Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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This form is provided to identify the minimum monthly reporting requirements of AWX Divisions to National Safety Manager.
DETAILS (To be completed and sent to National Safety Manager by the 3rd day of new month)
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Month:
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Year:
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Division Manager:
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- construct_industrial
- construction
- hospitality
- agribusiness
- mining
- marketing
- health
- first people
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Division: (please indicate your division with a cross)
- 100- C&I Brisbane
- 110- Health
- 150- Agri Qld
- 200- C&I Townsvile
- 210- AWX Construction
- 250- Mining
- 300- Hospitality
- 310- Agri South
- 350- NSW Traditional
- 400- C&I Mackay
- 500- C&I Gold Coast
- 600- C&I Sunshine Coast
- 700- Perth
- 950- Contract Planting
WORKFORCE NUMBERS &MAN HOURS WORKED
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Employee Category:
AWX -
Total No. of Employees
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Total No. Of Hours Worked
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Employee Category:
subcontractors -
Total No. of Employees
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Total No. Of Hours Worked
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Employee Category:
Total (current month) -
Total No. of Employees
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Total No. Of Hours Worked
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Employee Category:
Total (year to date financial year) -
Total No. of Employees
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Total No. Of Hours Worked
INDIGENOUS WORKFORCE NUMBERS (included in the above)
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No. Of AWX Indigenous Employees
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Total No. Indigenous Employees
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% of Indigenous Employees on site
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What is indigenous target No. For this Division? (if measured)
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% (a) / Total No. Of employees
GROUP REPORTING REQUIREMENTS
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INCIDENTS REPORTED
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Injury Incidents (i)
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No. Of Lost Time Injuries (LTI)
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No. Of Medical Treatment Injuries (MTI)
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No. Of Alternative Duty Injuries (ALT)
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No. Of First Aid Injuries (FAI)
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Damage Incidents (d)
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No. Of Plant Damage
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No. Of Business Loss Incidents
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No. Of Heavy Vehicle Incidents
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No. Of Light Vehicle Incidents
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No. Of Theft Incidents
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Other Incidents (o)
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No. Of Non-statical Incidents
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No. Of near Misses
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No. Of Environmental Incidents
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No. Of Hazards
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TOTAL NO. OF INCIDENTS (i) + (d) + (o) = Total incidents
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TARGET TRIFR - Total Recordable Injury Frequency Rate
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ACTUAL TRIFR
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TARGET TEIFR - Total Environmental Incident Frequency Rate
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ACTUAL TEIFR
OTHER INFORMATION
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No. Of sig incident alerts generated
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List new clients for current month: 1. 2. 3. 4.
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No. Of days lost due to LTI's
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Have all Host Inspection From 001&002 been completed
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List Host Inspection Companies completed: 1. 2. 3. 4.
AUDITS AND QUARTERLY RISK REVIEWS
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Was a QRR completed this month?
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Was a Q&E audit completed this month?
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Was a H&S audit completed this month?
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No of Inspections planned as per schedule
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No of Inspection completed as per schedule
QUALITY AND ENVIRONMENT
DRUG TESTING
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No. Of tests conducted
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No. Of confirmed positive results received
ALCOHOL TESTING
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No. Of tests conducted
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No. Of confirmed positive results received
BUSINESS UNIT REPORTING REQUIREMENTS
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Divisions positives for Month (Safety / Environment Related):
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Divisions Areas of improvement (Safety/Environment Related):
Actions Required Safety & Environment Related:
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Action
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Person responsible
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Date to be Completed
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Closed out Date
