Service Stream - Linemarking Shift Report.

• Date

  Date

• Client

• Report Completed By

• Shift Type

  Select Day shift Night Shift Weekend

  • Day shift
  • Night Shift
  • Weekend
• Site Location
  Address

• First Aid Representative Onsite

• Toolbox Talk Completed Prior to Works Commencing, with all workers present

  Yes

  No

  N/A

• The SDS Register is Located Onsite and Accessible for all Personal

  Yes

  No

  N/A

• Notes

• Related Photos

  Media

Stock / Equipment Request

• Stocks Request

  Yes

  No

  N/A

• List in detail the stock and the amount required

• Date Required by

  Date

• Tooling / Equipment Request

  Yes

  No

  N/A

• Details of tools and or equipment required

• Date Required by

  Date

Employee - Shift Sign On Declaration

• By signing here below - He / She agrees to and confirms that -
  - He / She has attended the pre shift “Toolbox Talk”.
  - He / She has been trained in and understands the related SWMS.
  - He/ She has previously and successfully completed all related Service Stream training requirements. This includes related inductions required to work on a Service Stream work site, required to work and preform the tasks at hand.
  - He / She will always conduct oneself in a safe, professional manner.
  - He / She is trained, competent, capable, physically fit and well to undertake any task required of them.
  - He / She is not under the influence of, nor have they previously consumed any drugs or alcohol in the 12 hour period prior to or during the duration of this or any shift working for Service Stream.
  - He / She agreed to undertake random drug and alcohol testing if and when requested by a Service Stream representative. - He / She confirms that they will always conduct themselves in a professional manner and with a SAFETY FIRST attitude / manner, that is in accordance with or exceeds the Service Stream Operational and also occupational health and safety policies.
  - He / she acknowledges and confirms that they will immediately report any and all accidents, incidents and near misses when if or when they occur
  
  He / She also agrees to undertaking, complete and comply with the following -
  
  - All related Inductions. - Competency Training. - Ticketing and licensing required for the operation of any vehicle, plant and equipment they may be required to operate. - The correct handling, application and disposal of any hazardous/ non hazardous substances, in a manner to comply with the related legislation and Manufacture Product “Safety Data Sheet” or “SDS”.
  - Will always comply with any and all related Environmental Legislation / laws, including correct disposal of waste.

• Start Start Time

  Date

• Employee 1 - Sign on / Declaration

  Sign

• Employee 2 - Sign on / Declaration

  Sign

• Employee 3 - Sign on / Declaration

  Sign

• Employee 4 - Sign on / Declaration

  Sign

• Notes

Employee shift Sign Off

• Shift End Time

  Date

• Employee 1 - Sign off

  Sign

• Employee 2 - Sign off

  Sign

• Employee 3 - Sign off

  Sign

• Employee 4 - Sign off

  Sign

• Notes

Traffic Control

• Traffic Control Engaged This Shift

  Yes

  No

  N/A

• Cancellation Time Of TC Crew. (If Applicable)

  Date

• TC Company

• Number of Accredited Traffic Controllers Working Onsite

• TC Setup On Time and In Accordance With the ITP / TCP -

  Yes

  No

  N/A

• TC Time Onsite

  Date

• TC Time Off Site

  Date

• Total TC Crew Hire Hours

• TC Equipment Left Onsite

• Notes

• Related Photos

  Media

Traffic Control Incident / Accident Register

• TC Accidents / Incidents This Shift

  Yes

  No

  N/A

• Additional TC Resources Required Next Shift

Job Site 1.

• Location
  Address

• Shift Status

  Select Commence On Hold Cancelled

  • Commence
  • On Hold
  • Cancelled

• Job Progress Status

  Completed

  Ongoing

• Shifts Remaining

• Time Onsite

  Date

• Time Off Site

  Date

• Weather Onsite

  Media

• Details of Unexpected Delays / Time Lost.

• Notes

• Photos

  Media

Job site 1. Instated Linemarking Record

• Record Measurements as per instruction

• L1 or Lane Lines (Total Number of Individual Lines Instated)

• S1 or Double Centrelines (Measurement in Lineal Meters)

• E1 or Edge Lines. (Measurement in Lineal Meters)

• C1 or Merge Lines. ( Total Number of Individual Dashes Instated )

• Transverse “Stop” Lines. ( Measurement in Lineal Meters )

• Transverse “Giveway” Dashes. ( Total Number of Individual Dashes Instated )

• Dragons Teeth ( Total Number of Individual Teeth Instated)

• Road Signage “40km” ( Total Number of Individual Stencils Instated)

• Directional Arrows. ( Total Number of Individual Arrows Instated)

Job Site 2.

• Location
  Address

• Shift Status

  Select Commence On Hold Cancelled

  • Commence
  • On Hold
  • Cancelled

• Job Progress Status

  Completed

  Ongoing

• Shifts Remaining

• Time Onsite

  Date

• Time Off Site

  Date

• Weather Onsite

  Media

• Details of Unexpected Delays / Time Lost

• Notes

• Photos

  Media

Job site 2. Instated Linemarking Record

• Record Measurements as per instruction

• L1 or Lane Lines (Total Number of Individual Lines Instated)

• S1 or Double Centrelines (Measurement in Lineal Meters)

• E1 or Edge Lines. (Measurement in Lineal Meters)

• C1 or Merge Lines. ( Total Number of Individual Dashes Instated )

• Transverse “Stop” Lines. ( Measurement in Lineal Meters )

• Transverse “Giveway” Dashes. ( Total Number of Individual Dashes Instated )

• Dragons Teeth ( Total Number of Individual Teeth Instated)

• 40km Zone Stencils. ( Total Number of Individual 40km Zone Stencils Instated)

• Directional Arrows. ( Total Number of Individual Arrows Instated)

• All Personal Working on This Job Site Must Complete The Following Mandatory Minimum Requirements Prior to Commencing Work.

• Induction - all workers have completed the Service Stream Induction Process

  Yes

  No

  N/A

• Task Training - all workers have been suitably trained in OR undertaking ongoing “on the job” training to obtain the skills and knowledge required to undertake the required task at hand

  Yes

  No

  N/A

• SWMS - all workers have been training in, full understands and have signed onto the related SWMS

  Yes

  No

  N/A

• Plant Risk Assessments - all workers have been trained in, read, fully understands and signed onto the related assessment.

  Yes

  No

  N/A

• SDS Register - all workers have been trained in, read and fully understand each and every “SDS” relating to the individuals task at hand. Is there a SDS register available onsite and easily accessible.

  Yes

  No

  N/A

• ITP - all workers have read and fully understand the ITP and the Traffic Management Plan for this particular job site

  Yes

  No

  N/A

• Certificates of Competency and Licensing - all workers are in possession of the related Tickets, Certificates of Competency and Licences required by law, to complete the individuals required task/s.

  Yes

  No

  N/A

• Notes

• Photos

  Media

Accidents, Incidents and Near Miss Report Register

• In the case of a incident, accident of near miss occurring, immediately after all personal and the situation have been made safe and the related emergency services notified, your Service Stream manager / supervisor must be notified via phone call immediately and without delay. Following this a full and detailed report of the event must be recorded in the section.

• Accident - Full and Detailed Report

• Related Photos

  Media

• Incident - Full and Detailed Report

• Related Photos

  Media

• Near Miss - Full and Detailed Report

• Related Photos

  Media

• Notes

Training Register

• Name of Trainer

• Name of Trainee

• Training Activity / Task

  Select Securing loads on a Utility Reading and Understanding Linemarking Plans Linemarking Set Out protocol Handling Preformed Thermoplastic Linemarking Igniting and use of a LP Gas Blow Torch Preformed Thermoplastic Linemarking Instatement on Concrete pavements Preformed Thermoplastic Linemarking Instatement on Asphalt pavements Manuel Handling LP Gas - Correct handling protocol Working in and around traffic and a site Operating under Traffic Control

  • Securing loads on a Utility
  • Reading and Understanding Linemarking Plans
  • Linemarking Set Out protocol
  • Handling Preformed Thermoplastic Linemarking
  • Igniting and use of a LP Gas Blow Torch
  • Preformed Thermoplastic Linemarking Instatement on Concrete pavements
  • Preformed Thermoplastic Linemarking Instatement on Asphalt pavements
  • Manuel Handling
  • LP Gas - Correct handling protocol
  • Working in and around traffic and a site Operating under Traffic Control

• Training Hours undertaken this Shift

• Trainee task competency Level.

  Select Additional training in this particular task is required. The trainee is confident and competent to undertake this task, with no further training required. The trainee showed no interest in learning this particular task. Further training is fruitless.

  • Additional training in this particular task is required.
  • The trainee is confident and competent to undertake this task, with no further training required.
  • The trainee showed no interest in learning this particular task. Further training is fruitless.

• Trainee Signature

  Sign

• Trainers Signature

  Sign

Training Register

• Name of Trainer

• Name of Trainee

• Training Activity / Task

  Select Securing loads on a Utility Reading and Understanding Linemarking Plans Linemarking Set Out protocol Handling Preformed Thermoplastic Linemarking Igniting and use of a LP Gas Blow Torch Preformed Thermoplastic Linemarking Instatement on Concrete pavements Preformed Thermoplastic Linemarking Instatement on Asphalt pavements Manuel Handling LP Gas - Correct handling protocol Working in and around traffic and a site Operating under Traffic Control

  • Securing loads on a Utility
  • Reading and Understanding Linemarking Plans
  • Linemarking Set Out protocol
  • Handling Preformed Thermoplastic Linemarking
  • Igniting and use of a LP Gas Blow Torch
  • Preformed Thermoplastic Linemarking Instatement on Concrete pavements
  • Preformed Thermoplastic Linemarking Instatement on Asphalt pavements
  • Manuel Handling
  • LP Gas - Correct handling protocol
  • Working in and around traffic and a site Operating under Traffic Control

• Training Hours undertaken this Shift

• Trainee task competency Level.

  Select Additional training in this particular task is required. The trainee is confident and competent to undertake this task, with no further training required. The trainee showed no interest in learning this particular task. Further training is fruitless.

  • Additional training in this particular task is required.
  • The trainee is confident and competent to undertake this task, with no further training required.
  • The trainee showed no interest in learning this particular task. Further training is fruitless.

• Trainee Signature

  Sign

• Trainers Signature

  Sign

Training Register

• Name of Trainer

• Name of Trainee

• Training Activity / Task

  Select Securing loads on a Utility Reading and Understanding Linemarking Plans Linemarking Set Out protocol Handling Preformed Thermoplastic Linemarking Igniting and use of a LP Gas Blow Torch Preformed Thermoplastic Linemarking Instatement on Concrete pavements Preformed Thermoplastic Linemarking Instatement on Asphalt pavements Manuel Handling LP Gas - Correct handling protocol Working in and around traffic and a site Operating under Traffic Control

  • Securing loads on a Utility
  • Reading and Understanding Linemarking Plans
  • Linemarking Set Out protocol
  • Handling Preformed Thermoplastic Linemarking
  • Igniting and use of a LP Gas Blow Torch
  • Preformed Thermoplastic Linemarking Instatement on Concrete pavements
  • Preformed Thermoplastic Linemarking Instatement on Asphalt pavements
  • Manuel Handling
  • LP Gas - Correct handling protocol
  • Working in and around traffic and a site Operating under Traffic Control

• Training Hours undertaken this Shift

• Trainee task competency Level.

  Select Additional training in this particular task is required. The trainee is confident and competent to undertake this task, with no further training required. The trainee showed no interest in learning this particular task. Further training is fruitless.

  • Additional training in this particular task is required.
  • The trainee is confident and competent to undertake this task, with no further training required.
  • The trainee showed no interest in learning this particular task. Further training is fruitless.

• Trainee Signature

  Sign

• Trainers Signature

  Sign