RJV HSEQ Inspection (SF 4.25 - 1.1) REV 12

• Site

• Conducted on

  Date

• Prepared by

• Personnel

• Location
  Address

QUALITY

• Current drawings being used

  Yes

  No

  N/A

• Superseded drawings marked, clipped together and separate current drawings

  Yes

  No

  N/A

• Document register in file & matches documents on site

  Yes

  No

  N/A

• Inspection test plan is up to date

  Yes

  No

  N/A

• Evidence of one ITP follow through

  Yes

  No

  N/A

• Site administration SF 4.8 - 1.1a signed off

  Yes

  No

  N/A

• Non-conforming items in quarantine area, tagged and recorded

  Yes

  No

  N/A

• Calibration dates on equipment current

  Yes

  No

  N/A

HSEQ CONTROL (OSH Act 1984 Section 19, OSH Regulations 1996 3.1-3.2, Environmental Protection Act 1986 Section 72)

• Current HSEQ management plan is available

  Yes

  No

  N/A

• Start up risk assessment available and relevant actions signed off

  Yes

  No

  N/A

• Induction register is up to date

  Yes

  No

  N/A

• Daily sign in register being used

  Yes

  No

  N/A

• Pre shift agenda being conducted daily

  Yes

  No

  N/A

• Supervisor OHS weekly checklist being used

  Yes

  No

  N/A

• Safety, Environmental & Quality policies are displayed

  Yes

  No

  N/A

• JSEAs conducted as per SMP

  Yes

  No

  N/A

• Work conducted as per JSEA and all workers signed on

  Yes

  No

  N/A

• Safe Work Method Statement available and operators signed on

  Yes

  No

  N/A

• Fuel truck in designated area

  Yes

  No

  N/A

• Dust suppression in use

  Yes

  No

  N/A

• Visible dust along boundary

  Yes

  No

  N/A

• Permits and licenses in place

  Yes

  No

  N/A

• Implementation on controls from two items under significant risk register

  Yes

  No

  N/A

EMERGENCY ( OSH Regulations 1996 3.8-3.12)

• First aid box is on site where signs indicate

  Yes

  No

  N/A

• First aid box is fully stocked

  Yes

  No

  N/A

• Trained first aiders are on site and are identified

  Yes

  No

  N/A

• Evacuation plan is displayed

  Yes

  No

  N/A

• Assembly muster point sign is up

  Yes

  No

  N/A

• Emergency contact number is displayed

  Yes

  No

  N/A

• Fire extinguisher in compound available and in date

  Yes

  No

  N/A

WORKSITE MANAGEMENT (OSH Regulations 1996 3.1)

• Site communication methods displayed (UHF Channels)

  Yes

  No

  N/A

• Site fencing is intact (if main contractor)

  Yes

  No

  N/A

• Works undertaken on/or adjacent to public road has relevant signage and TMP

  Yes

  No

  N/A

• Traffic management on site matches TMP (if applicable)

  Yes

  No

  N/A

• Traffic management plan is relevant to the stage of works

  Yes

  No

  N/A

PUBLIC SAFETY ( OSH Act 1984 Section 20-22, OSH Regulations 3.17)

• Site entrance signage in place (if principle contractor)

  Yes

  No

  N/A

• Construction materials kept within the workplace

  Yes

  No

  N/A

• No risk of objects falling on the public

  Yes

  No

  N/A

• No trip hazard to the public

  Yes

  No

  N/A

• Public access controlled

  Yes

  No

  N/A

• Site perimeter fencing or barricades erected

  Yes

  No

  N/A

• Warning signs in place

  Yes

  No

  N/A

BARRICADES (OSH Act 1984 Section 20, OSH Regulations 1996 3.6-3.8, 3.11 & 3.17)

• Works adjacent to public thoroughfare de-marketed/ barricaded

  Yes

  No

  N/A

COMPOUND (OSH Regulations 1996 3.6-3.8, 3.11 & 3.17)

• Compound signage in place

  Yes

  No

  N/A

• Compound fence in tact

  Yes

  No

  N/A

• Site containers are neat and tidy (floors free of spills and obstruction)

  Yes

  No

  N/A

• List the chains and slings on site. Check for in services tags & in good condition. Damaged items in quarantine area and tagged out of service.

  Yes

  No

  N/A

• Toilets facilities are clean and well maintained

  Yes

  No

  N/A

• No smoking stickers outside crib room and office

  Yes

  No

  N/A

• Designated smoking areas enforced

  Yes

  No

  N/A

• Litter is placed in bins; bins are emptied regularly

  Yes

  No

  N/A

CHEMICAL AND HAZARDOUS SUBSTANCES (OSH Regulations 1996 Part V)

• Chemicals are storied in bunded area

  Yes

  No

  N/A

• Chemicals are stored in original or clearly labeled containers

  Yes

  No

  N/A

• Spill cleanup equipments available

  Yes

  No

  N/A

• Hydrocarbons stored in areas of containment

  Yes

  No

  N/A

• MSDS are available for all chemicals

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT WORN (OSH Regulations 1996 3.32, 3.40-3.44)

• High visibility clothing worn

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A

• Footwear

  Yes

  No

  N/A

• Eye protection

  Yes

  No

  N/A

• Head Protection

  Yes

  No

  N/A

• Sunscreen

  Yes

  No

  N/A

TAGGING PROCEDURES (OSH Regulations 1996 4.38)

• Danger tags & out of service tags available and being used

  Yes

  No

  N/A

• Out of service equipment is in quarantined area and isolated from use

  Yes

  No

  N/A

LIGHT VEHICLES (OSH Regulations 1996 3.1)

• Rotating yellow/orange light working

  Yes

  No

  N/A

• First aid box required

  Yes

  No

  N/A

• Seat belts in good condition and in use

  Yes

  No

  N/A

• Vehicles parked in correct area

  Yes

  No

  N/A

• Pre starts being completed

  Yes

  No

  N/A

WELDING AND CUTTING (OSH Regulations 1996 3.27)

• Hot works permit used

  Yes

  No

  N/A

• Equipment in good operating condition

  Yes

  No

  N/A

• Work area is clear of combustible material

  Yes

  No

  N/A

• Operator using PPE

  Yes

  No

  N/A

• Correct type of fire extinguisher near by

  Yes

  No

  N/A

• Gas cylinder secure and upright

  Yes

  No

  N/A

• Gas lines protected and in good condition

  Yes

  No

  N/A

• Double flash back arrestors

  Yes

  No

  N/A

• Welding/cutting screens used

  Yes

  No

  N/A

ELECTRICAL (OSH Regulations 1996 3.59-3.65, 4.38 & AS/NZS 3012:2012)

• Permanent live boards locked

  Yes

  No

  N/A

• Covers used correctly

  Yes

  No

  N/A

• Temporary boxes numbered

  Yes

  No

  N/A

• Insulated tie bars in place

  Yes

  No

  N/A

• Electrical tools and leads tagged, RCD used

  Yes

  No

  N/A

• Electrical leads raised

  Yes

  No

  N/A

OVERHEAD POWERLINES (OSH Regulations 1996 3.64)

• Electrical clearances over main access roads to job e-mailed to sub contractors

  Yes

  No

  N/A

• Permit to work under lines available and implemented

  Yes

  No

  N/A

• Danger zone clearances measured and displayed

  Yes

  No

  N/A

EXCAVATION (OSH Regulations 1996 3.109-3.113)

• Adequate access to excavation

  Yes

  No

  N/A

• Shoring erected

  Yes

  No

  N/A

• Excavation sides battered / benched

  Yes

  No

  N/A

• Adequate barriers and signs on excavation

  Yes

  No

  N/A

• Spoils being used as windrow of adequate size and protects workers from driving into excavation

  Yes

  No

  N/A

• Adequate distance between stacked material and excavation edge

  Yes

  No

  N/A

• Adequate distance between passing traffic and excavation edge

  Yes

  No

  N/A

RETAINING WALLS

• Mobile plant clearance area away from wall

  Yes

  No

  N/A

• Safety fencing if required

  Yes

  No

  N/A

PLANT EQUIPMENT (OSH Regulations 1996 Part IV)

• Pre-start books completed on a sample of plant

  Yes

  No

  N/A

• Observation of pre-start being conducted

  Yes

  No

  N/A

• Rotating yellow/orange light working

  Yes

  No

  N/A

• Reverse beepers working

  Yes

  No

  N/A

• Fire extinguisher in date and good order

  Yes

  No

  N/A

• Seat belts in good condition and in use

  Yes

  No

  N/A

• Two way radio in working order

  Yes

  No

  N/A

• Steps and grab rails in good order

  Yes

  No

  N/A

• Hire plant in good condition

  Yes

  No

  N/A

GENERAL

• Add media

  Media

• Add media

  Media

CORRECTIVE ACTION (IMMEDIATELY)

• Supervisor items to action

  Sign

• HSEQ items to action

  Sign

• Workshop items to action

  Sign

• Subcontractor (Drainage Supervisor to sign off if available)

  Sign

• Subcontractor (Wall Builder supervisor to sign off if available)

  Sign

• Subcontractor (other - list company name) Supervisor to sign off if available

  Sign

CORRECTIVE ACTIONS WITHIN 7 DAYS (That require close out confirmation by HSEQ Coordinator)

• Corrective action 1

• Corrective action to be actioned by

  Select supervisor to action project manager to action workshop to action HSEQ to action subcontractor drainer to action subcontractor wall builder to action subcontractor -other to action

  • supervisor to action
  • project manager to action
  • workshop to action
  • HSEQ to action
  • subcontractor drainer to action
  • subcontractor wall builder to action
  • subcontractor -other to action

• Corrective action 2

• Corrective action to be actioned by

  Select supervisor to action project manager to action workshop to action HSEQ to action subcontractor drainer to action subcontractor wall builder to action subcontractor -other to action

  • supervisor to action
  • project manager to action
  • workshop to action
  • HSEQ to action
  • subcontractor drainer to action
  • subcontractor wall builder to action
  • subcontractor -other to action

• Corrective action 3

• Corrective action to be actioned by

  Select supervisor to action project manager to action workshop to action HSEQ to action subcontractor drainer to action subcontractor wall builder to action subcontractor -other to action

  • supervisor to action
  • project manager to action
  • workshop to action
  • HSEQ to action
  • subcontractor drainer to action
  • subcontractor wall builder to action
  • subcontractor -other to action

• Corrective action 4

• Corrective action to be actioned by

  Select supervisor to action project manager to action workshop to action HSEQ to action subcontractor drainer to action subcontractor wall builder to action subcontractor -other to action

  • supervisor to action
  • project manager to action
  • workshop to action
  • HSEQ to action
  • subcontractor drainer to action
  • subcontractor wall builder to action
  • subcontractor -other to action

• Corrective action 5

• Corrective action to be actioned by

  Select supervisor to action project manager to action workshop to action HSEQ to action subcontractor drainer to action subcontractor wall builder to action subcontractor -other to action

  • supervisor to action
  • project manager to action
  • workshop to action
  • HSEQ to action
  • subcontractor drainer to action
  • subcontractor wall builder to action
  • subcontractor -other to action

• Corrective action 6

• Corrective action to be actioned by

  Select supervisor to action project manager to action workshop to action HSEQ to action subcontractor drainer to action subcontractor wall builder to action subcontractor -other to action

  • supervisor to action
  • project manager to action
  • workshop to action
  • HSEQ to action
  • subcontractor drainer to action
  • subcontractor wall builder to action
  • subcontractor -other to action

CORRECTIVE ACTIONS GREATER THAN 7 DAYS (close out to be determined by HSEQ Management on corrective actions register)

• Corrective action 1

• Corrective action to be actioned by

  Select supervisor to action project manager to action workshop to action HSEQ to action subcontractor drainer to action subcontractor wall builder to action subcontractor -other to action

  • supervisor to action
  • project manager to action
  • workshop to action
  • HSEQ to action
  • subcontractor drainer to action
  • subcontractor wall builder to action
  • subcontractor -other to action

• Corrective action 2

• Corrective action to be actioned by

  Select supervisor to action project manager to action workshop to action HSEQ to action subcontractor drainer to action subcontractor wall builder to action subcontractor -other to action

  • supervisor to action
  • project manager to action
  • workshop to action
  • HSEQ to action
  • subcontractor drainer to action
  • subcontractor wall builder to action
  • subcontractor -other to action

• Corrective action 3

• Corrective action to be actioned by

  Select supervisor to action project manager to action workshop to action HSEQ to action subcontractor drainer to action subcontractor wall builder to action subcontractor -other to action

  • supervisor to action
  • project manager to action
  • workshop to action
  • HSEQ to action
  • subcontractor drainer to action
  • subcontractor wall builder to action
  • subcontractor -other to action

• Corrective action 4

SIGN OFF

• RJV On site representative

  Sign

• Auditor

  Sign