Sediment/Litter/Waste Control Audit

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Officers Name

• Nominated PCA

• Time of Inspection/ Date of Inspection

  Date

• DA Number

Inspection Checklist

• Certifier's Sign

  Yes

  No

  N/A

• Builder's details

  Yes

  No

  N/A

• After hours number provided

  Yes

  No

  N/A

• Sediment Control in place and maintained

  Yes

  No

  N/A

• Any sediment on the road/gutter

  Yes

  No

  N/A

• All weather access point satisfactory and maintained

  Yes

  No

  N/A

• Waste bin present and maintained

  Yes

  No

  N/A

• Vehicles on nature strip

  Yes

  No

  N/A

• Is the footpath clear and unobstructed

  Yes

  No

  N/A

• Is the site secured to restrict public access

  Yes

  No

  N/A

• Photos taken

  Yes

  No

  N/A

• Photo

  Media

OFFICE USE ONLY:

• Full name of contact person (person/site foreman/contractor/spoken to during Inspection

• Company Name:

• Phone number:

• Mobile number:

• Fax number:

• Postal Address:

• Questions:

• Other comments:

• Advisory letter issued

• Clean up/ Prevention Notice to be Served:

• Infringements to be issued:

• Follow up inspection required

• Referral Action

  Workcover to be notified

  PCA Notified

  Builder Notified

  EPA Notified

• Other

• Officer

  Sign