Title Page

  • Site conducted

  • Conducted on

  • Prepared by (Enter First name and Surname)

  • Location
  • Supervisor

  • Crew

  • Shift

  • Today's Safety Focus is:

  • I AM FIT FOR WORK ACCORDING TO NBG GUIDELINES

  • Sign Inspection Sheet

Hotham River Pump Stations

  • Marradong Weir Level Reading

  • Hotham Weir Level Reading

  • Pumps not to be operating if Marradong weir level lower than 10.190

  • Should any pump stations be operating?

Pump Station 1

  • Which pumps are in operation?

  • Mode Of Operation

  • Line Pressure reading

  • Any unusual noises from the pumps?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any leaks in the pipework or vacuum breakers?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the Pump Station operating as expected?

  • Discussed Issue with Supervisor

Pump Station 2

  • Are the pumps in operation?

  • Line Pressure reading

  • Any leaks in the pipework or vacuum breakers?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any unusual noises, heat or vibration from diesel pump?

  • Troubleshoot and organise for repair, add photos and notes if possible

  • Notes on issue

  • Photos

  • Is the Pump Station operating as expected?

  • Discussed Issue with Supervisor

  • Is the fire extinguisher in date, pin in place and stored correctly?

  • Alert supervisor and arrange for replacement immediately

  • Is there a yellow spill kit bin in place, stocked and free of rubbish?

  • Cleanup any rubbish, notify your supervisor and arrange for restocking of spill kit

  • Is there rubbish around or is the work area untidy?

  • Remove of any rubbish from area and dispose of correctly.

D4 Dam

Pumps

Diesel Pump Transferring Water from D4 dam to SCWP

  • Diesel Pump Installed?

  • Is the fire extinguisher in date, pin in place and stored correctly?

  • Alert supervisor and arrange for replacement immediately

  • Is there a yellow spill kit bin in place, stocked and free of rubbish?

  • Cleanup any rubbish, notify your supervisor and arrange for restocking of spill kit

  • Is there rubbish around or is the work area untidy?

  • Remove of any rubbish from area and dispose of correctly.

  • Is a life ring in place, stored off the ground and with a retrieval rope in good condition?

  • Alert supervisor and arrange for replacement immediately

  • Diesel Pump Operating?

  • Any unusual noises from any pumps?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any leaks in the pipework?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

Embankment

  • Water Level (from Gauge Boards)

Seepage

  • Is there evidence of Seepage observed?

  • Evidence of Seepage

  • Location
  • Enter Time and Date Seepage Identified

  • Locate the Area of Seepage
  • Take Photo/s of the area

  • Is the seepage clear?

  • Contacted RDA Supervisor

Erosion

  • Is there evidence of Erosion observed?

  • Evidence of Erosion

  • Location
  • Enter Time and Date Erosion Identified

  • Locate the Area of Erosion
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Cracking

  • Is there evidence of Cracking observed?

  • Evidence of Cracking

  • Location
  • Enter Time and Date Cracking Identified

  • Locate the Area of Cracking
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Spillway

  • Fuesgates are in position as expected?

  • Record Issue

  • Issue
  • Enter Time and Issue Identified

  • Location
  • Take Photo/s

  • Contacted RDA Supervisor

  • Is there anything observed on the spillway that would affect the operation of it? (e.g. Blockage, erosion, structural failure)

  • Record Issue

  • Issue
  • Enter Time and Issue Identified

  • Location
  • Take Photo/s

  • Contacted RDA Supervisor

D1 Dam

  • Is life ring stored off the ground, in good condition with retrieval rope attached?

Pumps

Electric Transfer Pumps

  • Transfer Tank Pumps Operating?

  • Line pressure (kPa)

  • Any unusual noises from any pumps?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any leaks in the pipework or vacuum breakers?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the Pump Station operating as expected?

  • Discussed Issue with Supervisor

  • Does isolation valve pit have water in it?

  • Is the submersible pump in valve pit operational?

  • Description of issue

  • Photo of Issue

  • inform supervisor and resolve issue

Service Water Pumps

  • Service Water Pumps Healthy

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Has the pump been run up in the last week?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the pump in Auto?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

Embankment

  • Water Level (from Gauge Boards)

Seepage

  • Is there evidence of Seepage observed?

  • Evidence of Seepage

  • Location
  • Enter Time and Date Seepage Identified

  • Locate the Area of Seepage
  • Take Photo/s of the area

  • Is the seepage clear?

  • Contacted RDA Supervisor

Erosion

  • Is there evidence of Erosion observed?

  • Evidence of Erosion

  • Location
  • Enter Time and Date Erosion Identified

  • Locate the Area of Erosion
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Cracking

  • Is there evidence of Cracking observed?

  • Evidence of Cracking

  • Location
  • Enter Time and Date Cracking Identified

  • Locate the Area of Cracking
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Spillway

  • Fuesgates are in position as expected?

  • Record Issue

  • Issue
  • Enter Time and Issue Identified

  • Location
  • Take Photo/s

  • Contacted RDA Supervisor

  • Is there anything observed on the spillway that would affect the operation of it? (e.g. Blockage, erosion, structural failure)

  • Record Issue

  • Issue
  • Enter Time and Issue Identified

  • Location
  • Take Photo/s

  • Contacted RDA Supervisor

D1 Seepage Pump Back Station

  • 411-PPU-020 Pump in Auto Mode and Healthy?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the intake screen clear at the sump?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any leaks in the pipework?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the Pump Station operating as expected?

  • Discussed Issue with Supervisor

NCWP

  • Water Level Reading (%)

  • Is life ring on stand, in good condition with retrieval rope attached?

  • Inform Supervisor of finding and organise to have life ring re-enstated

Pumps

Electric Transfer Pumps

  • Transfer Tank Pumps Operating?

  • Line pressure (kPa)

  • Any unusual noises from any pumps?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any leaks in the pipework or vacuum breakers?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the Pump Station operating as expected?

  • Discussed Issue with Supervisor

  • Direct Feeding RO Plant?

34MBD Pond

Embankment

  • Water Level (m RL)

  • Is life ring on stand, in good condition with retrieval rope attached?

  • Inform Supervisor of finding and organise to have life ring re-enstated

Seepage

  • Is there evidence of Seepage observed?

  • Evidence of Seepage

  • Location
  • Enter Time and Date Seepage Identified

  • Locate the Area of Seepage
  • Take Photo/s of the area

  • Is the seepage clear?

  • Contacted RDA Supervisor

Erosion

  • Is there evidence of Erosion observed?

  • Evidence of Erosion

  • Location
  • Enter Time and Date Erosion Identified

  • Locate the Area of Erosion
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Cracking

  • Is there evidence of Cracking observed?

  • Evidence of Cracking

  • Location
  • Enter Time and Date Cracking Identified

  • Locate the Area of Cracking
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Spillway

  • Is there anything observed on the spillway that would affect the operation of it? (e.g. Blockage, erosion, structural failure)

  • Record Issue

  • Issue
  • Enter Time and Issue Identified

  • Location
  • Take Photo/s

  • Contacted RDA Supervisor

PWP/RWT 1 and 2

PWP

  • Is life ring stored correctly, in good condition with retrieval rope attached?

  • Inform Supervisor of finding and organise to have life ring re-instated

  • Level of PWP (%)

  • Any leaks in the pipework or vacuum breakers?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Damage on PWP liner?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • PWP LCRS
  • LCRS Level (%)

  • LCRS in Auto Mode and Healthy?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Seepage near LCRS clear? (CMS 14369)

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

RO Feed

  • Feed source of RO Plant?

Decant Return to 697-TNK-02

  • Is addition of Decant Return to 697-TNK-02 in Operation?

  • Any leaks on pipework?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

Storm Water Pond 1

  • Level of SWP1 (%)

  • Damage on SWP1 liner?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the diesel pump operating?

  • Any unusual noises, heat or vibration from diesel pump?

  • Troubleshoot and organise for repair, add photos and notes if possible

  • Notes on issue

  • Photos

  • Any leaks on the pipework?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the fire extinguisher in date, pin in place and stored correctly?

  • Alert supervisor and arrange for replacement immediately

  • Is there a yellow spill kit bin in place, stocked and free of rubbish?

  • Cleanup any rubbish, notify your supervisor and arrange for restocking of spill kit

  • Is there rubbish around or is the work area untidy?

  • Remove of any rubbish from area and dispose of correctly.

  • Is a life ring in place, stored off the ground and with a retrieval rope in good condition?

  • Alert supervisor and arrange for replacement immediately

A-Pit

  • Is a life ring in place, stored off the ground and with a retrieval rope in good condition?

  • Alert supervisor and arrange for replacement immediately

  • Is there rubbish around or is the work area untidy?

  • Remove of any rubbish from area and dispose of correctly.

  • Is A-Pit management in the current Work Instruction?

  • What are we doing with the Pit?

  • Is a diesel Pump Installed?

  • Any unusual noises, heat or vibration from diesel pump?

  • Troubleshoot and organise for repair, add photos and notes if possible

  • Notes on issue

  • Photos

  • Any leaks in the pipework or vacuum breakers?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the fire extinguisher in date, pin in place and stored correctly?

  • Alert supervisor and arrange for replacement immediately

  • Is there a yellow spill kit bin in place, stocked and free of rubbish?

  • Cleanup any rubbish, notify your supervisor and arrange for restocking of spill kit

  • Followed up on pump installation?

Impacted Water Sump

  • Is life ring on stand, in good condition with retrieval rope attached?

  • Inform Supervisor of finding and organise to have life ring re-instated

  • Is there rubbish around or is the work area untidy?

  • Remove of any rubbish from area and dispose of correctly.

  • Is the IWS sump empty?

Diesel Sump Pump

  • Is a diesel pump installed?

  • Is there a yellow spill kit bin in place, stocked and free of rubbish?

  • Cleanup any rubbish, notify your supervisor and arrange for restocking of spill kit

  • Is the fire extinguisher in date, pin in place and stored correctly?

  • Alert supervisor and arrange for replacement immediately

  • Diesel Pump operating?

Issue

  • Description of Issue

  • Photo of issue

  • Report to your supervisor and call Babylon to rectify issue.

Wet Well Dyke

  • Is life ring on stand, in good condition with retrieval rope attached?

  • Inform Supervisor of finding and organise to have life ring re-instated

Pumping

  • Totaliser (m3)

  • Is WWD management in the current Work Instruction?

  • What are we doing with the WWD?

  • Monitor Water Level

Embankment

  • Water Level Reading (m RL)

Seepage

  • Is there evidence of Seepage observed?

  • Evidence of Seepage

  • Location
  • Enter Time and Date Seepage Identified

  • Locate the Area of Seepage
  • Take Photo/s of the area

  • Is the seepage clear?

  • Contacted RDA Supervisor

Erosion

  • Is there evidence of Erosion observed?

  • Evidence of Erosion

  • Location
  • Enter Time and Date Erosion Identified

  • Locate the Area of Erosion
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Cracking

  • Is there evidence of Cracking observed?

  • Evidence of Cracking

  • Location
  • Enter Time and Date Cracking Identified

  • Locate the Area of Cracking
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Spillway

  • Is there anything observed on the spillway that would affect the operation of it? (e.g. Blockage, erosion, structural failure)

  • Record Issue

  • Issue
  • Enter Time and Issue Identified

  • Location
  • Take Photo/s

  • Contacted RDA Supervisor

Bubble Up Sump

  • Bubble Up Sump for WWD located in MWP02

    Bubbleup Sump.PNG
  • Is the Bubble Up Sump for WWD located in MWP02 Visible and accessible?

  • Is the water in the Bubble Sump clear?

  • Take a photo

  • Supervisor Notified

Mine Water Pond 02 (MWP02)

  • Is life ring on stand, in good condition with retrieval rope attached?

  • Inform Supervisor of finding and organise to have life ring re-instated

Pumping

  • Is MWP02 management in the current Work Instruction?

  • What are we doing with the MWP02?

  • Monitor Water Level

Embankment

  • Water Level (m RL)

Seepage

  • Is there evidence of Seepage observed?

  • Evidence of Seepage

  • Location
  • Enter Time and Date Seepage Identified

  • Locate the Area of Seepage
  • Take Photo/s of the area

  • Is the seepage clear?

  • Contacted RDA Supervisor

Erosion

  • Is there evidence of Erosion observed?

  • Evidence of Erosion

  • Location
  • Enter Time and Date Erosion Identified

  • Locate the Area of Erosion
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Cracking

  • Is there evidence of Cracking observed?

  • Evidence of Cracking

  • Location
  • Enter Time and Date Cracking Identified

  • Locate the Area of Cracking
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Spillway

  • Is there anything observed on the spillway that would affect the operation of it? (e.g. Blockage, erosion, structural failure)

  • Record Issue

  • Issue
  • Enter Time and Issue Identified

  • Location
  • Take Photo/s

  • Contacted RDA Supervisor

MWP02 Seepage

  • Sump Level below maximum?

  • Check Pump operation

  • Are the pumps 416-PPU-062 & 416-PPI-063 in auto and healthy?

  • Description of issue

  • photo of issue

  • Raise MN and inform supervisor

  • Any leaks in the pipework?

  • Description of issue

  • Photo of issue

  • Raise MN and inform your supervisor

  • Is the pump station operating as expected?

  • Discuss issue with your supervisor

MWT Transfer pumps

Electric Transfer Pumps

  • MWT Transfer pumps operating.

  • Line Pressure(kpa)

  • Any unusual noises from pumps?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise MN and inform Supervisor

  • Any Leaks in the pipework or vacuum breakers

Issue

  • Description of Issue

  • Photo of Issue

  • Raise MN and inform Supervisor

  • Is the Pump Station operating as expected?

  • Discussed issues with Supervisor

R4

Embankment

Seepage

  • Is there evidence of Seepage observed?

  • Evidence of Seepage

  • Location
  • Enter Time and Date Seepage Identified

  • Locate the Area of Seepage
  • Take Photo/s of the area

  • Is the seepage clear?

  • Contacted RDA Supervisor

  • Is life ring on stand, in good condition with retrieval rope attached?

  • Inform Supervisor of finding and organise to have life ring re-instated

Erosion

  • Is there evidence of Erosion observed?

  • Evidence of Erosion

  • Location
  • Enter Time and Date Erosion Identified

  • Locate the Area of Erosion
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Cracking

  • Is there evidence of Cracking observed?

  • Evidence of Cracking

  • Location
  • Enter Time and Date Cracking Identified

  • Locate the Area of Cracking
  • Take Photo/s of the area

  • Contacted RDA Supervisor

Spillway

  • Is there anything observed on the spillway that would affect the operation of it? (e.g. Blockage, erosion, structural failure)

  • Record Issue

  • Issue
  • Enter Time and Issue Identified

  • Location
  • Take Photo/s

  • Contacted RDA Supervisor

R4 Diesel Pumping

  • Water Level (%)

  • Is the fire extinguisher in date, pin in place and stored correctly?

  • Alert supervisor and arrange for replacement immediately

  • Is there rubbish around or is the work area untidy?

  • Remove of any rubbish from area and dispose of correctly.

  • Is there a yellow spill kit bin in place, stocked and free of rubbish?

  • Cleanup any rubbish, notify your supervisor and arrange for restocking of spill kit

  • Is a life ring in place, stored off the ground and with a retrieval rope in good condition?

  • Alert supervisor and arrange for replacement immediately

  • Is water required to be pumped out?

  • Diesel Pump Operating?

  • Any unusual noises, heat or vibration from diesel pump?

  • Troubleshoot and organise for repair, add photos and notes if possible

  • Notes on issue

  • Photos

  • Any leaks in the pipework or vacuum breakers?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

Western Seepage (Main Embankment) Pump Station

  • Sump Level (%)

  • Totaliser Reading

  • Pumps in Auto mode and Healthy?

  • Pumps in Operation

  • Any unusual noises from any pumps?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any leaks in the pipework?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

Eastern Seepage

Air Compressor 430-CMP-010

  • In Auto Mode and Healthy

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Air Compressor Running?

  • Any hydrocarbon leaks/spillage?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

Sump

  • Sump Level Low

  • Are sump pumps operational?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any unusual noises from any pumps?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any leaks in the pipework or vacuum breakers?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the Pump Station operating as expected?

  • Discussed Issue with Supervisor

Air Boreholes

  • All Air Boreholes Operating?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any leaks in the pipework or vacuum breakers?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

Eastern Seepage (North East) Station

Sump

  • Sump Level Low

  • Is sump pump 411-PPU-088 operational?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any unusual noises from any pumps?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Any leaks in the pipework or vacuum breakers?

  • Issue
  • Description of Issue

  • Photo of Issue

  • Raise WN and Inform Supervisor

  • Is the Pump Station operating as expected?

  • Discussed Issue with Supervisor

Was the Inspection able to be completed?

  • Was the Inspection able to be completed?

  • Please Select a Reason

  • Comment on why inspection was not completed

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.