WorkSafe ACT

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Vehicle and driver information

• Name of Licensee

• Name of Vehicle Driver

• Name of Organisation

• Address of Organisation

• Evidence of Insurance of not less than $5 million, including third party property.

  Yes

  No

• Note: Provide copy of Insurance Document

Additional applicant information

• Contract arrangement

• Note: from whom/where are you collecting the Clinical waste from?

• Volume and type of waste being collected

• Applicants supervision for activities

• Previous Experience

Vehicle requirements

• Vehicle registration number

• Expiry date

• Vehicle make

• Vehicle model

• VIN

• Is the vehicle registered

  Yes

  No

• Emergency information

  Yes

  No

• A Dangerous Goods – Initial Emergency Response Guide; or Emergency Procedure Guide for the Dangerous Goods transported on the vehicle and the EPG in relation to vehicle fire.
  Note: (EPG’s are a guide outlining procedures to be taken in the event of an emergency involving the Dangerous Goods)

• EPG Holder

  Yes

  No

• Labelled with the words ‘emergency procedures guide’ or ‘emergency information’ in red letters at least 10mm high on a white background.
  Note: securely located on the inside of a door of the cabin, or in a conspicuous position adjacent to the door.
  (ADG 6 – Section 11.2.1 to 11.2.4)

• Placarding

• Class 6.1 Toxic

  Yes

  No

• Class 6.2 Infectious

  Yes

  No

• Cytotoxic

  Yes

  No

• Do the placards dimensions comply with 250mm?

  Yes

  No

  N/A

• Is the vehicle fitted with placards to the front and back

  Yes

  No

  N/A

First Aid and Emergency

• First Aid Kit

  Yes

  No

  N/A

• Eyewash kit of a least 250ml, filled and ready for use.

  Yes

  No

  N/A

• Note: also small portable 10 X 30ml ready for use.

  Yes

  No

  N/A

• Gas tight goggles or full face shield.

  Yes

  No

  N/A

• Chemically resistant gloves or gauntlet gloves.

  Yes

  No

  N/A

• Chemically resistant suit and coveralls.

  Yes

  No

  N/A

• Chemically resistant boots.

  Yes

  No

  N/A

• Electric torch and in working order.

  Yes

  No

  N/A

• 3 X double – sided reflector triangles that are clean and in good condition.

  Yes

  No

  N/A

• Fire extinguisher, 1 X 30B stored pressure type.

  Yes

  No

  N/A

• Inspected and tested

  Yes

  No

  N/A

• Tested on

  Yes

  No

  N/A

• Readily accessible

  Yes

  No

  N/A

• Mounted in a quick release bracket

  Yes

  No

  N/A

• Spare tyre.

  Yes

  No

  N/A

• Jack and wheel brace

  Yes

  No

  N/A

Additional Equipment Requirements

• Absorbents

  Yes

  No

  N/A

• Buckets

  Yes

  No

  N/A

• Water

  Yes

  No

  N/A

• Disinfectant

  Yes

  No

  N/A

• Mop with disposable head

  Yes

  No

  N/A

• Shovel

  Yes

  No

  N/A

• Spare disposable containers/plastic waste bags

  Yes

  No

  N/A

Carrying section of vehicle

• Lockable load compartment, separated from driver’s cabin by a solid sealed partition.

  Yes

  No

  N/A

• Are walls and floor smooth and seamless as possible for easy cleaning.

  Yes

  No

  N/A

• Is floor bunded and drained to a sump

  Yes

  No

  N/A

• Not required for transport of waste in sealed metal or plastic bins or trolleys approved by the Clinical Waste Controller (CWC).

  Yes

  No

  N/A

• Are the Seems Sealed

  Yes

  No

  N/A

• Are all door lockable on the vehicle

  Yes

  No

  N/A

• Is there an effective cleaning programme

  Yes

  No

  N/A

• Are all containers secured and transported in an upright position.

  Yes

  No

  N/A

• Is load area separated from driver, and ventilated

  Yes

  No

  N/A