Resource Partner Field Inspection Checklist

• Conducted on

  Date

• CitiPower/Powercor Contract Responsible Officer

• Resource Partner (Contract Company)

• Contract No / PM Order No

• Location
  Address

• Inspection No

• Brief Description of Job

• Prepared by

C - CUSTOMER SERVICE

C1 - Identification

• List the names of all Traffic Controllers

Employee

• Name

C2 - Passports & Authorities

• Do ALL personnel have their relevant Authorities/Licences present?

  Yes

  No

  N/A

• Where applicable has site specific induction been performed?

  Yes

  No

  N/A

Passport/Licence Authority Matrix

• List the names of all Traffic Controllers

Employee

• Name

• Construction Industry Induction Card (e.g. White/Red Card)?

  Yes

  No

  N/A

• Traffic Management (3 yearly)?

  Yes

  No

  N/A

• Other?

  Yes

  No

  N/A

C3 - Vehicle Signage

• Do the vehicles have CP/PAL signage correctly displayed? (Only when working on CitiPower/Powercor related jobs)

  Yes

  No

  N/A

• List All Vehicles & Plant

Vehicles / Plant

• Registration No. & Vehicle Type

C4 - Company Logo

• Are the contract company employees wearing attire with their company logo clearly displayed? (Recommendation Only)

  Yes

  No

  N/A

Q - QUALITY

Q1 - JSA Related Documentation

• Are completed risk assessments available onsite?

  Yes

  No

  N/A

• JSA / Toolbox?

  Yes

  No

  N/A

• Traffic Plan?

  Yes

  No

  N/A

• Safe Work Method Statement?

  Yes

  No

  N/A

• Do the risk assessments reflect ALL hazards of the job and have the appropriate control measures been documented? (List additional risks as appropriate)

  Yes

  No

  N/A

• Does the work site reflect ALL the documented control measures?

  Yes

  No

  N/A

• Has the Traffic Control WSL signed onto the CitiPower/Powercor/Resource Partner JSA?

  Yes

  No

  N/A

Q2 - Job File Documentation

• Is sufficient information available to safely undertake the work? (e.g. Job file, location references, road speeds etc)

  Yes

  No

  N/A

• Is the job being performed in accordance with the Work Request?

  Yes

  No

  N/A

H - HEALTH & SAFETY

H1 - Personal Protective Equipment

• Are Hardhats being worn/available and within safety period? (Two (2) years from issue date)

  Yes

  No

  N/A

• Are Safety Boots being worn and in good condition?

  Yes

  No

  N/A

• Is High Visibility clothing/vest being worn?

  Yes

  No

  N/A

• Are Working Gloves required and/or worn?

  Yes

  No

  N/A

• Is Eye Protection required and/or worn?

  Yes

  No

  N/A

• Is Hearing Protection required and/or worn?

  Yes

  No

  N/A

• Is Sun Cream available and/or supplied?

  Yes

  No

  N/A

H3 - Traffic Management

• For which CitiPower/Powercor/Resource Partner is Traffic Control required?

  Yes

  No

  N/A

• In your opinion doe the Traffic Management Plan meet the requirements of Australian Standards & Vic Roads Code of Practice?

  Yes

  No

  N/A

• Is the Traffic Plan relevant for the work site and available?

  Yes

  No

  N/A

• Is the Traffic Plan a separate document or a linked Plan reference to the JSA?

  Yes

  No

  N/A

• Is the Traffic WSL qualified to draw a plan? (Traffic T/L must have RIIOHS205A Control traffic with a stop/slow bat & RIIOHS302A Implement traffic management plan or equivlent)

  Yes

  No

  N/A

• Are the appropriate traffic management signs & devices being used? (Class 1 Retro Reflective)

  Yes

  No

  N/A

• Advanced warning signs?

  Yes

  No

  N/A

• Worksite signs? (Symbolic Worker - Bright Orange)

  Yes

  No

  N/A

• Speed Indicator signs / Speed Advisory signs?

  Yes

  No

  N/A

• Traffic cones/bollards/barriers? (With Retro Reflective bands)

  Yes

  No

  N/A

• Detour signs / Road Closure signs?

  Yes

  No

  N/A

• Divergence signs?

  Yes

  No

  N/A

• Pedestrian signs?

  Yes

  No

  N/A

• Pedestrian Barriers? (e.g. Mesh fence)

  Yes

  No

  N/A

• Onsite traffic lights?

  Yes

  No

  N/A

• Electronic indicators/arrows?

  Yes

  No

  N/A

• Stop/Slow battens? (Identify signage used)

  Yes

  No

  N/A

• Is there a copy of the Traffic Memorandum of Authority ("Permission for works on the road") available and on site? (ALL Victorian Roads)

  Yes

  No

  N/A

• Is the Traffic signage monitored during the course of the work and has it been documented on the Traffic Plan and/or SWMS?

  Yes

  No

  N/A

• Has possible traffic congestion been considered and are sufficient measures in place to avoid it?

  Yes

  No

  N/A

• How does the Traffic Controller manage it?

• Have the speed limits been determined correctly through the worksite?

  Yes

  No

  N/A

• Are worksite signs reflecting the actual job and used in conjunction with other traffic signs as required?

  Yes

  No

  N/A

• Are the worksite and vehicles adequately protected and clearances maintained between workers/vehicles and adjacent traffic?

  Yes

  No

  N/A

• Is the 600mm clearance being maintained between the extended EWP boom elbow and/or crane counter weight and cones/barriers/bollards?

  Yes

  No

  N/A

• Is the method of traffic/plant/pedestrian management on site suitable and effective?

  Yes

  No

  N/A

• Have two flags been placed in the initial approach & speed indicator signs? (Flags are only required in Multi Message signs)

  Yes

  No

  N/A

• Are signs in pairs where needed? (if required)

  Yes

  No

  N/A

• Have signs been placed on ALL approach roads? (if required)

  Yes

  No

  N/A

• Are ALL spaces in multi-message signs filled? (with reflective yellow black minimum)

  Yes

  No

  N/A

• Is the signage level & at least 200mm off the ground?

  Yes

  No

  N/A

• Is the signage in a reasonable condition and of the correct size?

  Yes

  No

  N/A

• Is the signage legible, safely placed and clear of obstructions?

  Yes

  No

  N/A

• Have rotation & rest periods of Traffic Controllers been considered? (Break every 2 hours)

  Yes

  No

  N/A

H4 - Vehilces

• Are the vehicle(s), (including trailers) in a clean and serviceable condition?

  Yes

  No

  N/A

• Is the vehicle presented in an appropriate & road worthy manner? (i.e. Visually check for broken tail lights / windscreen etc)

  Yes

  No

  N/A

• Is the vehicle cabin, load area clean & tidy?

  Yes

  No

  N/A

• Can equipment be securely restrained when in transit? (including trailers)

  Yes

  No

  N/A

• Are safety pins on trailers fitted and being used? (If applicable)

  Yes

  No

  N/A

• Are ALL vehicle warning lights/arrows operable and being used appropriately? (Flashing Lights need to be operating when in a designated work zone unless on Private Property or over 3 metres from edge of the road)

  Yes

  No

  N/A

H5 - First Aid Kit

• Is the First Aid Kit available and located by signage?

  Yes

  No

  N/A

• Is the First Aid Kit clean and tidy?

  Yes

  No

  N/A

• Are both content and audit checklists included in the First Aid Kit?

  Yes

  No

  N/A

• Has the First Aid Kit been audited & signed off by an appropriate person? (Once yearly - minimum)

  Yes

  No

  N/A

• Date First Aid Kit last checked:

• Does the First Aid Kit contain the mandatory CPR Mask, Emergency Blanket and Disposal Gloves?

  Yes

  No

  N/A

H10 - Work Practices

• Were any unsafe work practices observed at the time of inspection?

  Yes

  No

  N/A

E - ENVIRONMENTAL

E1 - Site Management

• Are there any restrictions placed on entry to the property and/or roadway?

  Yes

  No

  N/A

E3 - Vehicle Washing

• Are vehicles clean? (e.g. No obvious mud or vegetation present on vehicles)

  Yes

  No

  N/A

OVERALL INSPECTION COMMENTS:

• Comments

COMMENTS REGARDING PREVIOUS NON-CONFORMANCES (if applicable):

• Comments

NON-CONFORMANCE / OBSERVATION Raised

• Non-Conformance

NC

• Section

• Identified Non-Conformance (Agree Corrective Action)

• Responsible Person(s)

• Date for Completion

• Has a CARE been raised?

  Yes

  No

  N/A

• CARE Number:

• Observation

OBs

• Section

• Identified Observation (Agree Corrective Action)

• Responsible Person(s)

• Date for Completion

• Has a CARE been raised?

  Yes

  No

  N/A

• CARE Number:

Inspected Party Representative - CP/PAL Inspector - Observer (if appliacble)

• Representative

Name

• Name

• Company / Position

• Signature

  Sign