Title Page
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Site conducted
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Completed on:
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Completed by:
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Works location:
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Contractors/workers present on site:
Administration and Control
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Have all workers signed out/in and are they contactable by RT?
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Do Main Contractors have SSSPs (or equivalent) in place and available on site?
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Has an Authority to Work (ATW) been issued for the work activities?
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Have any notifiable works been notified to WorkSafe by the Main Contractor?
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Has high level hazard identification and risk management been carried out for the project?
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Have Main Contractors provided hazard/risk registers for their works?
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Has a Permit to Work been issued for required work activites?
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Has a JSEA (or similar) been completed for all high-risk activities?
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Have all workers completing high risk tasks had appropriate training?
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Is there adequate/appropriate project signage in place across all work zones?
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Is there a suitable hazard board displayed in each work zone?
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Has a daily coordination meeting been held and attended by the required Main Contractors?
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Has the Main Contractor completed a daily pre-start meeting (or pre-start at the commencement of new activities)?
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Has the Main Contractor complete a toolbox talk for their work zone in the past week?
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Has the Main Contractor complete health and safety inspections for their work zone in the past week?
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Have work zone/site specific inductions been completed for all workers/stakeholders entering work zones?
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Are there provisions to deal with workers or other stakeholders visiting the work zone?
- Yes
- No
- N/A
Emergency Management
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Is there a work zone emergency and evacuation plan in place?
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Is emergency equipment on site and accessible?
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Do all workers hold a current first aid certificate?
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Are fire extinguishers available and checked/current?
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Are first aid kits available and appropriately stocked?
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Has emergency planning been completed for all high risk activities?
Incident Reporting and Investigation
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Is there an incident register on site (for each work zone)?
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Have any incidents/events occurred since the last assessment recorded?
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Have any incidents been notified to the SBR project management team as required?
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Have all incidents/events been investigated, the cause identified and preventative actions been agreed and actioned?
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Have there been any notifiable events? If so, have these been notified to WorkSafe NZ?
Hazardous Substances and Materials
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Is a current register of hazardous substances/materials held for each work zone?
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Are all substances/materials used on site included in the register?
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Are there any incompatible substances held on site?
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Is there appropriate storage for any flammables?
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Are Safety Data Sheets available and are they current?
Housekeeping
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Are all accessways clear to work zones/areas?
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Has delineation been set up around fixed work areas/zones and is it adequate?
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Is all waste being managed as per the Environmental Management Plan?
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Are all reinforcing steel bars capped?
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Are nails in timber made safe?
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Are slips and trips controlled?
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Are loose materials secured from the wind?
Personal Protective Equipment (PPE) and Clothing (PPC)
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Is information provided to workers to indicate the minimum PPE/PPC requirements for each work zone?
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Are workers wearing appropriate cold weather clothing including gloves?
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Is compliant safety footwear being worn
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Are hi-visibility vests/cloting being worn?
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Is hearing protection being worn?
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Are safety glasses being worn?
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Are respirators/dust makes being worn?
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Are other items of task specific PPE/PPC being worn?
Machinery/Tools
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Are nail guns being used in a safe manner?
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Do grinders have guards in place, correct disc for task/tool, dead man's switch and observed being used in a safe manner?
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Do table saws/power saws have guards in place, in good condition and observed being used in a safe manner?
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Are all other tools in use (including hand tools) observed being safety and the correct tool for the job?
Power Actuated Tools
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Do tools have current certification (6 monthly)?
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Do operators hold certificates of competence relating to the make of tool being used?
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Are barriers/signage in place to prevent unauthorised access to the firing zone?
Electrical
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Are all electrical tools/leads/equipment tagged 3-monthly?
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Is all electrical equipment beig used with an industrial rated RCD?
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Are leads protected in high-traffic areas?
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Are domestic splitter boxes and doubles adapters excluded from use?
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Are leads clear of water?
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Is equipment in good condition with appropriate guards in place?
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Is adequate temporary lighting in place?
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Have circuits been isolated (locked and tagged out)?
Ladders
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Are ladders on site industrial rated to AS/NZS standard?
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Are ladders in good condition?
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Are ladders used for short term work only?
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Are ladders being used safely?
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Where used for access are ladders footed, tied off and installed with a 4:1 ratio?
Heights Work
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Have all ground penetrations been covered, covers pinned and clearly marked when not being worked on?
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Are fall hazards controlled, including the use of appropriate edge protection or fall arrest/restraint?
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Are safety nets installed where required?
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Have anchors and rope lines been designed/installed by a competent person?
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Is work at heights being completed by trained and certified workers only?
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Is all heights safety equipment checked, tagged and certified?
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Is an appropriate rescue plan in place?
Scaffolding - Fixed
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Are all toe boards, mid rails and to rails in place at the correct height?
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Are all gates self-closing?
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Is the scaffold the correct height/width for the roof pitch?
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Are all planks tied down and secure?
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Is the scaffold within 300mm of the workface?
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Is the scaffold stable/on level footing?
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Have scaffolds over 5m been notified to WorkSafe NZ?
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Is the scaff-tag in place current?
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When not in use, is the scaffold adequately isolated?
Scaffolding - Mobile
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Are all toe boards, mid rails and top rails in place and at the correct height?
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Is the mobile scaffold being used on a sound, clear and level surface?
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Have the brakes been engaged and wheels turned out to prevent movement?
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Is the hatch door closed (except during access and egress)?
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Has the mobile scaffold been erected, maintained, altered and dismantled by the competent person (less than 5m) or a certified scaffolder (greater than 5m)?
Mobile Elevated Work Platforms (MEWP)
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Is the ground/surface firm/level and suitable for MEWP use?
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Is the MEWP rated for incline?
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Are outriggers extended and on a flat surface/sole plates where available?
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Are all guard rails/toe boards in place/anchor points in place and in good condition?
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Has the MEWP been inspected prior to use and is there documented evidence of this?
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Are maintenance records available and has the MEWP been inspected/tested in the last 6 months?
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Is the loading weight of the MEWP suitable for the worker/tools/materials being used?
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Is the operator wearing a harness/lanyard are they clipped into the anchor point?
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Is a spotter in visual/audible contact range?
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Is there an emergency rescue plan in place?
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Is the operational area free from structures/hazards that may come into contact with the MEWP?
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Is the operator appropriately trained/current and competent?
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Is the MEWP being operated safely?
Cranes/Lifting Activities
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Has a JSEA (or similar) or a lift plan been completed?
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Is the safe work load displayed on crane/machine and lifting tackle, and not exceeded?
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Is lifting equipment including tackle, lifting points and accessories fit for purpose, designed, installed, inspected, rated and certified?
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Have overhead services been identified and controlled to prevent contact and is a spotter in place where there is a risk of striking overhead services?
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Are exclusion zones in place?
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Are lifts being executed to ensure no lifting is being completed over occupied areas and no work is being undertaken under a suspended load?
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Have the ground conditions been assessed as suitable for the load and are stabilisers/outriggers fully deployed and locked in place?
Excavations
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Are plant, spoil heaps and materials at least 1m clear from the edge of the excavation?
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Are adequate exclusion zones in place?
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Have underground/ground laid services been located/marked out?
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Is the trench correctly shored, battered or benched?
Traffic Management
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Are works areas separated from site traffic/plant movements or are adequate controls in place?
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Are spotters being used for vehicle/plant positioning?
Transport and Mobile Plant
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Have Main Contractors completed pre-start checks on plant and addressed any issues identified?
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Are plant/vehicles well maintained and are log books (where applicable) and maintenance records present and up to date?
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Are plant/vehicles operators licenced, trained and competent, and are manufaturers instructions followed?
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Are all plant/vehicle and worker/pedestrian interactions adequately managed?
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Are people kepy away from slewing plant?
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Are spotters used for reversing plant/vehicles
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Are loads properly secured
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Are seatbelts worn?
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Are securing pins in place on excavator quick hitches?
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Are the appropriate ROPS/TOPS fitted?
General Observations
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General health, safety and wellbeing observations for the work zones: