Smith Brothers Group Pipeline/ Service Safety Audit

Vehicle and Equipment Check List

• Audit Date 7-2-14

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Drivers name SBG Plumber

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Vehicle registration ADH 476

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Vehicle make & model Toyota Hiace Van

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Vehicle mileage 126512

Section 1 - VEHICLE Plant & Equipment Procedures Safety Audit

• 1. Is vehicle displaying current contact centre number. And is it in good condition<br> - Double click here to add notes / image of vehicle

  Yes

  No

  N/A

• Is the vehicle parked safely

  Yes

  No

  N/A

• Is a traffic management plan in place

  Yes

  No

  N/A

• Are the correct signs/cones/bollards in place

  Yes

  No

  N/A

• Is the worker wearing appropriate uniform including reflective high vis

  Yes

  No

  N/A

• Is the vehicle clean and tidy internally including toolboxes and storage areas

  Yes

  No

  N/A

• Is the external of the vehicle clean

  Yes

  No

  N/A

• Is the vehicle maintained in a serviceable condition ie nothing broken or not working

  Yes

  No

  N/A

• Is PPE available to the workers is it serviceable and is it being used

  Yes

  No

  N/A

• Are appropriate SWMS available signed and being followed

  Yes

  No

  N/A

• Are safety data sheets available for chemicals and material be stored

  Yes

  No

  N/A

• Are Safe Operating Procedures Available and being followed

  Yes

  No

  N/A

• Are emergency procedures available and understood

  Yes

  No

  N/A

• Is a incident flow chart available and understood

  Yes

  No

  N/A

• Are blank copies of Incident Close Call forms avaialable

  Yes

  No

  N/A

• Are copies of guidance notes available for high risk work ie Working At Heights , Working with Sewage

  Yes

  No

  N/A

• Are copies of relevant Australian Standards, Whs Act & Regulations , Codes of practice readily available

  Yes

  No

  N/A

• Are tyres in good condition

  Yes

  No

  N/A

• Is windscreen clean and free of chips and cracks

  Yes

  No

  N/A

Tools, Plant, Equipment, Safety Equipment

• Are tools and electrical leads tagged ,tested and in date

  Yes

  No

  N/A

• Are Residual Current Devices available Tagged & Tested and being used

  Yes

  No

  N/A

• Are lock out tag out procedure available is it understood and is it being followed

  Yes

  No

  N/A

• Are energy sources being identified and locked out appropriately

  Yes

  No

  N/A

• Is a small supply of danger and out of service tags available

  Yes

  No

  N/A

• Are all tools on board safe and in a serviceable condition

  Yes

  No

  N/A

• Are fie extinguishers tagged tested and in date

  Yes

  No

  N/A

• Is a first aid kit available<br>

  Yes

  No

  N/A

• Is the first aid kit appropriately stocked<br>

  Yes

  No

  N/A

• Are guards in place and are they serviceable including marco drain cleaners

  Yes

  No

  N/A

• Is hand sanitizer available

  Yes

  No

  N/A

Oxy/Acetylene

• Is oxy acetylene being carried in vehicle

  Yes

  No

  N/A

• Are acetylene bottles stored in vented cabinets and secured

  Yes

  No

  N/A

• Are oxy/ acetylene bottles being stored and transported withe the gauges removed

  Yes

  No

  N/A

• Are cyclinders stored and secure in an upright position

  Yes

  No

  N/A

• Are gauges free from damage

  Yes

  No

  N/A

• Are flash back arresters and one way valves fitted to hoses and gauges

  Yes

  No

  N/A

• Have flash back arresters been tested in the last 12 months

  Yes

  No

  N/A

• Are hand pieces and hoses in good condition

  Yes

  No

  N/A

Roof Rack , Ladders, Materials Handling

• Are ladders stored and tied off securely on roof rack

  Yes

  No

  N/A

• Are ladders rated at120kg+

  Yes

  No

  N/A

• Are all ladders in a serviceable condition

  Yes

  No

  N/A

• Are long materials tied down correctly and are they fitted with a high vis flag

  Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Action plan

• Drivers Name & Signature

  Sign

• Auditors Name & Signature

  Sign