Title Page

  • Site conducted

  • Document No.

  • Client

  • Site

  • Vendor

  • Subcontractor

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Evidence of Induction

  • Has the all sub – contractor’s staff been through the site induction process?

Organisation of the site

  • Are works being conducted as per safety plan and/or SWMS?

  • Is the SWMS site specific and relevant to the works being undertaken

  • Are all persons working according to the SWMS signed off on the SWMS?

  • Site/work area is free from rubbish and obstructions?

  • Trenches etc are covered or barricaded?

  • All persons on site have current construction safety cards and can produce them?

  • Can the Electrician in charge produce is electrical licence

  • Sub-contractors are noted as attending Daily Pre-start meeting?

  • Do all persons operating plant have certificate/license to operate?

Plant

  • Is there is an EWP or fork lift onsite

  • Is the daily prestart filled out

  • Have you checked the maintenance part of the Plant log book to ensure the plant is safe to use

  • Is the plant being used correctly, ie, EWP has leveling feet in place

Electrical

  • Electrical equipment - power tools, leads etc are tested and tagged?

  • Portable RCD’s are used, where required?

  • Leads, plugs, sockets and switches appear to be in good condition (no exposed wires, no mechanical damage)?

  • insulated ladders are used near live exposed electrical equipment?

  • Is the ladder secured at roof level and protected at the base if being used in a vehicle access way

  • Are barricades being used to seperate work areas from the public

  • Is test equipment in calibration date

  • Is there a first aid kit onsite

  • Is the first aid kit in date

  • Is there a fire extinguisher onsite, is it in test (6 months)

  • Is there at least one lockout kit onsite with sufficient locks and tags for safe isolation?

Materials Storage

  • Building materials are stored according to set rules?

Personal Protective Equipment

  • Relevant Personal Protective Equipment is being used?

  • Are harnesses, lanyards and ropes in date

  • Is Hi Viz clothing been worn?

  • Is sun protection being worn?

Site Safety Management Plan

  • Are there site specific items in the site safety management plan that is not on the above list?
    If YES list them;

  • Is the contractor working in conformance to the CSMP?

  • Comments

Working at Heights

  • What type of safety system is being used

  • If it is permanent edge protection does it have a certificate from the scaffolder

  • If there are skylights what method is being used to protect workers

  • If there is no edge protection does the building provide a safe parapet to protect workers

  • If bollard and tape is being used is it secure and a minimum of 2 m from the live edge

  • If harnesses are being used will the lanyard prevent the worker contacting the ground in the event of a fall

  • Is there a safe drop zone below the work area that protects all workers, site staff and public

Evaluation

  • In your observations is the contractor meeting their obligations as assessed in these criteria?

  • Have identified non-conformance(s) observations been discussed with the contractor?

  • Has the contractor agreed to observations

  • Has non-conformance(s) been rectified?

  • Comments:

  • Observation completed by:

  • Contractor (or contractors representative)

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