Location
  Address

• Conducted on

  Date

• Contract

• JT Number

• SWP Number

• Dates

• Description of Works

Verification

• SWP Planner

• Date Issued

  Date

• Person in Charge (Verification)

• Date Verified

  Date

• Minimum of one shift prior to start

  Compliant

  Non-Compliant

  N/A

• Responsible Manager

• Date Authorised

  Date

• Person in Charge (Acceptance)

• Date Accepted

  Date

• Appendix A

  Compliant

  Non-Compliant

  N/A

• Add media

  Media

SWP

• Method of Protection

  Select Possession Line Block AB+Add Protection RETB Separated COSS+1

  • Possession
  • Line Block
  • AB+Add Protection
  • RETB
  • Separated
  • COSS+1

• Method of Protection Correct

  Yes

  No

  N/A

• Add media

  Media

• Hazard Directory

  Yes

  No

  N/A

• Covers Correct Mileage

  Yes

  No

  N/A

• Add media

  Media

• Sectional Appendix

  Yes

  No

  N/A

• Worksite Covered by Sectional Appendix

  Yes

  No

  N/A

• Add media

  Media

• Signal Diagrams

  Yes

  No

  N/A

• Correct Signal Diagrams Included

  Yes

  No

  N/A

• Add media

  Media

• Nearest Hospital

  Yes

  No

  N/A

• Add media

  Media

• Location Plan

• Task Briefing Ref Number / Dates From - To

• Add media

  Media

• Welfare Arrangements

  Yes

  No

  N/A

• Add media

  Media

• Permits

  Yes

  No

  N/A

• Add media

  Media

RT9909/COSS Briefing

• Date & Time Completed

  Date

• RT9909 Completed Correctly

  Yes

  No

  N/A

• Location

  Yes

  No

  N/A

• Add media

  Media

• Contact the Signaller

  Yes

  No

  N/A

• Add media

  Media

• Access Arrangements

  Yes

  No

  N/A

• Hazards

  Yes

  No

  N/A

• Add media

  Media

• Limits of working area

  Yes

  No

  N/A

• AC or DC Lines

  Yes

  No

  N/A

• Safe system of Works

• Add media

  Media

• Fenced

  Safe

  At Risk

  N/A

• Site Warden

  Safe

  At Risk

  N/A

• Add media

  Media

• Signature / Names

  Yes

  No

  N/A

• Add media

  Media

Line Blockages

• Ref Number

• Location

• Protecting Signals

  Safe

  At Risk

  N/A

• RT3180

  Yes

  No

  N/A

• GZAC No

  Yes

  No

  N/A

• General Arrangements

  Yes

  No

  N/A

• Will work affect the safety of the Line

  Yes

  No

  N/A

• Type of Additional Protection

  Select EPR Detonator Protection Signalling Disconnection Route Barring Token T-COD Lock Out Device

  • EPR
  • Detonator Protection
  • Signalling Disconnection
  • Route Barring
  • Token
  • T-COD
  • Lock Out Device

• Blocking the Line

  Safe

  At Risk

  N/A

• Granting Authority

• Level crossing arrangements

  Yes

  No

  N/A

• Additional Protection

  Safe

  At Risk

  N/A

• Permission to share Blockage

  Yes

  No

  N/A

• Change of COSS / PC

  Yes

  No

  N/A

Planning

• Line Blockage Request

  Yes

  No

  N/A

• SWP Register

  Yes

  No

  N/A

• 10% Reviewed by Responsible Manager

  Yes

  No

  N/A

• Changes to Packs

  Yes

  No

  N/A

• SWP Issued / Authorised < A Shift

  Compliant

  Non-Compliant

  N/A

Audited By

• Add signature

  Sign