Road Corridor Maintenance Safety Audit

• Project Name:

• Contract No.

• Job No.

• Client

• Contractor

• Date and Time of Audit

  Date

• Prepared by

• Location
  Address

• Personnel

TRAFFIC MANAGEMENT

• Are the TTM measures set up as per the Generic TMP for cyclic/OPEX works?

  Yes

  No

  N/A

• Is the implemented TTM Plan the correct one for the road and time?

  Yes

  No

  N/A

• Does TTM manage pedestrians and mobility scooters?

  Yes

  No

  N/A

• Is the onsite STMS suitably qualified?

  Yes

  No

  N/A

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SITE SPECIFIC SAFETY PLAN

• Has the Site Specific Safety Plan and Hazard ID been completed for the site and proceeding sites? (One per day)

  Yes

  No

  N/A

• Has the information on the JSEA been utilised on the Site Specific Safety Plan?

  Yes

  No

  N/A

• Have appropriate control methods been listed for the hazards evident on the site?

  Yes

  No

  N/A

• Have significant hazards for the site and activities been identified?

  Yes

  No

  N/A

• Has appropriate plant been listed for the works?

  Yes

  No

  N/A

• Has appropriate signage been listed for the works?

  Yes

  No

  N/A

• Has appropriate PPE been listed for the works?

  Yes

  No

  N/A

• Does the Leading Hand/Supervisor show competency in completing Site Specific Hazard ID?

  Yes

  No

  N/A

• Have the site crew been inducted and signed off to the Site Specific Safety Plan and Hazard ID?

  Yes

  No

  N/A

• Is there evidence that site visitors have been inducted onto the site?

  Yes

  No

  N/A

• Has works equipment been placed in a safe location on site from public and traffic?

  Yes

  No

  N/A

• Has works vehicles been parked in a safe location taking onto account traffic and pedestrians?

  Yes

  No

  N/A

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ENVIRONMENTAL

• Are relevant Resource Consents if any available on site?

  Yes

  No

  N/A

• Are relevant Resource Consent conditions being complied with?

  Yes

  No

  N/A

• Has environmental issues and controls been listed and discussed on the Site Specific Safety Plan?

  Yes

  No

  N/A

• There is no evidence that machinery, vehicles or materials have been stored on top of permeable drip line area of any tree or work has adversly affected any tree (unless authorised by an arborist)?

  Yes

  No

  N/A

• Are catch pit/drain protection measures in place?

  Yes

  No

  N/A

• Are silt control measures in place (if required)?

  Yes

  No

  N/A

• Are controls in place to manage flooding during the works (if required)?

  Yes

  No

  N/A

• Do storm water flooding discharges (if any) meet Resource Consent conditions?

  Yes

  No

  N/A

• Where the site is empty or idle, has the site been secured against environmental discharges (e.g. has exposed ground been stabilised)?

  Yes

  No

  N/A

• Has control measures been put in place to prevent discharge of concrete run off entering stormwater drains/catch pits or fresh water or marine areas?

  Yes

  No

  N/A

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PPE

• Are all PPE and equipment being worn as per the Hazard ID and Site Specific Safety Plan?

  Yes

  No

  N/A

• Is PPE being worn correctly?

  Yes

  No

  N/A

• Is PPE in good and serviceable condition?

  Yes

  No

  N/A

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EMERGENCY EQUIPMENT

• First aid kit is available on site?

  Yes

  No

  N/A

• First aid kit is fully stocked and no with expired items?

  Yes

  No

  N/A

• First aid training is up to date?

  Yes

  No

  N/A

• First Aider is known?

  Yes

  No

  N/A

• Fire extinguisher(s) is available?

  Yes

  No

  N/A

• Fire extinguisher is in serviceable condition with current lable?

  Yes

  No

  N/A

• Site Warden is known?

  Yes

  No

  N/A

• Site Warden has been suitably trained?

  Yes

  No

  N/A

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