WHS Site Inspection Form

• Document number

• Site being inspected

  Select
• Location
  Address

• Conducted on

  Date

• Person performing inspection

• Team Leader

• Team Members

• Job task being performed

JSA, SWMS, Plant Checks review

• Has a JSA been completed to manage the site-specific hazards?

  Yes

  No

  N/A

• Has the JSA been reviewed by the work crew preforming the works (signed onto)?

  Yes

  No

  N/A

• Have all hazards been identified & their risks managed in the JHA?

  Yes

  No

  N/A

• All workers including contractors have been inducted into the site?

  Yes

  No

  N/A

• Is a copy of the relevant SWMS available at the work & in date?

  Yes

  No

  N/A

• Has the SWMS been reviewed by the crew performing works (signed onto)?

  Yes

  No

  N/A

• Where required contractors have signed onto MCC SWMS & JHA?

  Yes

  No

  N/A

• Contractors have completed their JSA, SWMS?

  Yes

  No

  N/A

• Any further comments

Plant, Portable Equipment review

• Plant pre-starts have been completed?

  Yes

  No

  N/A

• Contractors have completed their plant pre-start checks?

  Yes

  No

  N/A

• Workers have appropriate licences & competences?

  Yes

  No

  N/A

• All electrical equipment have current test & tags?

  Yes

  No

  N/A

• Warning lights, audible warning devices are operating?

  Yes

  No

  N/A

• Are trainee operators maintaining logbooks?

  Yes

  No

  N/A

• WLL (working load limit) are displayed on all plant is legible?

  Yes

  No

  N/A

• All plant has a 'beware of overhead power electrical hazards' or 'lookup & live' stickers?

  Yes

  No

  N/A

• Chains are being used to secure plant to plant trailers?

  Yes

  No

  N/A

• Are plant load restraints fit for purpose?

  Yes

  No

  N/A

• Plant loaded on trailers have been suitably cleaned prior to being transported, i.e., tracks are not dirty, no loose rocks etc.?

  Yes

  No

  N/A

• Portable plant & equipment is in good order - guards are in place – no visible oil leaks etc.?

  Yes

  No

  N/A

• Plant & other equipment carried in utility trays, trailers are adequately restrained to prevent movement?

  Yes

  No

  N/A

• Has the JSA been reviewed the works (signed onto)?

  Yes

  No

  N/A

• Electrical leads are placed to avoid damage?<br>i.e., Not lying on ground etc.

  Yes

  No

  N/A

• Ladder are fit for purpose, setup correctly & industrial rated for correct weight of worker?

  Yes

  No

  N/A

• Are 3 points of contact is being maintained when working from a ladder?

  Yes

  No

  N/A

• Any further comments?

Traffic Control, Excavations, Site Establishment review

• Is appropriate TCP selected & implemented – signage is correct? (record TCP Number)

  Yes

  No

  N/A

• Placement of signage provides adequate advanced warning of hazards / requirements? (Side roads to be checked as well)

  Yes

  No

  N/A

• Are traffic controllers placed to ensure their safety?

  Yes

  No

  N/A

• After care signage is planned and available? (record AC TCP)

  Yes

  No

  N/A

• “Dial Before You Dig” has been obtained before commencing works?<br>(Record Sequence Number)

  Yes

  No

  N/A

• All identified underground assets have been identified and highlighted by a suitably qualified service locator?

  Yes

  No

  N/A

• Potholing has been used to confirm the location of all identified underground assets?

  Yes

  No

  N/A

• An accredited safety observer is available for all plant operating in and around overhead and underground electrical or other assets?

  Yes

  No

  N/A

• Where trenches are deeper than 1.5 metres are they benched, battered or shored?

  Yes

  No

  N/A

• Spoil is stockpiled greater than 1 metre from the edge & on the downslope of the excavation?

  Yes

  No

  N/A

• All excavations are adequately signposted?

  Yes

  No

  N/A

• Is there safe entry & exit points to the trench?

  Yes

  No

  N/A

• Excavations are adequately barricaded, protected when not occupied or being worked on?

  Yes

  No

  N/A

• Site housekeeping – general, amenities, facilities implemented & in good order?

  Yes

  No

  N/A

• Site protection & safe access / egress implemented?

  Yes

  No

  N/A

• Spoil, soil piles are being rehabilitation where they are onsite for long periods?

  Yes

  No

  N/A

• Appropriate erosion and sediment controls in place?

  Yes

  No

  N/A

• Pedestrian access around the work site is available and safe?

  Yes

  No

  N/A

• Any further comments

Confined Space Entry, Asbestos Removal review

• Is a confined space entry currently being performed on this site?

  Yes

  No

  N/A

• Has a confined space entry permit been completed?

  Yes

  No

  N/A

• Gas monitor has been bump tested and is in current calibration?

  Yes

  No

  N/A

• Atmosphere is being constantly monitored whilst confined space is occupied?

  Yes

  No

  N/A

• A dedicated Standby Person is available at all times whilst the space is occupied?

  Yes

  No

  N/A

• Workers within the confined space are wearing a safety harness and are attached to a retrieval device at all times?

  Yes

  No

  N/A

• Is asbestos removal occurring at this site?<br>(Record asbestos removal permit date)

  Yes

  No

  N/A

• Appropriate PPE for asbestos removal is being worn by all workers removing ACM?

  Yes

  No

  N/A

• ACM being removed is being kept moist at all times?

  Yes

  No

  N/A

• Not more than 10M2 is being removed from the site?

  Yes

  No

  N/A

• Workers removing ACM have been appropriately trained?

  Yes

  No

  N/A

• No more than 100kg of ACM is being transported at any single time?

  Yes

  No

  N/A

• ACM once removed is double wrapped in plastic and not allowed to dry out before being transported?

  Yes

  No

  N/A

• All slurry and broken pieces of ACM is being removed from excavations?

  Yes

  No

  N/A

• Any further comments

General Site Safety review

• If noisy plant or equipment operating is hearing protection in place?

  Yes

  No

  N/A

• Fuel containers (hydrocarbons) stored appropriately? (separate from other chemicals)

  Yes

  No

  N/A

• A dedicated refueling point has been establish with a spill kit available?

  Yes

  No

  N/A

• Safety Data Sheets available for all hazardous / dangerous chemicals?

  Yes

  No

  N/A

• Are there controls in place to prevent a worker falling from one level to another that is reasonably likely to cause an injury to that person (REG 78. 1 to 5)

  Yes

  No

  N/A

• Are workers advised of the risks of falls and the safe system of work required to prevent these fall when completing the site inductions?

  Yes

  No

  N/A

• Excavators / backhoes used for lifting / moving loads are fitted with burst protection?

  Yes

  No

  N/A

• Lifting slings, chains, straps appear to be in serviceable condition & in test date?

  Yes

  No

  N/A

• Fire extinguishers are readily available for hot work?

  Yes

  No

  N/A

• PPE is in good condition?<br>(Check hard hat expiry date)

  Yes

  No

  N/A

• Sun protection is implemented?

  Yes

  No

  N/A

• Excessive black exhaust smoke is not seen coming from plant?

  Yes

  No

  N/A

• Waste material has been removed from site / or appropriately stored prior to removal?

  Yes

  No

  N/A

• Observer is available for hot work?

  Yes

  No

  N/A

• Are work vehicles / plant not directly involved in work activities parked clear of public thoroughfares?

  Yes

  No

  N/A

• PPE applicable to work task and site requirements is being worn?

  Yes

  No

  N/A

• Are hand tools in good condition? (check some tools)

  Yes

  No

  N/A

• Site is adequately secured when unattended?

  Yes

  No

  N/A

• Communication to emergency services is available?

  Yes

  No

  N/A

• Are there adequate facilities for workers?<br>(Toilets, drinking water, shaded area for breaks)

  Yes

  No

  N/A

• Is the site being rehabilitated back to its original condition before work commenced?

  Yes

  No

  N/A

• Workers have adequate protection systems in place when they are working over or near water?

  Yes

  No

  N/A

• The risks of an object falling on a worker has been controlled

  Yes

  No

  N/A

• Any further comments

• Worksite is generally kept clean and tidy?

  Yes

  No

  N/A

Inspection review - sign-off

• Has Inspection Form been reviewed with Team Leader onsite?

  Yes

  No

  N/A

• Team Leader Signature

  Sign

• Send completed WHS Site Inspection to WHS Co-Ordinator and Relevant Works Manager