Information
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Conducted on
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Location
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Contractor
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Project Name
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Prepared by
Weather
Overnight / previous period rainfall
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Did it rain the previous night (or preceding period)?
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Has this rain prevented work occurring for this work shift?
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What work activity has been impacted?
Weather - first work period (eg morning)
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Weather (first period of work ie morning)
- Rain
- Sun
- Windy
- Cloudy / overcast
- Drizzle
- Cold
- Hot
- Warm
- Cool
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Has rain prevented work occurring this period?
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What work activity has been impacted?
Weather - second work period (eg afternoon)
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Weather (second period of work ie afternoon)
- Rain
- Sun
- Windy
- Cloudy / overcast
- Drizzle
- Cold
- Hot
- Warm
- Cool
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Has rain prevented work occurring this period?
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What work activity has been impacted?
General
Activity Checklists Completed and QAS Completed
Hold Points, Witness Points and Non Conformance Observations
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Photo/s
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Add media
Meetings Attended
Visitors to Site
General Site Observations and Comments
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Photo/s
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Add media
Materials delivered or Removed from site
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Photo/s
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Add media
Plant Mobilised or Demobilised or Out of Service
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Photos
Complaints from Public
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Photos
Work Activity Record
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Add work activity diary entry
Work Activity Entry
Activity summary
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Location /zone within site that activity is occurring
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Work activity description
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Is the activity on the critical path
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Subcontractor(s) assisting?
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Subcontractor(s) name
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Time of activity commencement
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Time of activity completion
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Comments on work activity / Directions provider to contractor
Personnel resources
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Supervisor on site
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Supervisors Name
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Leading hand on site
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Leading Hands Name
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Add personnel resource
Personnel
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Personnel description
Plant Resources
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Dogs included?
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Size of excavators?
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Add other plant and equipment (eg tools)
Plant / equipment
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Description of plant or equipment
Traffic Management
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Traffic control been implemented for activity
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Team Leaders Name
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Provide details of controls implemented ie TCP number, VMP, TC contractor, or other controls put in place, etc
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Controls incorrectly implemented
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Provide details of comments provided to supervisor
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Add photo of traffic controls
Traffic control photo
WHS
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Safety controls been implemented for activity?
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Provide details of controls implemented ie SWMS number, included as part of Toolbox/startup briefing, or other controls put in place, etc
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Safety controls correctly implemented
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Provide details of comments made to supervisor
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Add photo of safety controls
Safety photo
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Safety control photo
Environmental Controls
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Enviromental controls been implemented for activity?
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Provide details of controls implemented ie ESCP, or other controls put in place, etc
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Environmental controls correctly implemented
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Provide details of comments made to supervisor
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Add photo of environmental control
enviro photo
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Enviro control photo
Photos of work activity
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Add Photos of work activity
photo
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Add media
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Photo description
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Sign once competed. Surveillance Officer
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Sign once competed. Authorised Delegate