WHSEQ Audit Tool - ICP

• Site conducted

  Select

• Audit Title

• Client / SiteLocation

• Conducted on

  Date
• Location
  Address

• Prepared by

• Personnel

Scope of Works

• Current scope of works being performed:

• ICP Project Number:

• Customer Reference Number:

Operational Control

• Has a documented Risk Assessment been conducted for the works undertaken?

  Safe

  At Risk

  N/A

• Have all relevant team members had input into the risk assessment process?

  Safe

  At Risk

  N/A

• Capture image of the Risk Assessment including sign on evidence

  Media

• What are the significant hazards that have been identified with the works?

  Select Electrical Mechanical Acoustic Physical Potential Ergonomic Fire / Explosion Environmental Biological Chemical Psychological Radiation

  • Electrical
  • Mechanical
  • Acoustic
  • Physical
  • Potential
  • Ergonomic
  • Fire / Explosion
  • Environmental
  • Biological
  • Chemical
  • Psychological
  • Radiation

• Detail any other additional hazards identified:

• Has the Risk Assessment successfully identified all of the significant hazards associated with the works?

  Safe

  At Risk

  N/A

• Identify the required operational controls:

  Select Arc Rated Protective Equipment Communication System Competent Plant Operator Confined Space Classification Correct Manual Handling Techniques Cut Resistant Gloves Electrically Insulated Gloves Electrical Testing Equipment Exclusion Zone Face Shield Fall Arrest System Falling Object Prevention Fall Prevention Fall Restraint Technique Fatigue Management - 10 hour D2D Fire Extinguisher First Aid Kit Hard Hat Hazardous Fauna Identification Hazardous Flora Identification Hazardous Substances - PPE Hazardous Substances - Safety Data Sheet Hazardous Substances Spill Control Hearing Protection Housekeeping Hydration Lifting Plan Load Assessment Lock Out Tag Out Long Sleeves & Long Pants LV Rescue Kit Mechanical Lifting Aids Path of Evacuation Physical Barriers Pre Start Check Plant & Equipment Prevent Unauthorised Personnel from Entering Work Area Radiation Sources Rotation of Work Activities Safety Glasses AS/NZS 1337 Compliant Safety Observer Site Specific Induction Suitable Unloading Area for Plant & Materials Sun Protection - Shade Sun Protection - Wide Brim Sunscreen Temporary Lighting Traffic Control Verify Location of Underground Essential Services

  • Arc Rated Protective Equipment
  • Communication System
  • Competent Plant Operator
  • Confined Space Classification
  • Correct Manual Handling Techniques
  • Cut Resistant Gloves
  • Electrically Insulated Gloves
  • Electrical Testing Equipment
  • Exclusion Zone
  • Face Shield
  • Fall Arrest System
  • Falling Object Prevention
  • Fall Prevention
  • Fall Restraint Technique
  • Fatigue Management - 10 hour D2D
  • Fire Extinguisher
  • First Aid Kit
  • Hard Hat
  • Hazardous Fauna Identification
  • Hazardous Flora Identification
  • Hazardous Substances - PPE
  • Hazardous Substances - Safety Data Sheet
  • Hazardous Substances Spill Control
  • Hearing Protection
  • Housekeeping
  • Hydration
  • Lifting Plan
  • Load Assessment
  • Lock Out Tag Out
  • Long Sleeves & Long Pants
  • LV Rescue Kit
  • Mechanical Lifting Aids
  • Path of Evacuation
  • Physical Barriers
  • Pre Start Check Plant & Equipment
  • Prevent Unauthorised Personnel from Entering Work Area
  • Radiation Sources
  • Rotation of Work Activities
  • Safety Glasses AS/NZS 1337 Compliant
  • Safety Observer
  • Site Specific Induction
  • Suitable Unloading Area for Plant & Materials
  • Sun Protection - Shade
  • Sun Protection - Wide Brim
  • Sunscreen
  • Temporary Lighting
  • Traffic Control
  • Verify Location of Underground Essential Services

• Detail any other operational controls required to perform the task safely:

• Can the auditee demonstrate effective implementation the the operational controls?

  Safe

  At Risk

  N/A

• Have inherent and residual risk scores been calculated correctly?

  Safe

  At Risk

  N/A

Site Specific WHSEQ Plan

• Is the value of the works in excess of $250,000 (Section 292 Work Health Regulation 2011)

  Yes

  No

  N/A

• Is Yes, is a Site Specific WHSEQ Plan available for inspection?

  Safe

  At Risk

  N/A

• Have all Team Members onsite signed on the Site Specific WHSEQ Plan?

  Safe

  At Risk

  N/A

• Capture image of the Site Specific WHSEQ Plan sign on page

  Media

• Have all Team Members completed all required inductions?

  Safe

  At Risk

  N/A

High Risk Construction Activities

• Are any of the following High Risk Construction Activities being undertaken?

  Select On or Near Energised Electrical Installations <500mm Movement of Plant Risk of Fall >2m Disturbing Asbestos Confined Space Excavation Work >1.5m Depth Hazardous Atmospheres On or Near Roads <3m On or Near Water Extreme Temperatures

  • On or Near Energised Electrical Installations <500mm
  • Movement of Plant
  • Risk of Fall >2m
  • Disturbing Asbestos
  • Confined Space
  • Excavation Work >1.5m Depth
  • Hazardous Atmospheres
  • On or Near Roads <3m
  • On or Near Water
  • Extreme Temperatures

• Are Safe Work Method Statements available for all High Risk Construction Activities?

  Safe

  At Risk

  N/A

• Have all SWMS been authorised by the ICP Site Supervisor?

  Safe

  At Risk

  N/A

• Capture image of SWMS Authorisation

  Media

• Have all Team Members signed onto the SWMS?

  Safe

  At Risk

  N/A

• Capture image of Team Member SWMS sign on page

  Media

Electrical Safety

• Is suitably calibrated electrical testing equipment available for use?

  Safe

  At Risk

  N/A

• Capture image of calibration evidence

  Media

• Is a fully stocked LV Rescue Kit available for use?

  Safe

  At Risk

  N/A

• Nominate the following items available in the LV Rescue Kit:

  Select LV Rescue Bag Electrically Insulated Gloves Cotton Inners Leather Outers w/ Wrist Strap Fire Blanket Trauma Dressing Torch w/ Batteries Insulated Crook Isolate Here Tag Insulated LV Mat Arc Rated Face Shield

  • LV Rescue Bag
  • Electrically Insulated Gloves
  • Cotton Inners
  • Leather Outers w/ Wrist Strap
  • Fire Blanket
  • Trauma Dressing
  • Torch w/ Batteries
  • Insulated Crook
  • Isolate Here Tag
  • Insulated LV Mat
  • Arc Rated Face Shield

• Have any isolations been performed to complete the works

  Yes

  No

  N/A

• Does the isolation contain the following required elements:

  Select Personal Danger Tag Personal Lock Lock Out Device

  • Personal Danger Tag
  • Personal Lock
  • Lock Out Device

• Check 3 Electrical Cords for evidence of Testing & Tagging

  Safe

  At Risk

  N/A

• Capture image of completed Test Tags

  Media

• Have all required Electrical Tests been performed on the electrical installation / equipment?

  Safe

  At Risk

  N/A

• Are test records available for inspection as evidence of completion of required testing?

  Safe

  At Risk

  N/A

• Has a completed Certificate of Testing & Compliance been issued to the customer upon completion of works?<br>(verification that the works are electrically safe)<br>

  Safe

  At Risk

  N/A

Working at Heights Equipment

• Is there evidence of inspection available for all working at height equipment? <br>(6 months re-test frequency)

  Safe

  At Risk

  N/A

• Is unsuitable equipment clearly tagged "Out of Service"?

  Safe

  At Risk

  N/A

Hazardous Chemicals

• Are any of the following Hazardous Chemicals being used onsite:

  Select Silicone Butane Epoxy Resin Unleaded Petrol Conduit Glue CRC 2.26 Spray Gal Aerosol Paint Blaze Brake Sikaflex Cable Lubricant Cold Gal

  • Silicone
  • Butane
  • Epoxy Resin
  • Unleaded Petrol
  • Conduit Glue
  • CRC 2.26
  • Spray Gal
  • Aerosol Paint
  • Blaze Brake
  • Sikaflex
  • Cable Lubricant
  • Cold Gal

• Additional Hazardous Chemicals:

• Is a SDS available for inspection for all hazardous chemicals onsite?<br>(reviewed within 5 years)

  Safe

  At Risk

  N/A

• Has a risk assessment been conducted for the use of the Hazardous Chemicals?

  Safe

  At Risk

  N/A

• Are all Hazardous Chemicals stored appropriately?

  Safe

  At Risk

  N/A

• Are controls in place to manage the level of exposure to Respirable Crystalline Silica?

  Safe

  At Risk

  N/A

Incident Reporting

• Have there been any Near Misses onsite?

  Safe

  At Risk

  N/A

• Have there been any Incidents onsite?

  Safe

  At Risk

  N/A

• Have Incident Reports been completed where required?

  Safe

  At Risk

  N/A

• Detail any corrective actions required to be undertaken in response to any incidents:

• Is there evidence of the corrective actions being undertaken?

  Safe

  At Risk

  N/A

Environmental Impact

• Is storm water contamination being effectively managed?

  Safe

  At Risk

  N/A

• Has all recyclable waste been segregated appropriately?

  Safe

  At Risk

  N/A

• Are all noise generation restrictions being enforced correctly?

  Safe

  At Risk

  N/A

Public Protection

• Is access to the site effectively controlled?

  Safe

  At Risk

  N/A

• Is suitable barricading, signage and hoarding in place to deliniate work area?

  Safe

  At Risk

  N/A

• Is the lighting in the work area adequate?

  Safe

  At Risk

  N/A

• Are designated walkways free of obstruction?

  Safe

  At Risk

  N/A

Emergency Preparedness

• Is there a first aid kit located as close as practicable to the work area?

  Safe

  At Risk

  N/A

• Are all the items in the first aid kit in date?

  Safe

  At Risk

  N/A

• Capture image of first aid kit expiration date:

  Media

• Name of the Qualified First Aider onsite:

• What is the location of the emergency evacuation point:

• Do all personnel know the location of the emergency evacuation point?

  Safe

  At Risk

  N/A

Personal Protective Equipment

• Nominate items of PPE available:

  Select Safety Glasses Clear Safety Glasses Tinted Cut Resistant Gloves EN 388 4543 Glove Clip Safety Boots High Visibility Shirt Hard Hat Hearing Protection Leather Riggers Gloves First Aid Kit Wide Brim Hat Wide Brim for Hard Hat Sunscreen Face Shield P2 Respirator Coveralls Lock Out Tag Out Kit Photo ID Danger Tag

  • Safety Glasses Clear
  • Safety Glasses Tinted
  • Cut Resistant Gloves EN 388 4543
  • Glove Clip
  • Safety Boots
  • High Visibility Shirt
  • Hard Hat
  • Hearing Protection
  • Leather Riggers Gloves
  • First Aid Kit
  • Wide Brim Hat
  • Wide Brim for Hard Hat
  • Sunscreen
  • Face Shield
  • P2 Respirator
  • Coveralls
  • Lock Out Tag Out Kit
  • Photo ID Danger Tag

• Do all Team Members have the required mandatory PPE items?

  Safe

  At Risk

  N/A

• Is the PPE fit for purpose and in good condition?

  Safe

  At Risk

  N/A

• Are any other addtional PPE items required?

  Safe

  At Risk

  N/A

• I agree that the findings raised in this report are factual, accurate, fair & reasonable:

  Sign

• Auditor

  Sign