Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
CONTRACTORS
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Contractors working on site
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Are you completing a Contractor audit
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Name of person completing audit
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Is an Appointed Supervisor Onsite
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Are All Operators authorised?
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Does all equipment have current VEMP Inspection?
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Correct PPE Worn
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Photographs
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STOP Task Issue Correct PPE
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Signage in Order
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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General Housekeeping
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Bunding in Place
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
PLANT
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Is there plant being used on site
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Are you completing a Plant audit
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Name of person completing audit
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Does all equipment have current VEMP Inspection?
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Are Pre-start Books available for each piece of plant?
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Photographs
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STOP Task Issue Correct PPE
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Are Pre-start Books being used and current for each piece of plant?
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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General Housekeeping
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Are defects being reported and corrected?
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
ADMINISTRATION
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Are you completing an Administration audit
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Name of person completing audit
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Are the SWIs available to all persons?
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Are the Correct and current Acts and Regulations available to all persons?
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Photographs
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STOP Task Issue Correct PPE
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Is the Mine Record compete and up to date?
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Is there an Appointed SSE
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Are all Operators Authorised?
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Are all Persons In Statuary Positions Appointed By the SSE
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
PPE
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Are you completing a PPE audit
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Name of person completing audit
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Is adequate PPE Available to all Persons?
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Does all PPE meet Australian Standards?
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Photographs
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STOP Task Issue Correct PPE
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Is the required PPE easily accessible ?
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Photographs
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Corrective Actions
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Due Date For Corrective Actions
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Responsible Person
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Comments
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Comments
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Person(s) completing audit
Person
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Audit Complete