Van Equipment & Safety Audit - Optus Techs v1.0

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• What Type of Audit

  On Site Audit

  Van, Equipment Safety Audit

• Company Name

• Principle Name

• Rego

• Audit ref Number

Job Site

• Work Ahead Sign. Are signs placed to alert traffic?

  Yes

  No

  N/A

• Prepare to Stop Sign. Are signs placed to alert traffic?

  Yes

  No

  N/A

• Stop/Slow Bat. Is traffic control needed?

  Yes

  No

  N/A

• Traffic Cones (26 Cones). Cones used to warn of work area and potential hazards.

  Yes

  No

  N/A

• All Roads Covered. Are signs placed to alert oncoming traffic?

  Yes

  No

  N/A

• Sight Distance Appropriate to Speed. Are signs placed to alert oncoming traffic?

  Yes

  No

  N/A

• Traffic cones used for parked vehicle. Cones used to warn of work area and potential worksite hazards.

  Yes

  No

  N/A

• Traffic cones used for travel path. Cones used to warn of work area and potential hazards.

  Yes

  No

  N/A

• General site housekeeping.

  Yes

  No

  N/A

• Aerial Risk Assessment (form) completed?

  Yes

  No

  N/A

PPE

• 10 m anti slide orange rope

  Yes

  No

  N/A

• Dust Mask (must be P1 or P2 type mask)

  Yes

  No

  N/A

• Electrical (LV) Gloves stored in appropriate bag/location. LV Gloves clean/no holes or tears/kept in bag out of sunlight.

  Yes

  No

  N/A

• Gloves Tested Date

  Date

• Eye Protection - Clear and Dark.

  Yes

  No

  N/A

• Fall arrest/Restraint System. Serviceable date.

  Yes

  No

  N/A

• Tested Date

  Date

• Full body safety body harness. Serviceable date

  Yes

  No

  N/A

• Tested Date

  Date

• Hearing Protection

  Yes

  No

  N/A

• Ladder head rope. Attached to ladder

  Yes

  No

  N/A

• Pole Strap. Serviceable date

  Yes

  No

  N/A

• Tested Date

  Date

• Retro Reflective vest. Clean with reflective tape in good condition.

  Yes

  No

  N/A

• Riggers Gloves.

  Yes

  No

  N/A

• Safety Belt / Harness ( All locking clips checked). Check for fraying

  Yes

  No

  N/A

• Tested Date

  Date

• Safety Footware. No steel caps exposed.

  Yes

  No

  N/A

• Safety Helmet & Retaining Strap. Issue date checked.

  Yes

  No

  N/A

• Tested Date

  Date

• Safety Rope. 20 meters of rope

  Yes

  No

  N/A

• Sharps Container & Tongs

  Yes

  No

  N/A

• Uniform appropriate & in good condition. Check for wear holes.

  Yes

  No

  N/A

• Trauma Strap.

  Yes

  No

  N/A

Electrical Equipment ( Testing and Tagging)

• 240 volt stick.

  Yes

  No

  N/A

• Tested Date

  Date

• Battery Charger.

  Yes

  No

  N/A

• Tested Date

  Date

• Bonding strap.

  Yes

  No

  N/A

• Tested Date

  Date

• ELCBR (RCD)

  Yes

  No

  N/A

• Tested Date

  Date

• GPO Tester

  Yes

  No

  N/A

• Tested Date

  Date

• Hammer Drill

  Yes

  No

  N/A

• Tested Date

  Date

• Multimeter

  Yes

  No

  N/A

• Tested Date

  Date

• Watmaster Pencil Tester

  Yes

  No

  N/A

• Tested Date

  Date

• PDU Installation Kit

  Yes

  No

  N/A

• Tested Date

  Date

• Vehicle Amber Flashing Lights

  Yes

  No

  N/A

Ladder Check

• Loose steps or rungs ( consider loose if they can be moved by hand)

  Yes

  No

  N/A

• Cracked, split or broken stiles or rungs

  Yes

  No

  N/A

• Damaged or worn non slip rungs

  Yes

  No

  N/A

• Is the ladder free from corrosion?

  Yes

  No

  N/A

• Are the side rails and step free of oil or grease?

  Yes

  No

  N/A

• Are the ropes extension ladders intact without fraying or excessive wear?

  Yes

  No

  N/A

• Loose or Bent hinge spreaders ( Step Ladder)

  Yes

  No

  N/A

• Broken stop on hinge spreaders ( Step ladder)

  Yes

  No

  N/A

• Loose Hinges ( Step Ladder)

  Yes

  No

  N/A

• Loose, Broken, or missing extension clutch ( extension ladder )

  Yes

  No

  N/A

• Defective clutch that do not seat properly when the ladder is extended ( extension ladder)

  Yes

  No

  N/A

• Span Hooks ( extension ladder)

  Yes

  No

  N/A

• Ladder Levelers ( extension ladder)

  Yes

  No

  N/A

• Up and up feature ( extension ladder)

  Yes

  No

  N/A

• are the ropes on extension ladders intact without fraying or excessive wear? (step ladder)

  Yes

  No

  N/A

Documentation

• Project Safety Management Plan

  Yes

  No

  N/A

• Project Safety Work Instructions

  Yes

  No

  N/A

• CFWG

  Yes

  No

  N/A

• MSDS - Silastic's Adhesive

  Yes

  No

  N/A

• MSDS - Silicon Grease

  Yes

  No

  N/A

• MSDS - Gel Filled Cable

  Yes

  No

  N/A

• MSDS - ( Dangerous/Hazardous substances)

  Yes

  No

  N/A

• Optus ID Badge

  Yes

  No

  N/A

• Exp Date

  Date

• Stream Policies ( SHE. QUALITY, CONSULTATION, ect)

  Yes

  No

  N/A

Vehicle

• Vehicle Body in good condition

  Yes

  No

  N/A

• Vehicle lights working

  Yes

  No

  N/A

• Vehicle Clean

  Yes

  No

  N/A

• Tyres in good condition'

  Yes

  No

  N/A

• Shelving sufficient / appropiate

  Yes

  No

  N/A

• Pipe storage and Conduit Carrier ladder rack secure.

  Yes

  No

  N/A

• Vehicle Doors operational

  Yes

  No

  N/A

• Cargo area (secure load)

  Yes

  No

  N/A

• Vehicle Registration Current

  Yes

  No

  N/A

• Exp Date

  Date

• Vehicle Serviced

  Yes

  No

  N/A

• Due Date

  Date

Vehicle Content

• Ball Pein Hammer

  Yes

  No

  N/A

• Danger Tags ( min 5)

  Yes

  No

  N/A

• Fiberglass extension ladders (check ladder for cracks and damage)

  Yes

  No

  N/A

• Fiberglass step ladder ( check ladder for cracks and damage)

  Yes

  No

  N/A

• First Aid Kit ( check contents for currency)

  Yes

  No

  N/A

• Ladder Levelers

  Yes

  No

  N/A

• Measuring Stick

  Yes

  No

  N/A

• Pole Bucket

  Yes

  No

  N/A

• Prepare to stop sign ( class1) ( Should be clean / free from damage)

  Yes

  No

  N/A

• Retro Reflective cones ( 26) (should be clean / free of damage)

  Yes

  No

  N/A

• MSQ900 Signal Meter ( including Calabrationdate) (Power on)

  Yes

  No

  N/A

• Calibration Date

  Date

• Spray Bottle

  Yes

  No

  N/A

• Stop Slow Bat ( Class 1)

  Yes

  No

  N/A

• Worker ahead sign ( Class 1)

  Yes

  No

  N/A

License Checks

• ACAM Licence

  Yes

  No

  N/A

• ACAMA License Exp Date

  Date

• Construction Induction Card ( White)

  Yes

  No

  N/A

• Exp Date

  Date

• Drivers License Valid

  Yes

  No

  N/A

• Drivers License Exp Date

  Date

• OHS Induction Accreditation and Optus Induction Card

  Yes

  No

  N/A

• Exp Date

  Date

• Power Awareness

  Yes

  No

  N/A

• Power Awareness Exp Date

  Date

• Working at Heights

  Yes

  No

  N/A

• Working at Heights Exp Date

  Date

• Traffic Control

  Yes

  No

  N/A

• Traffic control Exp date

  Date

• Action Item 1

• Person to Action 1

• Close out 1

• Close out Date 1

  Date

• Action Item 2

• Person to Action 2

• Close out 2

• Close out Date 2

  Date

• Action Item 3

• Person to Action 3

• Close out 3

• Close out Date 3

  Date

• Action Item 4

• Person to Action 4

• Close out 4

• Close out Date 4

  Date

• Action Item5

• Person to Action 5

• Close out 5

• Close out Date 5

  Date

• FST Signature

  Sign

• Date Completed

  Date

• FS Signature

  Sign

• Date Completed

  Date