Information
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Audit Title
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Document No.
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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
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What Type of Audit
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Company Name
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Principle Name
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Rego
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Audit ref Number
Job Site
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General site housekeeping.
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Aerial Risk Assessment (form) completed?
PPE
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Dust Mask (must be P1 or P2 type mask)
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Eye Protection - Clear and Dark.
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Fall arrest/Restraint System. Serviceable date.
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Tested Date
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Full body safety body harness. Serviceable date
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Tested Date
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Hearing Protection
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Ladder head rope.
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Retro Reflective vest. Clean with reflective tape in good condition.
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Riggers Gloves.
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Safety Belt / Harness ( All locking clips checked). Check for fraying
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Tested Date
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Safety Footware. No steel caps exposed.
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Safety Rope. 20 meters of rope
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Sharps Container & Tongs
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Uniform appropriate & in good condition. Check for wear holes.
Electrical Equipment ( Testing and Tagging)
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ELCBR (RCD)
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Tested Date
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GPO Tester
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Tested Date
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Watmaster Pencil Tester
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Tested Date
Documentation
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Project Safety Management Plan
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Project Safety Work Instructions
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CFWG
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MSDS - Silastic's Adhesive
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MSDS - Silicon Grease
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MSDS - Gel Filled Cable
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MSDS - ( Dangerous/Hazardous substances)
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Optus ID Badge
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Exp Date
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Stream Policies ( SHE. QUALITY, CONSULTATION, ect)
Vehicle
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Vehicle Body in good condition
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Vehicle lights working
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Vehicle Clean
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Tyres in good condition'
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Shelving sufficient / appropiate
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Pipe storage and Conduit Carrier ladder rack secure.
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Vehicle Doors operational
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Cargo area (secure load)
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Vehicle Registration Current
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Exp Date
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Vehicle Serviced
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Due Date
Vehicle Content
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Fiberglass extension ladders (check ladder for cracks and damage)
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Fiberglass step ladder ( check ladder for cracks and damage)
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First Aid Kit ( check contents for currency)
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Signal Meter ( including Calabrationdate) (Power on)
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Calibration Date
License Checks
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Construction Induction Card ( White)
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Exp Date
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Drivers License Valid
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Drivers License Exp Date
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Working at Heights
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Working at Heights Exp Date
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Action Item 1
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Person to Action 1
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Close out 1
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Close out Date 1
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Action Item 2
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Person to Action 2
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Close out 2
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Close out Date 2
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Action Item 3
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Person to Action 3
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Close out 3
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Close out Date 3
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Action Item 4
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Person to Action 4
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Close out 4
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Close out Date 4
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Action Item5
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Person to Action 5
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Close out 5
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Close out Date 5
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FST Signature
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Date Completed
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FS Signature
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Date Completed