Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Basic Information
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Date and Time of Inspection
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Location
- R2
- R4
- R8
- R9
- R10
- R11
- R12
- R13
- R14
- R15
- R16
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Signature
Active Area
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Location / Area
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Findings
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Actions
Active Area
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Location / Area
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Findings
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Actions
Active Area
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Location / Area
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Findings
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Actions
Active Area
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Location / Area
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Findings
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Actions
Seat Belt Verification Inspection Details
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Location
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Vehicle ID
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Seat Belts Worn?
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Number of Passangers ?
- 1
- 2
- 3
- 4
- 5
- 5+
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Actions
Risk Assessments and Permits
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For work being completed in the above areas, was a risk assessment conducted for the task observed?
- Informal (BMA Safe)
- Formal (JSA)
- None
- N/A
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For the work being completed in the above areas, was the appropriate Sub-Permit / Authority observed?
- Permit to Work
- Working at Heights Sub-Permit
- Hot Work Sub-Permit
- Confined Space Sub-Permit
- Permit to Penetrate/Dig
- Permit to Disturb
- High Voltage Access Authority
- Authority to Travel Under Power Lines on a Non-Standard Route
- Authority to Operate within 25m of Powerlines and Sub-Stations
- Authority to Recover Vehicles and Mobile Equipment
- Complex Lift Plan
- N/A
Checklist
General
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Hazards – clearly marked, appropriately managed
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Personal protective equipment – adequate for task
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Plant Safety Inspections (Pre-starts) – completed, defects rectified
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Risk assessment – suitable quality, appropriate for task, positive communication
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Signage – appropriate, in place, visible, mounted correctly
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Positive Communication – when entering area and interacting work areas
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Parking areas – clearly indicated and demarcated
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Waste management – correct bins, accumulated waste, spill kits, sumps
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Hazardous Materials – stored and labelled correctly
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Supervisor area inspection – shift area inspection completed, actions rectified
Access Road
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Roads in good condition – graded, contoured, clearly signed
Truck, Shovel, Excavator and Dozer Operations
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Roads in good condition – graded, contoured, clearly signed
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Cable Management – delineated and laid out correctly
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50m Active Mining Area in place and functional
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Loading and discharge – correct process in place, procedures followed
Draglines
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In pit parking areas – clearly demarcated and correctly set up
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Roads in good condition – graded, contoured, clearly signed
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Cable Management – delineated and laid out correctly
Drill & Blast
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In pit parking areas – clearly demarcated and correctly set up
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Roads in good condition – graded, contoured, clearly signed
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Blast boards – functional and current
General Comments
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General Comments