SEWER/STORMWATER DIG UP.

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

EXCAVATOR

• Is an excavator going to be used?

  Yes

  No

  N/A

• Is there direct access to the work site?

  Yes

  No

  N/A

• Are there any fences , Trees , or other obstacles restricting access .

  Yes

  No

  N/A

• Will they have to be dismantled or removed?

  Yes

  No

  N/A

• Is the ground firm as to minimise track damage to the ground.

  Yes

  No

  N/A

• Is the excavator going to cross concrete paths and if so will there be any damage to concrete?

  Yes

  No

  N/A

SAFETY

• Is the work area well clear of any electrical sources EG. Overhead power lines or Underground Services?

  Yes

  No

  N/A

• Is the excavation away from pedestrian traffic?

  Yes

  No

  N/A

• Are there any Witches Hats out?

  Yes

  No

  N/A

• Is there adequate signage around work area?

  Yes

  No

  N/A

• Is the work area barricaded or fenced off?

  Yes

  No

  N/A

• Are al workers on site wearing Fluor clothing?

  Yes

  No

  N/A

• Has a JSA been filled out and any hazards noted?

  Yes

  No

  N/A

• Are they using Jack Hammers or Demolition Saws On Site?

  Yes

  No

  N/A

• Are they wearing the correct PPE for the task being performed?

  Yes

  No

  N/A

• How would you Rate the Safety of the Site on a Scale of 1-10?

Environment

• Is there any sewerage discharge into storm water drains.

  Yes

  No

  N/A

• Is the material being removed from the excavation being kept in close vicinity of the excavation?

  Yes

  No

  N/A

• Are there any concrete or asphalt paths or roadways that need to be cut?

  Yes

  No

  N/A

• Is there any broken pipers or concrete that needs to be removed from site?

  Yes

  No

  N/A

• Will the site be left neat and tidy with minimal indication of the dig up, Ground raked level and all debris removed from site.

  Yes

  No

  N/A

• Will any concrete damage be repaired prior to leaving site?

  Yes

  No

  N/A

• How would you rate the Tidiness of the Site on a Scale of 1-10?

• Please include some pictures of the overall Site.

  Media

• Comments.

• Audit Complete.

  Sign