RMS SURVEILLANCE REPORT

• Conducted on

  Date

• Project Name:

• Location:

• Prepared by

Overnight / previous period rainfall

• Did it rain the previous night (or preceding period)?

  Off

  On

• Rainfall recorded previous night (mm)

• Has this rain prevented work occurring for this work shift?

  Off

  On

• What work activity has been impacted?

Weather - first work period (eg morning)

• Temperature

• Weather (first period of work ie morning)

  Select Rain Sun Windy Cloudy / overcast Drizzle Cold Hot Warm Cool

  • Rain
  • Sun
  • Windy
  • Cloudy / overcast
  • Drizzle
  • Cold
  • Hot
  • Warm
  • Cool

• Enter rainfall recorded(mm)

• Has rain prevented work occurring this period?

  Off

  On

• What work activity has been impacted?

Weather - second work period (eg afternoon)

• Temperature

• Weather (second period of work ie afternoon)

  Select Rain Sun Windy Cloudy / overcast Drizzle Cold Hot Warm Cool

  • Rain
  • Sun
  • Windy
  • Cloudy / overcast
  • Drizzle
  • Cold
  • Hot
  • Warm
  • Cool

• Enter rainfall recorded(mm)

• Has rain prevented work occurring this period?

  Off

  On

• What work activity has been impacted?

• Add work activity diary entry

Work Activity Entry

Activity summary

• Location /zone within site that activity is occurring

• Work activity description

• Subcontractor(s) assisting?

  Off

  On

• Subcontractor(s) name

• Time of activity commencement

  Date

• Time of activity completion

  Date

• Comments on work activity / Directions provider to contractor

Personnel resources

• Foreman / supervisor

  Off

  On

• Leading hand

  Off

  On

• Labourers (including plant operators)

• Spotters / Marshalls

• Add personnel resource

Personnel

• Personnel description

• Number of personnel

Plant Resources

• Number of trucks

• Dogs included?

  Off

  On

• Number of excavators

• Size of excavators?

• Number of support vehicles (Utes or small work truck)

• Number or bobcats?

• Number or backhoes?

• Add other plant and equipment (eg tools)

Plant / equipment

• Description of plant or equipment

• Number of plant

Traffic Management

• Traffic control been implemented for activity?

  Yes

  No

  N/A

• Provide details of controls implemented ie TCP number , VMP, TC contractor, or other controls put in place, etc

• Controls incorrectly implemented?

  Off

  On

• Provide details of comments provided to supervisor.

• Add photo of TC

TCP photo

• Photo of traffic control arrangement

  Media

WHS

• Safety controls been implemented for activity?

  Yes

  No

  N/A

• Provide details of controls implemented ie SWMS number, included as part of Toolbox/startup briefing, or other controls put in place, etc

• Controls incorrectly implemented?

  Off

  On

• Provide details of comments provided to supervisor.

• Add photo of safety controls

Safety photo

• Safety control photo

  Media

Environmental Controls

• Enviromental controls been implemented for activity?

  Yes

  No

  N/A

• Provide details of controls implemented ie ESCP, or other controls put in place, etc

• Controls incorrectly implemented?

  Off

  On

• Provide details of comments provided to supervisor.

• Add photo of environmental control

enviro photo

• Enviro control photo

  Media

Photos of work activity

• Add Photos of work activity

photo

• Add media

  Media

• Photo description

• Sign once competed

  Sign