Six Monthly Maintenance Check - Vehicle, Equipment & PPE

• JTPW Operator:

• Conducted on

  Date

Do you have the following gear/ equipment?

• Cones 900mm

  Yes

  No

• Signs / hazard boards

  Yes

  No

• High visibility vests (with JT Group branding)

  Yes

  No

• High visibility wet weather gear

  Yes

  No

• Paper chemical suit

  Yes

  No

• Filter mask

  Yes

  No

• Road Barriers

  Yes

  No

• Antiseptic hand cleaner

  Yes

  No

• ipad

  Yes

  No

• Safety footwear

  Yes

  No

• Steel cap boots

  Select Yes No

  • Yes
  • No

• Uniform - polo shirt and warm jacket or fleece top

  Yes

  No

• Truck signage

  Yes

  No

• Comments...

Do you have the following gear and equipment and is it in a safe condition to use?

• Harness Kit - one per person

  Yes

  No

• Ropes

  Yes

  No

• Lanyards

  Yes

  No

• Carbon cartridge mask

  Select Yes No

  • Yes
  • No

• Ear Protection

  Yes

  No

• Gloves

  Yes

  No

• Fire Extinguisher

  Yes

  No

• First aid kit

  Yes

  No

• Exhaust pipe protected on water blaster to prevent skin burns

  Yes

  No

• Hard hat

  Yes

  No

• Water blaster pump 32L/3500psi

  Yes

  No

• Honda 24hp Vtwin motor

  Yes

  No

• 70m Hydraulic Hose

  Yes

  No

• 100m low pressure hose

  Yes

  No

• High pressure reel

  Yes

  No

• Low pressure reel

  Yes

  No

• Extension lance

  Yes

  No

• High pressure extension lance

  Yes

  No

• Long handled brushes

  Select Yes No

  • Yes
  • No

• Pressure gun butt and assorted lances

  Yes

  No

• Ladder

  Yes

  No

• Vehicle

  Yes

  No

• Trailer

  Yes

  No

• Blaster framing mount and water tank

  Select Yes No

  • Yes
  • No

• 1 Kerrick wet vac pump including hoses for waste water recovery

  Yes

  No

• Pure water filtration system

  Yes

  No

• Carbon Fibre Poles to reach third storey

  Yes

  No

• Comments...

Chemicals

• Are chemicals secured in vehicle in regulated amounts?

  Yes

  No

• Do you have ultra filter socks?

  Yes

  No

• Do you have an ultra drain guard?

  Yes

  No

• Comments...

Training & Certification: do you have the following qualifications?

• Height and Harness Safety

  Yes

  No

• Fall Arrest Systems

  Yes

  No

• Are you qualified to use a cherry picker or a scissor/boom lift?

  Yes

  No

• Are you qualified to use chemicals required to complete spider treatment?

  Yes

  No

• Do you have a 10L pump sprayer?

  Yes

  No

• Is it safe to use?

  Yes

  No

• Are you qualified to complete first aid?

  Yes

  No

• Does at least one person in your team hold this certification?

  Yes

  No

• Please list the contractor(s) who hold(s) this certification below

• Comments...

Harness, Ropes & Lanyards

• Do you have a Harness/Ropes/Lanyard for use on JT work sites?

  Yes

  No

• Impact Indicator

  Safe

  At Risk (Action Required)

• D-Rings

  Safe

  At Risk (Action Required)

• D-Ring Plate

  Safe

  At Risk (Action Required)

• Buckles

  Safe

  At Risk (Action Required)

• Connectors

  Safe

  At Risk (Action Required)

• Labels - Must be present, attached and legible

  Yes

  No

• Plastic Keepers

  Safe

  At Risk (Action Required)

• Wire Rope

  Safe

  At Risk (Action Required)

• Webbing

  Safe

  At Risk (Action Required)

• Shock Absorber

  Safe

  At Risk (Action Required)

• Stitching

  Safe

  At Risk (Action Required)

• Rope

  Safe

  At Risk (Action Required)

Hi-Vis

• Is your Hi-Vis clean and in good condition

  Yes

  No

Gloves

• Gloves - In good condition

  Yes

  No

Ear Protection

• Ear Protection - In good condition

  Yes

  No

Fire Extinguisher

• Is your Fire extinguisher disposable?

  Yes

  No

• Date of last service/check (NZ standards state that fire extinguishers must checked every 12 months)

  Date

• undefined

• Was the extinguisher certified to use upon purchasing?

  Yes

  No

• Date of purchase (NZ standards state that fire extinguishers must checked every 12 months)

  Date

• undefined

• Has the Fire Extinguisher been certified? (NZ standards state that fire extinguishers must checked every 12 months)

  Yes

  No

• Please provide the date in which the extinguisher was certified, if not certified upon purchasing

  Date

• please provide the date you intend to certify extinguisher

  Date

First Aid Kit

• Is your First Aid Kit fully stocked?

  Yes

  No

• Please list the missing items from your first aid kit

• Please provide date for which you intend first aid kit to be fully stocked

  Date

• Notes:

• I declare that the maintenance checks were performed by me personally and all the information provided is true and correct.

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