Title Page
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Site conducted
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Conducted on
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Prepared by
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Name & Signature
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Location
Inspection Details
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Are there Additional inspectors (eg contractors, senior managers, etc)
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Names
Health and Safety Systems
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WHS policy displayed
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Induction records
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Rehabilitation policy available
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Emergency procedures in place
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Documented safe work procedures
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SDS available
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Management safety representative appointed
Housekeeping
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Work areas free from rubbish and obstructions
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Surfaces safe and suitable
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Free from slip and trip hazards
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Is Mobile Plant and Equipment Applicable to this Inspection?
Mobile Plant and Equipment
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Plant and equipment in good condition
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Defect reporting and rectification system used
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Operators trained and licensed
Road Maintenance
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Warning and instructions displayed
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Warning lights operational
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Reversing alarm operational
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Satisfactory operating practices
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Fire extinguisher
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Tyres satisfactory
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SWL of lifting or carrying equipment displayed
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Certificates of competency sighted
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Trainee log books in use
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Plant keys and unattended plant kept secure
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Is PPE and Safety Clothing Applicable to this Inspection?
Personal Protection
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PPE being worn by employees
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Employees provided with PPE
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Regular maintenance checks performed on PPE
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Employees trained in the use of PPE
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Sun cream and sunglasses provided
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Correct signage at access points
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Hard hat areas correctly signposted
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Hard hats available to visitors on site
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Is Chain of Responsibility applicable to this inspection?
Chain of Responsibility
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Container weight declaration carried by heavy vehicle driver
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Onboard operating scales fitted
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National Heavy Vehicle Work diaries in use
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Loads restrained with rated tie downs / cargo nets / tarpaulins
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Is Hazardous Substances Applicable to this Inspection?
Page 2
Safety Clothing
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Safety footwear appropriate to the job is worn
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High visibility clothing is worn
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Clothing is in good condition
Manual Handling
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Mechanical aids provided and used
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Safe work procedures in place
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Manual handling risk assessment performed
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Manual handling controls implemented
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Is Traffic Control Applicable to this Inspection?
Traffic Control
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Appropriate traffic control plan available
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The plan is correctly implemented
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All side road access to worksite controlled
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Signage and devices erected according to the traffic control plan
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Traffic controllers trained and their tickets sighted
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High visibility clothing is worn
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Daily records of sign arrangements kept
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Is First Aid Applicable to this Inspection?
First aid
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Cabinets and contents clean and orderly
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Stocks meet requirements
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First aiders names displayed
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First aiders location and phone numbers
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Qualified first aider(s)
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Record of treatment and of supplies dispensed
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Defibrillator
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AED Status – check the indicator is flashing green (Daily)
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Verify monitor display is functional
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Check Unit and accessories for damage, dirt or contamination (Monthly)
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Battery pack and pads expiry date (Monthly)
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Is Public Protection Applicable to this Inspection?
Public Protection
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Appropriate barricades, fencing, hoarding, gantry secure and in place
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Footpaths clean and free from debris
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Suitable lighting for public access
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Site access controlled
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Traffic control procedures in place
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Dust and noise controls in place
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Public complaints actioned
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Signage in place
Fire control
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Extinguishers in place
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Fire fighting equipment serviced/tagged
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Appropriate sign-posting of extinguishers
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Extinguishers appropriate to hazard
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Alarm/communication system adequate
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Smoking, naked flame restrictions observed
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Flammable storage procedures
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Emergency personnel identified and trained
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Emergency procedures documented and issued
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Emergency telephone numbers displayed
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Trial evacuations conducted
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Personnel trained in use of fire fighting equipment
