SafeWork NSW - Construction Team - Harm Prevention Program

• Developer:

• Site Name

• Developers ABN:

• Inspection Conducted By:

• Conducted on

  Date
• Location
  Address

Principle Contractor

• Principle Contractor:

• Principle Contractors ABN:

• Principle Contractors Contact Person:

• Phone Number

• WC Certificate of Currency?

  Yes

  No

  N/A

• WC Policy Number:

• Consistent with WIC

  Yes

  No

  N/A

• Number of Employees:

Scaffolding Contractor

• Scaffolding Contractor:

• ABN:

• Contact Person:

• Phone Number:

Scaffolding - Planning & Documentation

• Handover Certificate for completed scaffold R225(2)

  Yes

  No

  N/A

• Regular Scaffold Inspections R225(3)

  Yes

  No

  N/A

• Engineered design - Cantilevered needles, suspended systems etc

  Yes

  No

  N/A

• Scaffolders HRWL

  Yes

  No

  N/A

Scaffold - Design & Use

• In good condition, erected plumb, level and square on solid foundation

  Yes

  No

  N/A

• Safe entry and exit to all working platforms

  Yes

  No

  N/A

• Edge protection provided where a person could fall

  Yes

  No

  N/A

• Decks are fully planked

  Yes

  No

  N/A

• Gap to building does not exceed 225mm

  Yes

  No

  N/A

• Has containment sheeting been considered as part of the design?

  Yes

  No

  N/A

Electrical Hazards

• Are there any overhead power lines within 4 meters or less of site?

  Yes

  No

  N/A

• Electrical switchboards in good condition with RCDs fitted and tested

  Yes

  No

  N/A

• Main switch (point of supply) clearly identified and labeled

  Yes

  No

  N/A

• Construction Wiring run in solid conduit to prevent mechanical damage and labelled “Construction Wiring”

  Yes

  No

  N/A

• Electrical tools and extension leads tested and tagged (within last 3 months)

  Yes

  No

  N/A

• Tigertails installed on low voltage overhead power lines near the site (if cranes, pumps, excavators or other machinery exists)

  Yes

  No

  N/A

• Evidence of consultation with electricity supply authority (advice letter) if workers and/or machinery working near overhead power lines ( eg: Loading Zones – Crane use)

  Yes

  No

  N/A

• Valid Dial Before You Dig Plans exist for excavation/digging/trenching work on or near public property

  Yes

  No

  N/A

Formwork Contractor

• Formwork Contractor:

• ABN:

• Contact Person:

• Phone Number:

Formwork - Planning & Documentation

• Engineering plan- sequence, propping, cure time, back propping etc.

  Yes

  No

  Needs Work

• SWMS- erecting, altering, stripping etc

  Yes

  No

  N/A

• Engineers signoff prior to pour

  Yes

  No

  N/A

Formwork - Equipment & Workers

• In good condition

  Yes

  No

  N/A

• Suitable access & egress to work areas

  Yes

  No

  N/A

• Adequate fall protection- edges, penetrations, voids, joist spacing etc.

  Yes

  No

  N/A

• Adequate supervision/instruction of workers

  Yes

  No

  N/A

• Limiting access by other trades on incomplete decks and during pours

  Yes

  No

  N/A

Inspector Observations:

• <br>In your observations are the PCBU and/or workers aware of the risk factors when working with formwork?

  Yes

  No

  Needs Work

• In your observations do the PCBU and/or workers understand the correct method in erecting/ dismantling formwork? (either conventional/engineered)

  Yes

  No

  Needs Work

• Is the PCBU or Workers aware of practical solutions and controls currently available? (Eg: Proprietary handrails, penetration covers, portable stair systems etc.)

  Yes

  No

  Needs Work

• In your opinion does the PCBU and workers think SafeWork NSW is a reliable source of information?

  Yes

  No

  Needs Work

• Overall - what status of controls for hazards associated with formwork did you observe?

  Select Not Compliant Mostly Compliant Compliant Exceeds Compliance Not Observed

  • Not Compliant
  • Mostly Compliant
  • Compliant
  • Exceeds Compliance
  • Not Observed

• In your opinion does the PCBU and workers think SafeWork NSW is a reliable source of information?

  Yes

  No

  N/A

Any Additional Comments

• Any Additional Comments:

• Is this site recommended for a FOI Project Visit?