WSH Audit

• Document No.

• Audit Title

• TASK DESCRIPTIONS

• Dept / Unit / Site Name

• Conducted on

  Date
• Location
  Address

• Prepared by

• Verified by

  Sign

1. DOCUMENTS

• A. Permit to Work approved and signed by Authorised Manager

  Compliant

  Non-Compliant

  N/A

• B. Toolbox meeting conducted

  Compliant

  Non-Compliant

  N/A

• C. SWP / RA available

  Compliant

  Non-Compliant

  N/A

• D. Emergency contact list available

  Compliant

  Non-Compliant

  N/A

2. WORK AREAS

• A. Work area checked and free from hazards

  Compliant

  Non-Compliant

  N/A

• B. Protected side or holes

  Compliant

  Non-Compliant

  N/A

• C. Materials housekeep in orderly manner

  Compliant

  Non-Compliant

  N/A

• D. Turn on air ventilation (if in pump station)

  Compliant

  Non-Compliant

  N/A

3. OPENING OF MANHOLE

• A. Manhole covered with grating

  Compliant

  Non-Compliant

  N/A

• B. Back supporter used when carrying heavy manhole

  Compliant

  Non-Compliant

  N/A

• C. Permission to open Manhole permit

  Compliant

  Non-Compliant

  N/A

4. ENVIRONMENT

• A. No water receptacles / water ponding

  Compliant

  Non-Compliant

  N/A

• B. Sanitary areas cleaned

  Compliant

  Non-Compliant

  N/A

• C. Trash bins covered

  Compliant

  Non-Compliant

  N/A

5. CONFINED SPACE

• A. Personnel are trained and certified

  Compliant

  Non-Compliant

  N/A

• B. Gas testing done and record before entering confined space

  Compliant

  Non-Compliant

  N/A

• C. Confined Space Rescue Plan available

  Compliant

  Non-Compliant

  N/A

• D. Rescue equipment checked and inspected

  Compliant

  Non-Compliant

  N/A

• E. Lighting is adequate

  Compliant

  Non-Compliant

  N/A

6. EXCAVATION WORKS

• A. Trained personnel

  Compliant

  Non-Compliant

  N/A

• B. Access / Egress

  Compliant

  Non-Compliant

  N/A

• C. Shoring/shielding/sloping done

  Compliant

  Non-Compliant

  N/A

• D. Excavation area barricade

  Compliant

  Non-Compliant

  N/A

• E. Spoil pile safe

  Compliant

  Non-Compliant

  N/A

• F. Continuous gas monitoring done ( if more than 1.5m deep)

  Compliant

  Non-Compliant

  N/A

7. WORKING AT HEIGHT

• A. Fall Prevention Plan

  Compliant

  Non-Compliant

  N/A

• B. Personnel competent and trained

  Compliant

  Non-Compliant

  N/A

• C. Fall Protection used appropriately and inspected (body harness, self-retractable line, if any in use)<br>

  Compliant

  Non-Compliant

  N/A

• D. Scaffold inspected (if in use)

  Compliant

  Non-Compliant

  N/A

• E. Ladder used appropriately and inspected

  Compliant

  Non-Compliant

  N/A

8. LIFTING WORKS

• A. Lifting plan and rescue plan available<br>

  Compliant

  Non-Compliant

  N/A

• B. Rescue equipment inspected and ready to use<br>

  Compliant

  Non-Compliant

  N/A

• C. Personnel trained and competent<br>

  Compliant

  Non-Compliant

  N/A

9. ELECTRICAL WORKS

• A. Equipments and power tools check and inspected

  Compliant

  Non-Compliant

  N/A

• B. Industrial type connector used

  Compliant

  Non-Compliant

  N/A

• C. Lock Out / Tag Out checked and labelled (if any)

  Compliant

  Non-Compliant

  N/A

• D. Live cables are hung and housekeep neatly<br>

  Compliant

  Non-Compliant

  N/A

10.FIRE SAFETY

• A. Is the emergency response plan in place

  Compliant

  Non-Compliant

  N/A

• B. Fire fighting equipments ( fire extinguisher, hosereel and smoke detector, others) inspected and valid

  Compliant

  Non-Compliant

  N/A

• C. Are all fire safety signs and area according to Fire Safety Act

  Compliant

  Non-Compliant

  N/A

11. OTHER TASKS NOT SPECIFIED ABOVE

• A. Compliant or Non-compliant

  Compliant

  Non-Compliant

  N/A

• B. Compliant or Non-compliant<br>

  Compliant

  Non-Compliant

  N/A

• C. Compliant or Non-compliant

  Compliant

  Non-Compliant

  N/A

OFFICER'S SIGNATURE

• WSHO

  Sign

• PUB OFFICER IN CHARGE

  Sign

• CONTRACTOR SUPERVISOR

  Sign