Information
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Site Manager
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Project Site
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Conducted on
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Prepared by
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Personnel
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Document No.
Site Office
SITE OFFICE
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Site Establishment Plan - On display?
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Emergency Contact Details - On display?
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Emergency Evacuation Instructions - On display?
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Evacuation Siren - available and tested?
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Visitor Register - Available and in use?
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Is the First Aid cabinet suitably stocked with contents date current?
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Fire Extinguisher tags up-to-date? (6 months)
Lunchrooms
Lunchroom
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Clean and tidy?
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Emergency Evacuation Instructions - On display?
Toilets
Toilets
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Toilets in functioning order?
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Toilet paper, Soap & Hand towel stocked?
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Are any taps or fixtures leaking water?
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Toilets cleaned weekly?
Signage
Signage
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Entry Signage displayed at front gate and in good condition?
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Safety signage is appropriate for the site?
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Cooper & Oxley identification and registration number displayed?
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Emergency Muster Point - sign located at Muster Point?
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Site Office & First Aid locations easily identifiable?
Safety Noticeboard
Safety Noticeboard
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OHS Policy - On display?
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Environmental Policy - On display?
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OHS Representative - Name on display?
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Site Establishment Plan - On display?
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Emergency Evacuation Instructions - On display?
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Toolbox meeting minutes - On display?
Safe Work Method Statement Complaince
SWMS Compliance
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Subcontractor Observed
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SWMS Title:
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Observed work is in compliance with SWMS?
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SWMS reviewed and resigned monthly?
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Is a review of the SWMS required?
Electrical
Electrical
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Site shed RCD's test/tagged (6 monthly)
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Electrical tools test/tag - random inspection (subcontractor, tool, tag number, name of tester)
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Power Boxes - Numbered and test/tagged?
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Power Boxes - Leads entering through correct entry holes?
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Power Boxes - RCD push button tested?
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Power Boxes labelled appropriately? (I.e electrical hazard warning sign, board ID, supply location)
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Any leads on the ground or hanging from steel structures?
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Lead stands/hangers in use and insulated?
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Leads no longer than 30m in use?
Excavations
Excavations
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Excavation Permit has been completed, including details of the defined SWMS?
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Barricading erected around excavation areas?
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Excavations with a potential to collapse inward, benched, battered or shored?
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Plant and spoil kept or placed at least 1m from edge of excavation?
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Spoil or stock piles kept away from drains, buildings, fences, trees?
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Excavations have safe means of access/egress?
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Daily excavation checklists completed as required?
Working at Height
Powered Plant & Equipment
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Subcontractor:
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Plant ID:
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Plant risk assessment submitted to site?
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Plant maintenance records submitted to site?
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Plant logged into plant/equipment register?
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Plant specific SWMS signed?
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Daily pre-start checks completed?
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Plant free from obvious leaks?
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Maintenance identified in pre-start has been communicated to those responsible?
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Plant operators hold current licence or competency?
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Lifting slings, chains, harnesses, fire extinguishers etc. certified/tagged?
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Are appropriate machine guards in place?
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Plant is being operated clear of overhead power lines?
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Plant being operated at a site specific speed limit?
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Seat restraints being used correctly?
Powered Plant & Equipment
Working at Heights
SCAFFOLD
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Last scaffold inspection within 30 days?
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Scaf tags updated and legible with inspector name?
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Scaf tags at all scaffold entry points?
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Are feet centrally located on sole boards?
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Edge protection complaint with:<br>Guard rail, mid rail, toe boards, or;<br>Guard rail and mesh panel
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Work platform clean and free from obstructions?
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Scaffold 4m and above, erected by licensed scaffolder?
LADDERS
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Ladders extend a minimum of 1m above connection point and are secured (I.e tie down)
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Ladders are maintained in good condition?
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Step ladders have legs correctly spaced and locked/tied off?
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Top step of step ladder being used as a working platform?
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Defective ladders tagged out of service and placed in quarantine area?
OPEN FLOOR PENETRATIONS
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Holes or openings in floors are barricaded or boarded with danger signs
GUARD RAILS
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Guard rails in place where a person can fall 2m or more from a stair, landing or fixed platform?
FALL ARREST/RESTRAINT
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Harness tagged? (6 monthly)
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Harness in use and attached or anchor point?
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Working at Height Permit has been completed, including details of the defined SWMS?
Hazardous Substances and Dangerous Goods
Hazardous Substances & Dangerous Goods
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Hazardous substances register is up to date?
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Hazardous substances assessed as High risk or above, have been approved by Site Manager?
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MSDS register and file up to date?
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Storage facility is labelled HAZCHEM?
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Storage facility is well ventilated and away from potential ignition sources?
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All Hazardous substances appropriately labelled?
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Gas cylinders secured?
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Gas cylinders have flashback arresters in use?
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Incompatible chemicals segregated?
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Spill kit proportionate to size of project available?
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Subcontractor hazardous substances stored correctly?
Personal Protective Equipment
PPE
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Mandatory PPE is being worn by subcontractors?
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PPE is in good condition?
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Task specific PPE is being used?
Other
Other
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Subcontractor sheds/sea containers tidy with correct storage requirements
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Quarantine area established and orderly to house out of service items?
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Star pickets/reinforcing rods protected by caps?
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All other work permits have been completed, including details of the defined SWMS?
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Site safety documentation properly completed and filed away?
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Public safety controls remain effective (fencing, locks, signage)?
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Public safety concerns are communicated to the OHSE Department?
Environmental
Environment
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Excessively noisy tasks are not undertaken in the early morning? (Disturbing local community)
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Vibration dampening equipment is installed where necessary?
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Site fencing shade cloth is secured and in good condition to minimise dust movement?
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Dust generated by vehicle movement is minimised?
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Dust generated by concrete/brick cutting is minimised?
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Water hoses turned off when not in use?
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Water hoses/replaced when leaking?
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Refuelling of plant is conducted at the designated area or by using appropriate size bund?
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Designated concrete wash out is in use where practicable?
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Site has been inspected for significant spills?
Audit Rating
Corrective actions (include into site CA Register)
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CORRECTIVE ACTION
Corrective Action
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What?
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By Who?
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By When?
Worker Participation
Worker Participation
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Name of worker / Subcontracting company
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Q1) Do you have any health and safety concerns that you would like to raise?
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Q2) Is there anything within reason that Cooper & Oxley can do to make this site safer?
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Q3) Do you have any general observations you would like to identify to Cooper & Oxley?
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Signature or worker