Western Land Services-DAILY WORKS REPORT (V1)

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Work order number

• Permit number

• Site location
  Address

• Customer

• Date and time

  Date

• Site Name

Risk Assessment

• Traffic management

  Select work signs erected at start and finish of job site traffic management contractor engaged closed site gates are locked to prevent public access barrier cones erected spotter required

  • work signs erected at start and finish of job site
  • traffic management contractor engaged
  • closed site gates are locked to prevent public access
  • barrier cones erected
  • spotter required

• Designated Assembly Area in case of emergency

• Services and Utilities/Overhead or Underground

  Select no services present services present but will not be impacted spotter engaged DBYD information on site

  • no services present
  • services present but will not be impacted
  • spotter engaged
  • DBYD information on site

• Ground and Terrain conditions

  Select flat and clear flat and rocky hilly and rocky long grass PPE-Gumboots, Lace up boots pre start inspection done deep water near work area waterway in works area

  • flat and clear
  • flat and rocky
  • hilly and rocky
  • long grass
  • PPE-Gumboots, Lace up boots
  • pre start inspection done
  • deep water near work area
  • waterway in works area

• Flora and Fauna protection

  Select operators skilled in NRM Pre-Start site inspection known GSM habitat area endangered herb species in works arae

  • operators skilled in NRM
  • Pre-Start site inspection
  • known GSM habitat area
  • endangered herb species in works arae

• Noise and Dust

  Select pipe hearing protection pipe dust mask ppe safety glasses

  • pipe hearing protection
  • pipe dust mask
  • ppe safety glasses

• Spills and Leaks

  Select spill kit with crew plant pre start done regular maintenance done

  • spill kit with crew
  • plant pre start done
  • regular maintenance done

• Exposure

  Select PPE-Hearing protection PPE-Safety Glasses PPE-Respirator/Dust mask L/S hi-vis shirts long trousers sunscreen gloves wide brimmed hat

  • PPE-Hearing protection
  • PPE-Safety Glasses
  • PPE-Respirator/Dust mask
  • L/S hi-vis shirts
  • long trousers
  • sunscreen
  • gloves
  • wide brimmed hat

• Manual Handling

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Mechanical Hazards

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Other Hazards (please document)

Daily works report and observations

Herbicide Used

• List

  Select kenock glyphosate garlon grazon simazine fusilade tordon

  • kenock
  • glyphosate
  • garlon
  • grazon
  • simazine
  • fusilade
  • tordon

Equipment Used

• Equipment used

  Select quick spray unit ATV Boomspray Birchmeir backpack Tractor/Landcruiser 10 m Boomspray Tractor and Slasher Tractor and plough Kubota excavator Caterpillar Skidsteer Truck and 3000L water tank UD tipper Brushcutter Chainsaw Kubota deck mower Kubota zero turn Trailer Honda picket driver Planting auger Seed harvester

  • quick spray unit
  • ATV Boomspray
  • Birchmeir backpack
  • Tractor/Landcruiser 10 m Boomspray
  • Tractor and Slasher
  • Tractor and plough
  • Kubota excavator
  • Caterpillar Skidsteer
  • Truck and 3000L water tank
  • UD tipper
  • Brushcutter
  • Chainsaw
  • Kubota deck mower
  • Kubota zero turn
  • Trailer
  • Honda picket driver
  • Planting auger
  • Seed harvester

Supervisors and field crew

• Start time

  Date

• Supervisors name

  Sign

• Bush crew member 1

  Sign

• Bush crew member 2

  Sign

• Bush crew member 3

  Sign

• Finish time

  Date

• This is a true and accurate record.

  Sign

• Date and time

  Date