Title Page
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Site
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Conducted on
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Prepared by
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Personnel
Traffic/Pedestrian Management
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Is Traffic/pedestrian management required<br>
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Is there a TGS<br>
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Does the TGS appear compliant
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Are staff/pedestrians segregated from equipment where possible
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Any other issues
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Refer to HSW traffic management officer
Power and Services
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Is there risk of hitting overhead powerlines
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Authorised spotter in place
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Spotter clearly identifiable
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Does spotter have adequate communication to operator and whistle
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Is spotter doing any other duties
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Any other issues
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Is there risk of hitting underground services
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Dial before you dig completed and available
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Services located and marked
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Services isolated where required
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Any other issues
Plant/Vehicles
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Plant/vehicles in use
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Operator VOC completed/licensed where required
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Prestart completed (spot check)
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PPE worn for vehicles in use (helmets for excavator etc)
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Exclusion zones established and in force where required
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Lifting/working at heights equipment tagged in date and and appears suitable for use
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Loads are restrained/covered adequately
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Equipment guarding in good condition and being utilised
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Hearing protection worn where required operating or near plant and equipment (quick cut saw etc)
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Any other issues
Confined Space
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Confined space
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Permit current
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Gas detector being used and calibrated (6 month)
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SWMS relevant to task
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Any other issues
Excavation
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Excavation
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Is excavation over 1.5m
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Is excavation benched battered or shored
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Do controls appear sufficient
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Excavation sufficiently barricaded
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Any intrusions (water etc)
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Are staff in the trench
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Is there any at risk activity
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Do staff have any concerns
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Is there a mechanism in place for excavation checks/inspections
Asbestos
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Asbestos
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Asbestos management plan
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Appears compliant
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Any other issues
Manual Handling
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Manual handling
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Are staff using gloves where required
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Are mechanical aids available when needed
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Are staff suitably trained
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Any other issues
Hazardous Materials/Chemicals
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Hazardous materials/chemicals
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Stored correctly
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Segregated correctly
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SDS present, current and relevant
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Labelling correct per GHS
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Evidence of material/chemical being used correctly and handled as per SDS (PPE)
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Spill kit/Emergency equipment available
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Eye wash station/shower required
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Is water cool and station free of debris
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Are there procedures in place for testing station
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Any other issues
Working at Heights
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Working at heights
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Scaffolding being used
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Erected by competent persons
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Fitted with scafftags (signed and in date)
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EWP being used
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Operator licensed and trained
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Appears to be operated correctly as per operators manual
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Ladders being used and have load rating and are undamaged
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Permit current for tasks over 1.5m
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SWMS relevant to task
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Any other issues
General Site
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SWMS being used for high risk activities
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Personnel inducted to site (spot check)
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Site personnel adhering to PPE procedure
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Slips trips and falls/ site hazards appear adequately managed
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Adequate facilities onsite for staff (Toilets, hygiene, fresh water, shade)
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Electrical equipment test and tagged and plugged into RCD
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Hot work hazards managed
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First aid kit/s available and current
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Adequately trained first aid persons available
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Suitable fire extinguishers available and tested
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Sunscreen available
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Any other issues