Title Page
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Conducted on
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Project Name
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Project Number
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Location
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Auditor
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Auditee (leading site representative)
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Buried Services & Excavations
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Confined spaces
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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CoSHH
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Crush
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Drugs & alcohol
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Electricity
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Emergency preparedness
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Fire
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Fleet
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Height
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Impact
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Laceration
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Lifting operations
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Musculoskeletal
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Noise
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Plant
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Respiratory
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Vibration
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Welfare
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Individual
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Job
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
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Organisation
- As expected or good practice.
- Nonconformance
- Action required
- OFI
- Not applicable
- Not observed during this visit
Summary
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Summary or other notes.
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Any accidents or near misses?
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Any toolbox talks provided?
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Has manager's report been completed using form 1?
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Have actions from previous inspections been closed?
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Have there been any client or other inspections or audits?
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Any problems or support needed?
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Any training or competence problems?
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Any new staff on site?
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Any candidates for the QSS award?
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Auditor's signature
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Auditee's signature (site representative agreeing content of the report)
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Notes. Individual: attitude, behaviour, capabilities, communication, health, wellbeing.
Job: access & egress, housekeeping, layout, materials, tools & equipment, work environment, workload.
Organisation: communication, competence management, culture, design, documentation, monitoring, procedure, project management, resourcing, risk assessment, supervision, work scheduling.
Severity of noncompliance & definitions
24hrs - Action within 24 hours.
1wk - Action within 1 week.
CDI - Corrected during inspection.
* Actions/instructions of lower priority or for low risk requirements or ongoing expectations. Need completion when other priority actions have been closed. Needs completion before a task is conducted again.
OFI - Opportunity for improvement. An opportunity that may be used to improve the business system.
