Information

  • Conducted on

  • Location Gordonvale To Edmonton

  • Contractor HSA

  • Project Name E2G

  • Prepared by Steve Clark

Weather

    Overnight / previous period rainfall
  • Did it rain the previous night (or preceding period)?

  • Rainfall recorded previous night (mm)

  • Has this rain prevented work occurring for this work shift?

  • What work activity has been impacted?

Weather - first work period (eg morning)

  • Temperature

  • Weather (first period of work ie morning)

  • Enter rainfall recorded(mm)

  • Has rain prevented work occurring this period?

  • What work activity has been impacted?

Weather - second work period (eg afternoon)

  • Temperature

  • Weather (second period of work ie afternoon)

  • Enter rainfall recorded(mm)

  • Has rain prevented work occurring this period?

  • What work activity has been impacted?

General

Activity Checklists Completed and QAS Completed

Hold Points, Witness Points and Non Conformance Observations

  • undefined

  • Photo/s

  • Add media

Meetings Attended

  • undefined

Visitors to Site

  • undefined

General Site Observations and Comments

  • undefined

  • Photo/s

  • Add media

Materials delivered or Removed from site

  • undefined

  • Photo/s

  • Add media

Plant Mobilised or Demobilised or Out of Service

  • undefined

  • Photos

Complaints from Public

  • undefined

  • Photos

Delays

  • Caused by

  • Details

  • Photo

WHS, Traffic Management and Environmental Controls

WHS

  • Safety controls been implemented for activity?

  • Provide details of controls implemented ie SWMS number, included as part of Toolbox/startup briefing, or other controls put in place, etc

  • Safety controls correctly implemented

  • Provide details of comments made to supervisor

  • Add photo of safety controls

Safety photo

  • Safety control photo

Traffic Management

  • Traffic control been implemented for activity

  • Access and entry points in accordance with access approvals

  • Controls correctly implemented

  • Provide details of comments provided to supervisor

  • Add photo of traffic controls

Traffic control photo

Environmental Controls

  • Enviromental controls been implemented for activity?

  • Provide details of controls implemented ie ESCP, or other controls put in place, etc

  • Environmental controls correctly implemented

  • Provide details of comments made to supervisor

  • Add photo of environmental control

enviro photo

  • Enviro control photo

Work Activity Record

  • Add work activity diary entry

  • Work Activity Entry

Activity summary

  • Location /zone within site that activity is occurring

  • Work activity description

  • Time of activity commencement

  • Time of activity completion

  • Comments on work activity / Directions provider to contractor

Personnel resources

  • Supervisor on site

  • Supervisors Name

  • Leading Hand onsite

  • Leading Hand Name

  • Labourers

  • Spotters / Marshalls

  • Add personnel resource

  • Personnel
  • Personnel description

  • Number of personnel

Plant Resources including operators

  • Number of trucks

  • Select from range

  • Dogs included?

  • Number of excavators

  • Size of excavators?

  • Number of support vehicles (Utes or small work truck)

  • Add other plant and equipment (eg tools)

  • Plant / equipment
  • Description of plant or equipment

  • Number of plant

Photos of work activity

  • Add Photos of work activity

  • photo
  • Add media

  • Photo description

  • Sign once competed. Roadworks Inspector

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.