Work Site Review Form/Checklist PFM

• Project:

• Location
  Address

• Inspection Date:

  Date

• Inspected By:

• Workers/subcontractors Inspected:

• Task being Carried out

• Task Job Number/Order Number

Section 1.0 Paperwork

• Are all drivers licences, trade qualification / tickets, and Inductions current and carried by the crew members?

  Yes

  No

  N/A
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• 1.2 Are Take 5 Pads available on site and are they being used?

  Yes

  No

  N/A
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• 1.3 Are all vehicles and equipment being used on roads registered?

  Yes

  No

  N/A
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• 1.4 Is the Job Control Form on site, does it contain the correct information, ie. clear instructions, time limits or restrictions, purchase order number?

  Yes

  No

  N/A
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• 1.5 Have the vehicle / Equipment log books been completed correctly with any faults recorded and notified?

  Yes

  No

  N/A
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• 1.6 Has the JSA / SWMS been completed correctly and identified all hazards and lists appropriate controls, and all crew members onsite have signed the documents?

  Yes

  No

  N/A
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Section 2.0: Vehicles / Equipment / Resources

• 2.1 Are all vehicles / equipment in a servicable damage free condition?

  Yes

  No

  N/A
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• 2.2 Are all guards/ safety equipment in place and operating correctly?

  Yes

  No

  N/A
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• 2.3 Are ladders being used on the task and are they servicable, being used correctly and restrained properly?

  Yes

  No

  N/A
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• 2.4 Are all electrical equipment and tools being used correctly tagged and within calibration dates?

  Yes

  No

  N/A
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• 2.5 Is all load restraint / lifting gear in good condition, tagged correctly and within calibration / check dates?

  Yes

  No

  N/A
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• 2.6 Is any vehicle or equipment being used overloaded or being used outside manufacturers guidelines?

  Yes

  No

  N/A
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• 2.7 Are all flamible goods and chemicals stored appropriately, are all containers correctly labeled?

  Yes

  No

  N/A
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• 2.8 Have any vehicles or equipment been left running unnecessarily?

  Yes

  No

  N/A
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• 2.9 Has any water use been minimised?

  Yes

  No

  N/A
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• 2.10 Have all consumables been used appropriately, ie. not wasted or over used?

  Yes

  No

  N/A
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• 2.11 Has any water run off been controlled, ie. silt traps in place?

  Yes

  No

  N/A
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• 2.12 Are there spill / clean up kits available, and are they correctly stocked?

  Yes

  No

  N/A
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Section 3.0: Waste Removal

• 3.1 Has all rubbish been bagged and disposed of properly?

  Yes

  No

  N/A
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• 3.2 Has all Prescribed / Hazardous waste been removed as per MSDS requirements?

  Yes

  No

  N/A
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Section 4.0: Site Defined/ Controlled

• 4.1 Has the site been defined by barriers/cones etc.?

  Yes

  No

  N/A
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• 4.2 Has Pedestrian Safety/Access been considered, and are the appropriate controls in place?

  Yes

  No

  N/A
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• 4.3 Has Traffic Management been appropriately assessed and controlled?

  Yes

  No

  N/A
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Section 5.0: PPE and Uniform

• 5.1 Are the correct uniforms being worn by all crew members ie. high vis vests, long long shirt and trousersetc.?

  Yes

  No

  N/A
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• 5.2 Is all of the correct PPE being worn for the task being arried out, ie. gloves, safety glasses, respiratory masks etc. and is it being worn correctly and the correct size?

  Yes

  No

  N/A
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• 5.3 Is all PPE in good condition, ie. still providing the designed protection not worn out?

  Yes

  No

  N/A
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• 5.4 Are safety harnesses being used for the task, and is it tagged and still in a servicable condition and within calibration dates?

  Yes

  No

  N/A
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• 5.5 Does the task involve CSE, if so are all harnesses, ropes rescue equipment servicable, tagged and within calibration dates?

  Yes

  No

  N/A
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Section 6.0: OHS considerations

• 6.1 Is there a firs aid kit available?

  Yes

  No

  N/A
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• 6.2 Is the first aid kit appropriately stocked, and all products within service/disposal dates?

  Yes

  No

  N/A
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• 6.3 Is there a fire extinguisher available on site?

  Yes

  No

  N/A
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• 6.4 Is the fire extinguisher the correct type to use for the potential fire hazards, is it in good conditio and within the service dates?

  Yes

  No

  N/A
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• 6.5 Are correct Manual Handling Techniques being used for all manual handling during the task?

  Yes

  No

  N/A
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• 6.6 Where necessary is Team Lifting being used, ie. awkward lifts or for weights over 20kg.?

  Yes

  No

  N/A
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• 6.7 Does the task involve "Working at Heights"? If so then are the appropriate controls in place, is all access controlled? Note, do not just consider platforms, ladders, working on a roof, consider excavations and equipment being worked on or used for the task.

  Yes

  No

  N/A
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• 6.8 If ladders are used are they servicable, been placed and used correctly, and secured to prevent movement?

  Yes

  No

  N/A
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• 6.9 Has emergency response been considered for unexpected situations and events, ie. nearest safe exit or route to use, emergency contacts, nearest medical facility?

  Yes

  No

  N/A
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• 6.10 Are proper hygiene practices being followed?

  Yes

  No

  N/A
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Section 7.0: Customer/Management Considerations

• 7.1 Has the customer been made aware of the task being carried out, ie. notified on site, expected duration of the works, any restrictions to be placed due to the task?

  Yes

  No

  N/A
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• 7.2 Have any disruptions to customers or the public been minimised?

  Yes

  No

  N/A
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• 7.3 Is the personal appearance of the crew, vehicles and equpment appropriate and within guidelines?

  Yes

  No

  N/A
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• 7.4 Is the crew conduct on site appropriate, ie. no loud music, smoking, bad language etc.?

  Yes

  No

  N/A
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Section 8.0: Task Specific Considerations

• 8.1 Crew understands all requirements and processes to ensure that all targets are achieved or exceeded?

  Yes

  No

  N/A
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• 8.2 The task is being managed in a proper and efficient sequence?

  Yes

  No

  N/A
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• 8.3 The crew has the correct skills, attitude and work practices to complete the task?

  Yes

  No

  N/A
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Section 9.0 Opportunities for Improvement

• Are there any Opportunities for Improvement identified in the audit?

  Yes

  No

  N/A
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• Enter the details of the identified opportunities.

Section 10:Signatures and sign off.

• Signature of Auditor/Supervisor/Manager

  Sign

• Signature of Additional Auditor / Supervisor / Manager

  Sign

• Signature of Crew Member 1

  Sign

• Signature of Crew Member 2

  Sign

• Signature of Crew Member 3

  Sign