Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Project Name:

  • Project Reference Number:

  • Company/Cotractor:

  • Date of Inspection

  • Time Inspection Started.

  • Time Inspection Completed.

  • Person completing Inspection:

HEALTH SAFETY AND ENVIRONMENT SYSTEMS

  • Sign In / Sign Out book ?

  • Injury report book / forms?

  • "If you are injured" poster?

  • Hazard reporting forms ?

  • Job Safety Analysis forms (each day) ?

  • Site Inductions for all who enter ?

  • Daily Tool Box Meeting minutes ?

  • Contractor Health & Safety Plan (copy) ?

  • Construction work = Red Card ( sight) ?

  • Environmental Management Plan (copy)

  • Environment included in site induction?

HOUSEKEEPING AND WASTE MANAGEMENT

  • Waste Management Plan?

  • Waste Storage and Disposal?

  • Recycling Practices?

  • Work areas free from rubbish ?

  • Areas free of slip and trip hazards ?

  • Penetrations and openings covered ?

  • Stock/ material, stored safely & secured ?

  • Prescribed Waste Management?

ELECTRICAL

  • Certificate of Electrical Safety on the wall in the amenities room ?

  • No broken plugs, sockets, switches ?

  • No frayed or defective leads ?

  • Power tools in good condition ?

  • Power tools and leads tagged ( 3 monthly) ?

  • No lead or cable trip hazards ?

  • Lead supported above ground ?

  • Lock out for unsafe equipment in place ?

SWITCHBOARDS - Amenities and Power Access

  • Circuit Breaker switches identified ?

  • Circuit Breaker covered and locked ?

  • Main Isolation identified and lockable ?

  • RCD ( safety switches ) installed ?

MOBILE PLANT AND EQUIPMENT

  • Daily safety inspections completed ?

  • Plant free from oil/fluid leaks?

  • Operators trained and licensed ?

  • Warning lights and alarms operational ?

  • Fire extinguishers installed ?

  • Design envelope displayed in the cabin ?

  • Lifting chains / slings maintained and marked with Safe Weight Limit ?

  • Lifting attachment points marked with SWL where used as crane ?

  • Doors of equipment closed ( where fitted ) ?

  • Seatbelt's being worn by operators ?

CHEMICALS

  • Register of all chemicals on site ?

  • Material Safety Data Sheets available ?

  • Chemical introduction forms completed ?

  • Containers labelled with contents ?

  • There is storage ventilation ?

  • HAZCHEM sign ( example petrol > 250L ) ?

  • Fuels/Chemicals correctly contained and/or bunded?

  • Refueling procedures in place including spill response?

  • Spill kits available?

HOT WORK SAFETY

  • Gas cylinders securely fixed ?

  • Flash back arresters fitted to hoses ?

  • Area well ventilated for fumes ?

  • Fire fighting equipment available ?

  • Hot work permits used ?

ASBESTOS REMOVAL

  • Removalist trained (sight) ?

  • AC Removal Plan (evidence) ?

  • Licensed Removal Operators ?

  • Neighboring Businesses informed ?

  • Disposal controls in place ?

  • Warning signs displayed ?

MECHANICAL EXCAVATIONS (trenches, shafts, pits greater than 1.5 meters deep)

  • Ground support in place ?

  • Worksafe notified (evidence) ?

  • Excavation is protected from public ?

  • Excavation supervisor on site ?

  • Edges battered, spoil 500mm from edge ?

  • Clear access around excavation ?

  • Ladder access and secured ?

  • Hard hats worn ?

  • "Dial before you Dig" current?

  • Services identified and located?

  • Access to existing services maintained?

  • Contact details for service providers available?

WORKING AT HEIGHT

  • Work platforms have secure handrails, guarding or fence panels ?

  • Fall protection when working at height ?

  • Ladders being used are industrial type ?

PERSONAL PROTECTIVE EQUIPMENT

  • PPE in good and clean condition ?

  • PPE provided and worn ?

  • PPE signage at entrance site ?

SITE ACCOMMODATION & FIRST AID

  • Toilet facilities provided ?

  • Toilets clean and tidy ?<br>

  • Sufficient paper and hand cleaner ?

  • Meal room or shaded area provided ?

  • Meal room clean and tidy ?

  • Cool drinking water available ?

  • First aid cabinet clean and Orderly?

  • First aider on site when working ?

  • Site drainage and plumbing is appropriate ( erosion control, sanitary facilities, etc.)

TRAFFIC CONTROL & PUBLIC PROTECTION

  • Barricades, fencing in place to restrict unauthorized access ?

  • Traffic management plan in place ?

  • Traffic control and signage in position ?

  • Footpaths clean of debris ?

  • Site access controlled ?

  • Road Authorities notified ?

  • Principal Contractor details at the entrance ?

CONFINED SPACES

  • Safety equipment in good condition ?<br>

  • CS Entry trained (evidence) ?

  • Entry Permits and Logs (evidence) ?

  • JSA completed (evidence) ?

EMERGENCIES & FIRE CONTROL

  • Extinguishers, correct type (water for combustibles, Dry Chemical for flammables and electricity) ?

  • Extinguisher tagged (6 months) ?

  • Emergency procedures displayed ?

  • Emergency phone numbers displayed ?

SCAFFOLDING

  • Load rating displayed ?

  • Is the scaffold stable ?

  • Scaffolding planks appropriate, no trip ?

  • Ladder access secured top and bottom ?

  • Ladder extends 900mm above platform ?

  • >2m guardrails, mistrials & toeboards ?

  • >4m competent erector ?

  • Handover certificate available ?

POWERLINES

  • Horizontally no closer than 4.6m ?

  • Vertically 5m from lines ?

FLORA AND FAUNA

  • Sensitive Flora and Fauna identified?

  • Flora and Fauna protection in place and maintained?

LAND CONTAMINATION

  • Plant and equipment cleaned prior to entry to site?

  • Appropriate hygiene controls for weed and soil pathogen control?

  • Weed management controls in place?

WATER QUALITY

  • Stockpiles away from waterways and drains?

  • Sedimentation controls in place?

  • Management of discharge of chlorinated water?

  • Management of discharge of groundwater/drainage water?

NOISE

  • Works within local bylaws relating to noise?

  • Plant fitted with noise suppression?

AIR QUALITY

  • Dust suppression in place ?

  • Odour controls in place ?

  • "burning off" in accordance with local bylaws?

CULTURAL HERITAGE

  • Is a CHMP in place for works?

  • Does Site induction include Cultural Heritage?

  • A copy of CHMP on site?

SIGNATURES

  • Project Superintendents Representative:

  • Wannon Water Project Manager

  • Contractor Representative

COMMENTS

  • Sketch Pad

TRIM INFORMATION

  • Select date

  • Folder Number:

  • TRIM Number:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.