Safety Mods - Anchor Bolt Testing and Inspection

• Document No.

• Client

  Sydney Water

• Audit Title

  Anchor Bolt Inspection and Testing

• Conducted on

  Date

• Conducted By

  Safety Mods

SWMS - Pre Start Checks

• SWMS Available and Understood?

  Yes

  No

  N/A

Work Environment and Conditions

• Environment inspected for hazards - slips, trips and falls, uneven ground, dogs, cats, etc?

  Yes

  No

  N/A

• Controls put in place to manage hazards identified?

  Yes

  No

  N/A

Systems/Standards/Procedures

• Standard: AS/NZS 1891.4:2000 understood and followed?

  Yes

  No

  N/A

• Competence for task?

  Yes

  No

  N/A

Site Condition Assessment

• Are the number of anchor points the same as stated on the work order?

  Yes

  No

  N/A

• If answer is NO above provide details.

• Conduct visual inspection of all anchor points on site?

  Yes

  No

  N/A

• Conduct practical strength testing using hydraulic jacking system as per AS/NZS 1891.4:2000 on all anchor points on site?

  Yes

  No

  N/A

• Did all anchor points comply as per testing requirements?

  Passed

  Failed

• Anchor testing photos

  Media

• Replace anchor points that failed?

  Yes

  No

  N/A

• If answer is YES above, provide asset number details

Site Task Completion

• Anchor point testing completed?

  Yes

  No

  N/A

• Site test report completed and left onsite?

  Yes

  No

  N/A

• Report Photo

  Media

• Site left in safe condition?

  Yes

  No

  N/A