Site Safety Inspection Form

1. All workers are carrying current Tas Gas Networks ID, a Construction Induction “White” card and relevant competency cards.

2. The crew leader / site controller holds a Cert 111 in Gas Industry Operations or greater and is on site during the works.

3. All workers, including visitors, are inducted to site and signed on to the current Tas Gas Pre-start Hazard Identification Checklist and workers are signed onto a relevant JSEA held on site.

4. The Pre-start is correctly completed (including progressive recording of air monitoring results).

5. Permits are in place and noted on pre-start as required.

6. Safety Data Sheets are available for paints, solvents, chemicals, concrete additives, fuels, etc. Any Hazardous Substances introduced to site have been risk assessed and personnel trained in use?

7. Any other risk related documents relevant to the job are available and on site where required, e.g. NPRA’s, DBYD’s, TMP’s, major equipment Operators Manuals e.g. HDD Operations.

8. The Works Manual folder containing current documents is on site.

9. Traffic management is set up as per plan, documented as required.

10. A Spotter is appointed for work involving excavation and / or o/head power lines.

11. Clearance from power lines is maintained.

12. Trenches & excavations are barricaded. Trench rescue is in place. Other notices and safety controls are in place to assist pedestrians.

13. There is evidence that all underground assets have been marked out and / or physically located.

14. Harness and line are available and harness is within inspection date.

15. Live gas equipment is available and operational, e.g. signage, 2 fire extinguishers within test date, fire retardant overalls.

16. Mandatory PPE is worn. Other PPE is identified and available when required (hearing protection, sunblock, gloves, respirator ABE1P2, etc.)

17. Manual Handling risks assessed and controlled / Heavy lifts identified (lifting aids available e.g. barrows, hoists).

18. Air monitoring equipment is available, operational and worn / used on site as required (check calibration).

19. Slings are in good working order and within inspection date.

20. Compressed air hoses in good condition and safety clips available and used when required.

22. Power tools and leads have been tested/ tagged (within 3 months).

23. Equipment calibrations are current, e.g. electro fusion or butt welder, pressure gauges.

24. Spill kit available at site and environmental contamination assessed / controlled.

25. Clear access around worksite maintained, footpaths and private driveways kept clear.

26. Rubbish removed from site, no loose litter.

27. Site is safeguarded for public and after hours (e.g. locked plant, barricaded trenches, road plates secured).

28. Smoking is controlled on site, e.g. not within work zone or vehicles.

29. If working on or within 1 metre of strategic steel - a standover has been requested and they are on site (note exceptions).

30. Risks have been assessed and documented for all work activities carried out on site.

31. The appropriate controls have been put into place for identified risks / hazards:

32. A First Aider is nominated for the site and holds current certification.

33. Location of the First Aid kit known, and a contact list for emergencies is available.

34. Emergency procedures for the site, including designated safe zone, are known by all workers and communicated to visitors.

Comments:

NB: If any actions are required, please discuss with the site crew leader or person in charge, and if possible, agree on the remedy, the person responsible and the “do by” date and have them acknowledge the inspection in the box below. Clearly state this information on a Corrective Action Report form BMSDOC-18-691 and forward to LRC with this Inspection form.

Inspected By:

Signature:

Inspected By:

Signature:

Acknowledged by:

NB: Acknowledgement is required by the crew leader / supervisor / manager of the site being inspected.

Signature:

Non Conformance / Corrective Action Report Attached