Van Audit

• Conducted on

  Date

• Prepared by

• Location
  Address

• Site contract:

• Inspected by:

• Date/Time:

  Date

• Sub-contractor/BRS worker

• Address:
  Address

• Is PPE being used as required by task, fit for purpose and where applicable, within expiry date range? (Hard-hat, Hi-Viz safety vest, safety boots, gloves, ear plugs or earmuffs, safety glasses, long/long compliance, fire rated overalls, respirator and face-shield).

  Yes

  No

  N/A

• Has a Job Start been completed for the activity being carried out?

  Yes

  No

  N/A

• Have task hazards been adequately identified, controlled and recorded on the Job Start?

  Yes

  No

  N/A

• Have visitors signed onto the Job Start?

  Yes

  No

  N/A

• Is there a TC STMS on site?

  Yes

  No

  N/A

• Have working at height risks been identified and controls implemented including safe drop zones?

  Yes

  No

  N/A

• Is Traffic Management required? Is it adequate/suitable? – Does it comply with TMP on site?

  Yes

  No

  N/A

• Is the workplace clean and tidy?

  Yes

  No

  N/A

• Have slips, trips and fall hazards been controlled?

  Yes

  No

  N/A

• Is clean water available for washing or flushing?

  Yes

  No

  N/A

• Are staff focused on task at hand?

  Yes

  No

  N/A

• Is there a JA/JSA/SWMS for the task identified on the Job Start? Record title/No

  Yes

  No

  N/A

• Do staff have an understanding of the risks on their work site and what controls are required?

  Yes

  No

  N/A

• Are all fuels and chemicals safely and securely stored?

  Yes

  No

  N/A

• Are temporary walkways/paths in place for pedestrians and cyclists?

  Yes

  No

  N/A

• Have prestart checks been completed for any plant or equipment?

  Yes

  No

  N/A

• Are compressors being used? Spill kit with compressor? Are whip checks fitted?

  Yes

  No

  N/A

• Are WOF, RUC’s and Registration current?

  Yes

  No

  N/A

• Are tyres free of damage and tread depth meets NZTA requirements?

  Yes

  No

  N/A

• Are vehicle windows free of chips or cracks?

  Yes

  No

  N/A

• Are harnesses within 10 years of manufacture date and compliance tagged within last 6 months? <br>Record date of Manufacture:<br>Record date of compliance check:

  Yes

  No

  N/A

• Are Ladders fit for purpose and inspection tagged?

  Yes

  No

  N/A

• Are electrical leads, residual current devices (RCD’s) and tools been tested and tagged within contract requirements?<br>Record date:

  Yes

  No

  N/A

• Are fire extinguishers accessible and indicator is in the green zone?

  Yes

  No

  N/A

• Is there a first aid kit available? Are contents within expiry dates?

  Yes

  No

  N/A

• Are SDS’s or the Chem-Watch app available? Are hard copy SDS’s within 5 years of issue date?

  Yes

  No

  N/A

• Is there an agreed incident management procedure in place?

  Yes

  No

  N/A

• Include any task specific items to be verified as required:

• Observations

• Corrective actions

• Recommendations

• Positives

All corrective actions are appropriate and have been completed

• Auditor name:

• Date/Time:

  Date