VICSES - PPC & E Spot Check

• Inspection Date:

  Date

• Reason for Audit

  Select

• Auditor:

  Select

• By signing this audit sheet, I acknowledge I am required to carry out the audit to the best of my ability as well as making right any minor issues observed. Any major issues that are unable to be rectified will be immediately reported to the Deputy Controller Operations:

• Signature:

  Sign

Mandatory

• Helmet

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Helmet Lamp (or equivalent)

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Safety Glasses

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Ear plugs (or equivalent)

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• P2 Mask

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Overalls

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Name Tag

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Gloves (riggers gloves/road rescue gloves)

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Pager (battery fully charged)

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Note pad and pen (or equivalent)

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Nitrile gloves (or equivalent)

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Boots

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• UDO phone charge level

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Pocket knife

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Whistle

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Field Operations Guide

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Wet weather jacket (and pants - optional)

  Meets Standard

  Minor Issue

  Needs Repair/Missing

  Not Applicable

• Comments

• I hereby certify that all information is accurate and that an actual inspection was conducted.

• Select

• By signing this audit sheet, I acknowledge I am required to carry out the audit to the best of my ability as well as making right any minor issues observed. Any major issues that are unable to be rectified will be immediately reported to the Deputy Controller Operations:

• Signature:

  Sign