Zero Harm Observation (Modified Downer NRLFM009)

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Enter Name, Position and Signature

  Sign

• To add text or photo information for "Yes" and "N/A" options double tap button.

People:

• Persons wearing correct PPE

  Yes

  No

  N/A

• Track Protection Coordinators Book completed regularly

  Yes

  No

  N/A

• Safeworking Books completed for track protection and/or lookout working

  Yes

  No

  N/A

• Regular pre-start meetings or toolbox talks conducted

  Yes

  No

  N/A

• Persons on site properly inducted, including adequate site-specific inductions

  Yes

  No

  N/A

• Do staff have appropriate rail industry approved licensing/accreditation to perform their duties (ARTC SOC, RailCorp RISI, Conduction Induction Ticket etc)

  Yes

  No

  N/A

• Persons operating mobile plant and vehicles are properly licensed

  Yes

  No

  N/A

• Persons aware of site hazards, excavation and first aid procedures

  Yes

  No

  N/A

• Site Supervisor can describe the last incident and corrective actions taken

  Yes

  No

  N/A

Plant & Vehicles:

• Daily pre-start checks completed on all mobile plant

  Yes

  No

  N/A

• Operators properly licensed

  Yes

  No

  N/A

• Plant operators trained in the safe operating procedures (e.g. JSA / WMS)

  Yes

  No

  N/A

• Safe operating procedures freely available on site

  Yes

  No

  N/A

• Reversing kept to an absolute minimum

  Yes

  No

  N/A

• Spotters used correctly (e.g. while reversing etc)

  Yes

  No

  N/A

• 3-meter distance maintained between moving plant and persons on foot

  Yes

  No

  N/A

• Safe speed maintained (brisk walking pace around persons on foot)

  Yes

  No

  N/A

• On site tipping properly controlled - Drivers provided with adequate instruction and supervision

  Yes

  No

  N/A

• Safe area established for on site cleaning of vehicles (signage in place)

  Yes

  No

  N/A

• Plant is fit for purpose, including correct guards, reversing alarms, lights etc

  Yes

  No

  N/A

• Plant maintained to a acceptable standard, including general housekeeping

  Yes

  No

  N/A

• Persons maintain a distance of at least 1.2 meters from passing public traffic

  Yes

  No

  N/A

Processes & Housekeeping:

• Worksite risk assessment conducted and reviewed on a daily basis

  Yes

  No

  N/A

• Traffic Management Plan in place (documented) - Controls in place as per plan

  Yes

  No

  N/A

• Unsafe plant/equipment tagged out

  Yes

  No

  N/A

• Isolation, lock-out and tag-out applied during maintenance and repairs

  Yes

  No

  N/A

• Electrical equipment tagged, tested and fit for purpose

  Yes

  No

  N/A

• Emergency equipment available and serviced (e.g. Extinguishers / first aid kits)

  Yes

  No

  N/A

• Manual handling risks adequately controlled (e.g. mechanical aids, correct lifting techniques, job rotation etc)

  Yes

  No

  N/A

• Overhead wires identified and controlled (e.g. demarcated)

  Yes

  No

  N/A

• Excavations identified and controlled

  Yes

  No

  N/A

• Housekeeping maintained to an acceptable standard

  Yes

  No

  N/A

• Worksite amenities adequate (e.g. drinking water, toilets, shelters etc)

  Yes

  No

  N/A

Contractor Management:

• Contractors authorised to commence work (i.e. ATWP or Authority to Work Register)

  Yes

  No

  N/A

• Contractors possess induction card and have completed site-specific induction

  Yes

  No

  N/A

• Contractors possess necessary licenses/competency certificates

  Yes

  No

  N/A

• Contractors trained in safe work procedures and these are available on site

  Yes

  No

  N/A

Environment:

• Waste disposal adequate (e.g. rubbish bins provided and used)

  Yes

  No

  N/A

• Noise levels reduced as far as possible

  Yes

  No

  N/A

• Are sediment controls in place where applicable; note what controls are in place

  Yes

  No

  N/A

• Has vegetation regrowth been implemented.

  Yes

  No

  N/A

• Spills cleaned up adequately

  Yes

  No

  N/A

• Is dust suppression required and adequate.

  Yes

  No

  N/A

• Drums and bulk storage vessels properly bunded

  Yes

  No

  N/A

• Air emissions reduced as much as possible

  Yes

  No

  N/A

Other Issues Identified:

• Please complete section below and highlight any additional observations and actions

• Please add photo if required

  Media

• Please sketch diagram if required

  Drawing

• Distribution: Zero Harm Observation (ZeroHarm.Reporting@downerediworks.com.au); Harley Taylor (Health and Safety Coordinator); Relevant Manager and/or Supervissor