WRWP (PFM) Field Audit Report & Checklist

• WRWP (PFM) Field Audit Report & Checklist

• Document No.

• Permit Number

• Conducted on

  Date

• Prepared by

• Location : 1 Wiiliam Thwaite Drive Cocoroc 3030
  Address

• Personnel

• Select date

  Date

• List the names of the crew/s?

  Yes

  No

  N/A

• Select the crew/s from drop down list

  Select Underground Logistics Other Tox Free Rangedale

  • Underground Logistics
  • Other
  • Tox Free
  • Rangedale

• Enter the task being carried out

  Yes

  No

  N/A

OHS Considerations

• Has the JSA been completed correctly with all risks identified? Has the JSA been signed by all personnel on site?

  Yes

  No

  N/A

• Are all personnel on site wearing or carrying their Identification Cards?

  Yes

  No

  N/A

• Is the proper PPE being worn? For example, long long uniform, hard hats, vest etc.

  Safe

  At Risk

  N/A

• Is the PPE in good condition and being worn correctly?

  Safe

  At Risk

  N/A

• Is there a First Aid Kit available and is it stocked appropriately for the activity being undertaken?

  Safe

  At Risk

  N/A

• Are all hazardous substances correctly labelled?

  Safe

  At Risk

  N/A

• Are all activities being conducted within written procedures?

  Safe

  At Risk

  N/A

• Are correct manual handling techniques being used by all personnel?

  Safe

  At Risk

  N/A

• Have all other services in the vicinity of the Site been identified and located?

  Yes

  No

  N/A

Traffic & Pedestrian Management

• Has the Traffic Management Assessment been completed? If so, has the appropriate Traffic Management Plan been implemented?

  Yes

  No

  N/A

• Is there appropriate Pedestrian / Traffic protection?

  Safe

  At Risk

  N/A

• Has the worksite been taped off to prevent unauthorized entry?

  Safe

  At Risk

  N/A

• Is there Para Webbing available for use, if required, to restrict entry to the area?

  Yes

  No

  N/A

• Are all signs and equipment being used in required condition?

  Yes

  No

  N/A

Confined Space Entry

• Is this activity involving Confined Space Entry?

  Yes

  No

  N/A

• Do all personnel performing the Confined Space Entry have the appropriate training and licenses?

  Safe

  At Risk

  N/A

• Have the correct Confined Space permit/s been obtained and filled out correctly? Take specific notice of the rescue plan and make comment.

  Safe

  At Risk

  N/A

• Is the Confined Space Entry being conducted to the Confined Space Entry Plan?

  Yes

  No

  N/A

• Has the OCC been notified of the Confined Space Entry?

  Yes

  No

  N/A

• Is all PPE being used for the Confined Space Entry in service and in proper condition for it's use?

  Safe

  At Risk

  N/A

Vehicles Plant and equipment

• Are all vehicles and equipment in good working order and clean and presentable?

  Yes

  No

  N/A

• Are the correct tools/truck/crew being used for the task, I.e. no cross contamination due to a sewer spill carrying out a water task, or vice versa?

  Yes

  No

  N/A

• Carry out a vehicle, Plant and Equipment inspection and report any deficiencies.

  Safe

  At Risk

  N/A

• Are vehicle and plant log books correctly filled out with any faults listed?

  Yes

  No

  N/A

• Is there a Fire Extinguisher available, is it secured correctly and is it in service, I.e. been checked and in date with the regular service checks?

  Safe

  At Risk

  N/A

• Is there a refueling container available, is it fitted with a fuel transfer nozzle?

  Safe

  At Risk

  N/A

• Is the Plant and Equipment being operated as per requirements, I.e. not overloading or using appropriate actions and work practices?

  Yes

  No

  N/A

Environmental Aspects

• Has the worksite been reinstated as per requirements and standards? (eg. The cleanup of driveways, gutters nature strip etc.)

  Yes

  No

  N/A

• Are silt traps in place to prevent excessive entry into storm water drains?

  Safe

  At Risk

  N/A

• Are the silt traps placed correctly to ensure that contaminants are trapped?

  Safe

  At Risk

  N/A

• How many silt traps are placed out? How many silt traps are available for use, I.e. minimum of three required.

  Yes

  No

  N/A

Customer

• Have customers been notified of the activity if required?

  Yes

  No

  N/A

• Prior to commencing the activity, have all considerations for customers been taken, I.e. , water off to site whilst the repairs are being carried out?

  Safe

  At Risk

  N/A

• Has the water been shutdown? Have the "water off" times been minimized?

  Yes

  No

  N/A

• On completion of the task was the main, service, or hydrant flushed and or disinfected to ensure a clean supply?

  Yes

  No

  N/A

• Does the worksite require a specific clean up/ disenfection due to a sewer spill etc.

  Yes

  No

  N/A

• Has there been any damage caused to other assets or customers property?

  Yes

  No

  N/A

• If there are damages, have all of the relevant details been recorded and reported?

  Yes

  No

  N/A

Excavation

• Is the excavation for the activity appropriate in size?

  Yes

  No

  N/A

• Is the excavation over 1.5 mt deep? Are proper shoring devices being used?

  Safe

  At Risk

  N/A

• Does the operator of the excavator have the appropriate license? Who is the appointed operator? Are they licensed? Name the spotter.

  Safe

  At Risk

  N/A

• Was the correct equipment used for the excavation, I.e. shovel digging first and then a mud bucket?

  Safe

  At Risk

  N/A

• Is the available back fill material appropriate, and is there sufficient quantity available to complete the task?

  Yes

  No

  N/A

• Has the excavation been back filled correctly and compacted?

  Yes

  No

  N/A

• Is the black carried separately in the tray of the truck, I.e. small amount in a hessian bag?

  Yes

  No

  N/A

Road opening

• Have the correct materials been used, compacted and all cuts and drill holes filled?

  Yes

  No

  N/A

• Has the road opening been measured and correctly marked for completion?

  Yes

  No

  N/A

• Provide a photo of the road opening.

  Yes

  No

  N/A

Safety Conversations

• We're any safety conversations conducted during this audit? If so please record the conversation.

  Yes

  No

  N/A

• Has the crew been practicing their SafeStart exercises as a warm up before commencing the task?

  Yes

  No

  N/A

• Has the crew been doing reset exercises?

  Yes

  No

  N/A

Opportunity for Improvement

• Were there any opportunities for improvement identified during this audit? If so please record the details and ensure that the OFI is reported, registered and followed up.

  Yes

  No

  N/A

Sign off

• Auditor signature

  Sign

• Additional Auditor Signature

  Sign

• Crew signature

  Sign

• Crew signature

  Sign