Title Page

  • Document No.

  • Subtitle

  • Conducted on

  • Client :

  • Prepared by

  • Location
  • Personnel Attending

  • Subcontractor Company

  • Activity

Site Entry Box

  • Are the site contacts displayed and up to date? Is there specific information to relevant site rules , and PPE?

  • Is there a copy of the site prestart in the box? Have all workers signed onto daily prestart (view document and ascertain signatures)<br><br>

  • Are all the site hazards listed?

  • Is there a haul road management plan as to where plant is operating and plant movement rules that apply to haul roads?

  • Is there an emergency plan with information as to assembly area?

Site portacom facilities

  • Are there adequate facilities for staff?<br>Lunchroom, toilet, hand washing all in clean condition?

  • Is there a notice board that is currently updated with safety and site information.<br>Are all contacts displayed?

  • Are all the site hazards listed?

  • Is there an emergency plan with information as to assembly area?

  • Is there compliant emergency equipment available I.e. First aid kits, fire extinguishers.<br>Working emergency horn.

  • Is there information displayed as to general site hazards and risks?

  • Is the housekeeping up to an acceptable standard?

  • Is the lock out tag board current?

  • Hydration-is there quality drinking water available?<br>In summer is there an adequate supply of ice to cool water containers?

Risk Management

Risk Management

  • Is the current Work Instruction and Operational Risk Register available at the location of works and and all workers have signed on they clearly understand the tasks and risk?

  • Have all workers in the crew signed on to the site specific pre-start and have a clear understanding of the tasks at hand and risks associated?

  • Can workers demonstrate the site specific controls for the hazards/risks associated with the activity? Give examples and evidence

  • Can workers explain and demonstrate their understanding of the "Golden Rules" applicable to their task at the time of this visit and applying the rules e.g. Operating plant mandatory requirements

  • Up to date, valid & coloured service plans available on site including asbuilts and asset owners?

  • Is there a current an up to date Traffic Management Plan in place and a qualified STMS on site where required?

  • Are the relevant Permits available for critical activities and controls being followed?

  • Structures: are all safety handrails/work platforms displaying a current scarf tag?

  • Are all excavations being managed (trench shields, battered back, benched holes covered)

General Site Observations

General Site Observations

  • Are amenities clean and tidy?

  • Are personnel undertaking good ergonomic practices; not over stretching or twisting body

  • Personnel wearing the minimum personal protective equipment/clothing e.g. Hard hat;safety lace up boots:safety eyewear;long pants and long sleeve shirts, clean and zipped up orange hi-vis vest (unless STMS) and carrying gloves for manual activity tasks

  • Additional PPE available for specialised activities e.g. Double eye protection for cutting or grinding, chaps etc.

  • Are tools and equipment in good condition, no obvious defects (if not tag out and remove from site immediately?)

  • Are all electrical tools/equipment, leads, RCD devices being used currently tested and tagged by a competent person?

  • Are all leads off the ground and not causing a potential trip hazard?

  • Is the lifting chains/strops D shackles and equipment displaying a current test/tag?

  • Are harnesses/lanyards tested and tagged, showing no signs of deterioration and stored safely when not in use?

  • Housekeeping up to standards, no visible trip hazards, facilities clean and tidy, rubbish bins provided and not overflowing?

  • Are compliant emergency equipment available and on site e.g. First aid kits/fire extinguishers

  • Is the worker displaying an induction sticker on helmet? ( Confirm name and number)<br>Has the worker produced CONSTRUCTSAFE card.

  • Are haul roads being managed appropriately with watering so risks are minimised?

  • Are there any activities being undertaken that require checklists/permits? Is there evidence that these have been signed by foreman and operators?

  • Are site speed limits being adhered to ( use camera for checks)

Plant/Equipment/Vehicles

Plant/Equipment/Vehicles

  • Do operators have valid licenses, e.g. Full drivers licence, WTR endorsed? Photo required.

  • Have operators completed a daily plant pre-checklist prior to operating the plant/equipment?

  • Have you observed operators, drivers of light vehicles and passengers wearing seatbelts in moving vehicles?

  • Has the plant been Project inducted and Risk Assessed and displaying an<br>induction sticker?

  • Is there current 'Certified Safe' sticker displayed on the cab window?

  • Are vehicles parked safely e.g reverse parking where practicable? Parked against bunds or in V drains if not chocks in place.

  • Are exclusion zones set up where practicable using flags cones hit sticks and spotters standing in a safe place where required?

  • Are seat belts being worn in moving plant.

  • Is plant using orange flashing lights?

Environment

Environment

  • Are erosion and Sediment controls in place and effective?

  • Spill kits available?<br>Are they stocked?<br>Are there any signs of leaks or spills

  • Is dust and noise and waste being managed?

  • Are hazardous substances stored safely in bunded trays and containers labelled correctly?

  • Are the Safety Data Sheets available and current (within 5 years) and are crews aware of the control measures?

  • Are sediment ponds/exavations retaining water visible to the public fenced and signage displayed?

  • Are consents in place and being complied with.

  • Are environmental hazards and controls specified on hazard ID?

  • Trees and waterways check that runoff from site doesn't enter waterways. Trees not to be impacted without correct authorisation.

  • Are all activities involving concrete,lime, or cement being managed to prevent runoff or pollution?

  • Is weather being monitored for any risky activities?

Critical Risk Non-Compliance

If any of the following safety critical areas are not compliant then work must stop until the issue is resolved. Please provide non-compliance brief description and how you mitigated the risk to prevent recurrence.

  • Permits not in place e.g Working at Heights, B4UDig, Confined Spaces, Hot Works etc.

  • Add media

  • Work Training Competencies - If any certificates are out of date or crew are undertaking work for which they hold no valid training qualification

  • Add media

  • Traffic Management Plan not being followed / members of the public safety at risk

  • Add media

  • Breach of Work Instructions/Golden Rules (not following procedures)

  • Add media

  • Unsafe behaviour/act/conditions e.g. Horseplay, operating faulty machinery, disobeying site rules

Action/Recommendations

Any other Actions/Recommendations

Positive Behaviours Identified

Sign Off

  • Site Representative Agreed Actions

  • Add signature

  • Add signature

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