Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Add drawing

Information

Report Details

  • Work Title

  • Work Order or Scheme Number

  • Who is undertaking the works?

  • Insert contractor name

  • Landowner/Occupier Ref

Access

Access

Access Documents

  • Are Access instructions on site?

  • Which access documents are present?

  • Record documents

  • Have access instructions been adhered to?

  • Have access routes been followed?

  • Have land owners/third parties been notified prior to access being taken?

  • Are all gates locked and secure?

Land Damage and Crop Loss

  • Has any land damage been reported?

  • Add location marker
  • Is there any unexpected land damage?

  • Add location marker

Safety Documentation

Safety

  • Are there any personnel on site?

  • Is appropriate PPE being worn?

  • Has a site induction/tool box talk been carried out?

Safety Observations

  • Any visible hazards?

  • Have appropriate measures been taken to minimize risk to personnel and the public?

  • Are lone working policies being adhered to?

  • Are there any overhead lines in the vicinity?

  • Are GS6 barriers being used?

Risk Assessments and Method Statements

  • Is there a copy of the RAMS on site?

  • Are the RAMS being followed?

  • Comments/Notes:

  • Are all required safety documents on site?

  • Are safety documents up to date?

Working Area

Working Area

  • Is the working area clearly defined?

  • Are the working areas clean and tidy?

  • Are the safety zones clearly demarcated and easy to identify?

  • Is the use compliant with the access instructions?

  • Have works been completed?

  • Is the site clear of waste and rubbish?

  • Has all the equipment been removed from site?

  • Notes/Comments:

Vehicles and Plant

Vehicles and Plant

  • Are there any vehicles on site?

Operational Vehicles

  • Are the vehicles suitable for the ground conditions/environment?

  • Are the vehicles being used in compliance with the access notes/maps?

Additional Plant or Vehicles

  • Is there any plant or machinery on site?

  • Has the appropriate consent been given?

  • Are there welfare facilities on site?

  • Have the appropriate permissions been given?

  • Are the facilities in an appropriate location?

  • Enter Location marker

Traffic Management

Traffic Management

  • Is traffic management required?

  • Is there traffic management in place?

NRSWA

  • Is the traffic management in accordance with the NRSWA requirements?

  • Is there adequate signage?

  • Insert photo of signage

  • Is the permit number displayed?

  • Insert photo of permit board

  • Are the permit conditions being adhered to?

  • Are there personnel on site?

  • Is appropriate PPE being worn?

  • Notes/Comments:

Site specific traffic management

  • Is there a Banksman/Personnel in place?

  • Is appropriate PPE being worn?

  • Are F10 boards present/visible?

  • Insert image

  • Are boards and signage up to date?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.