Review of the implementation of the site-specific WHS Management Plan

• Document No.

• Project:

• Client:

• Conducted on

  Date

• NSW Public Works AP:

• Principal Contractor Site Representative:

• Name of person completing this form:

• Review summary:

1.Management Responsibility

• 1. Has the Principal Contractor a copy of the Site-Specific Safety Management Plan available on site (WHS Reg 313)

  Yes

  No

  N/A

• 2. Can the Principal Contractor provide evidence to show that the subcontractor has been informed about the content of the WHS Management Plan and where it is kep

  Yes

  No

  N/A

• Comment:

2. Communication and Consultation

• The Principal Contractor has established WHS communication and consultation arrangements for the site (WHS Act Part 5)

  Yes

  No

  N/A

• Comment:

3. At the time of the site visit were the any of the following high risk construction work activities observed?

• The following high risk construction work activities were observed:

  Select involves risk of person falling more than 2 metres is carried out on Telecommuncations Tower involves demolition of an element of a structure that is load bearing or otherwise related to the physical integrity of the structure involves, or is likely to involve the disturbance of asbestos involves structural alterations or repairs that require temporary support to prevent collapse is carried out in or near a confined space is carried out in or near a shaft or trench with an excavatied depth greater than 1.5 m or a tunnel is carried out on or near pressurised gas distribution mains or piping involves the use of explosives is carried out on or near chemical, fuel or refidgerant lines is carried out on or near energised electrical installations oe services is carried out in an area that may have a contaminated or flammable atmosphere involves tilt up or per cast concrete is carried out on or adjacent to a road, railway, shipping lane or other traffic corridor that is in use by traffic other than pedestrians is carried out in an area in which there are artificial extremes of temperature is carried out in or near water or other liquid that involves risk of drowning involves diving work

  • involves risk of person falling more than 2 metres
  • is carried out on Telecommuncations Tower
  • involves demolition of an element of a structure that is load bearing or otherwise related to the physical integrity of the structure
  • involves, or is likely to involve the disturbance of asbestos
  • involves structural alterations or repairs that require temporary support to prevent collapse
  • is carried out in or near a confined space
  • is carried out in or near a shaft or trench with an excavatied depth greater than 1.5 m or a tunnel
  • is carried out on or near pressurised gas distribution mains or piping
  • involves the use of explosives
  • is carried out on or near chemical, fuel or refidgerant lines
  • is carried out on or near energised electrical installations oe services
  • is carried out in an area that may have a contaminated or flammable atmosphere
  • involves tilt up or per cast concrete
  • is carried out on or adjacent to a road, railway, shipping lane or other traffic corridor that is in use by traffic other than pedestrians
  • is carried out in an area in which there are artificial extremes of temperature
  • is carried out in or near water or other liquid that involves risk of drowning
  • involves diving work

• Comment:

4. Risk Management - SWMS

• Has Principal Contractor/Sub Contractors provided Safe Work Method Statements (SWMS) for current high risk activities? (WHS Reg 302)

  Yes

  No

  N/A

• Has the Principal Contractor reviewed the SWMS provided by the SubContractors? (WHS Reg 302)

  Yes

  No

  N/A

• Has the Principal Contractor monitored subcontractor compliance with SWMS and Legislation (WHS Reg 300)

  Yes

  No

  N/A

• Has the Principal Contractor established procedures for managing site emergencies (WHS Reg 43 & 74

  Yes

  No

  N/A

• Comment:

5. Are measures in place to manage the risk associated with construction work

• Dial before you dig

  Yes

  No

  N/A

• Asbestos removal undertaken by a licensed contractor and workers supervised <br>(WHS Reg 458 and 462) (How to safely remove asbestos)

  Yes

  No

  N/A

• Site securely fenced to prevent unauthorised access (WHS Reg 298)

  Yes

  No

  N/A

• No electrical work is being done live (CoP low voltage electrical work)

  Yes

  No

  N/A

• Signed confined space entry permits and risk assessments (WHS Reg 67) (CoP confined spaces)

  Yes

  No

  N/A

• Scaffolds fully decked with hand and mid rails in place and kick boards used <br>(CoP managing the risk of falls at work places)

  Yes

  No

  N/A

• Scaffold handover and inspection certificates available (WHS reg 225)

  Yes

  No

  N/A

• Edge protection for persons at risk of fall from height (WHS Reg 78)

  Yes

  No

  N/A

• Traffic management plan available and is it being implemented (CoP moving plant on construction sites)

  Yes

  No

  N/A

• Mobile plant being operated, eg. Barricaded areas, plant/people separated, reversing alarms, flashing lights, spotter for work close to overhead/underground power lines/cables (WHS Reg 214 &215)

  Yes

  No

  N/A

• Location of underground services identified and clearly marked, provided to persons engaged to carry out excavations (WHS Reg 304)

  Yes

  No

  N/A

• Items of electrical plant being used on site have current inspection and test tags<br>(AS/NZ 3012:2010)

  Yes

  No

  N/A

• Excavations shored and/or benched (WHS Reg 305 & 306)

  Yes

  No

  N/A

• Engineers inspection certificates available for form work (CoP formwork

  Yes

  No

  N/A

• High risk construction work being carried out as described in SWMS (WHS reg 300)

  Yes

  No

  N/A

• Site security fence panels not being used are laid on the ground or secured to prevent them from tipping over

  Yes

  No

  N/A

• Name do Principal Contractor and after hours contact details displayed (WHS reg 308)

  Yes

  No

  N/A

• Signs and barricades in place to prevent unauthorised entry to work areas where explosive powered tools are being used

  Yes

  No

  N/A

• Personal floatations devices worn by persons working near water where ther is a risk of drowning

  Yes

  No

  N/A

• Comment:

6. WHS Training

• Has Principal Contractor verified site workers WHS General induction for Construction Work qualification (WHS Regs 317 & 318<br><br>Sighted details of site workers WHS General Induction training for construction work card or certificate recorded

  Yes

  No

  N/A

• Has the Principal Contractor provided training and instruction to workers (WHS Reg 39)<br><br>If none of the multiple choice answers chosen, contractors mist demonstrate how training and induction is provided to workers

  Yes

  No

  N/A

• Have the site workers been instructed/trained in the requirements of their PCBU's site specific SWMS (WHS Reg 299)<br><br>Sighted the site workers names. Signatures and dates recorded on SWMS

  Yes

  No

  N/A

• Comment:

7. Inspection, Testing and Servicing

• Has the Principal Contractor been carrying out documented site safety inspections (SSI)<br><br>Sighted completed site safety inspection records

  Yes

  No

  N/A

• Has the Principal Contractor taken action to correct issues identified in SSI<br><br>Sighted sign off recording that action was taken to correct the safety issues identified

  Yes

  No

  N/A

• Has the Principal .Contractor available for review records of inspections, testing and servicing

  Select Sighted Electrical Plant & Equipment Test & Tag Register Sighted Mobile Plant Register Sighted site-specific Hazardous Chemicals Register Sighted Roof Mesh Handover Certificate Sighted scaffold handover certificates Sighted Formwork Engineers Certificate Sighted Plant Registe

  • Sighted Electrical Plant & Equipment Test & Tag Register
  • Sighted Mobile Plant Register
  • Sighted site-specific Hazardous Chemicals Register
  • Sighted Roof Mesh Handover Certificate
  • Sighted scaffold handover certificates
  • Sighted Formwork Engineers Certificate
  • Sighted Plant Registe

8. Observed Safety Breaches

• Photographs

  Media

• Site observations:

9. WHS Management Plan implementation: Non-conformances / Observations

• Non-conformances / Observations:

10. Signatures

• Have you brought the observed safety breaches to the immediate attention of the Principal Contractor site management representative

  Yes

  No

  N/A

• Have you issued a site safety instruction for the observed safety breaches

  Yes

  No

  N/A

• Completed by:

  Sign

• Issued to:

  Sign

• date and time

  Date

• Response date due:

• The purpose of the on site review of the implementation of the site specific safety management plan is for the Principal Contractor to demonstrate their site specific safety management plan. The review program for the implementation do the site specific safety management plan must be based on the project risk assessment. Where the project involves a high level of risk for example a reservoir, water/sewerage plant, dam, pipeline, multi-storey construction, work in an area in an occupied area, demolition, asbestos removal, contaminated land, there should be a greater number of reviews As a minimum an on site review of the Principal Contractors implementation do the site specific safety management plan should be carried out within one month do construction work commencing on site and then once every month until completion Ensure a representative from the Principal Contractor with the authority to immediately rectify any breaches participates in the on site review. If possible issue a copy of the on site checklist for reviewing implementation of site specific safety management plan is to be provided to the Principal Contractor immediately following the review. Issue a site instruction with the on site checklist for reviewing site specific safety management plan attached that requires the Principal Contractor to address any non conformance a within 24hrs or for any life threatening risks, immediately. Require the Principal contractor to,provide evidence of both immediate response and the improvements made to their management system to close out the non conformance(s) If it is not possible to issue a written site instruction a No provide a copy of the checklist then a verbal instruction should be given to the Principal Contractor representative on the day of the on site review. The verbal instruction must then be followed up as soon as possible with site instruction, together with a copy of the completed on site checklist for reviewing implementation of site specific safety management plan. The authorised person reviews the Principal Contractors response to the site instruction referring any complex issues to the Project Safety Advisor for advice A copy of the on site checklist for reviewing implementation of site specific safety management plan and a copy of the site instruction that is issued must be forwarded to the Regions Project Safety Adviso.