Information

  • SHE Leadership Visit Record Title (include project, location, etc.)

  • Document No. VS-HS-HSC-037 Issue 1

  • Conducted on

  • Project

  • Conducted by

  • Work activity

  • Location
  • Personnel / Contractors Visited

Telecommunications Safety Essentials

  • 1.1 Does work involve working with electricity?

  • Above the line controls/comments

  • 1.2 Can work result in a fall of more than two metres?

  • Above the line controls/comments

  • 1.3 Does work require workers to drive longer than two hours?

  • Above the line controls/comments

  • 1.4 Are workers required to work in the vicinity of overhead/underground utilities?

  • Above the line controls/comments

  • 1.5 Does work involve excavation works or require persons to work in excavations deeper than 1.5m?

  • Above the line controls/comments

  • 1.6 Is the worksite in the vicinity of vehicular traffic?

  • Above the line controls/comments

  • 1.7 Are workers required to work in or around mobile plant?

  • Above the line controls/comments

  • 1.8 Are workers required to work in remote or isolated locations?

  • Above the line controls/comments

  • 1.9 Does work involve heavy lifting (>75% safe working limit) using a crane or mobile plant?

  • Above the line controls/comments

  • 1.10 Are workers exposed to asbestos?

  • Above the line controls/comments

Environmental Impacts

  • 2.1 Noise / air pollution

  • Comments

  • 2.2 Fire management

  • Comments

  • 2.3 Vehicle wash down

  • Comments

  • 2.4 Cultural heritage

  • Comments

  • 2.5 Waste management

  • Comments

  • 2.6 Erosion and sediment control

  • Comments

  • 2.7 Vegetation clearance / reinstatement

  • Comments

  • 2.8 Land access

  • Comments

  • 2.9 Prescribed waste disposal

  • Comments

  • 2.10 Spill management

  • Comments

  • 2.11 Fauna / flora

  • Comments

  • 2.12 Noxious weeds / insects

  • Comments

Topics Discussed

  • 3.1 Is the SHEWMS current and available?

  • Comments

  • 3.2 Were workers wearing the appropriate PPE?

  • Comments

  • 3.3 Were any significant safety breaches observed?

  • Comments

  • 3.4 Is there evidence of the latest Telecommunications safety information being received?

  • Information received / comments

  • 3.5 Were safety or environmental topics discussed?

  • Topics discussed / comments

Comments / Corrective Actions

  • Are there any further comments or corrective actions required? (Corrective actions must be assigned to action owner in Cintellate)

  • Comments / corrective actions

Sign-off

  • Person completing visit

  • Select date

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