SF-037Jul 2012 Rev 14Page 1 of 4 CONSTRUCTION SITE CHECKLIST Job No: Site: Date: Tick Result Task or Condition YESNON/A Actions to Address(If result is NO, then include an action) 1Site Induction / Toolbox a Has a site induction/toolbox talk been conducted and signed by all personnel involved in the task? 2Daily Risk Assessment: (Please write document and Rev no) SF-012.____Rev.____ (Check Rev) aIs the Risk Assessment available on site?Mandatory Incident Report for NO bIs it site specific? cIs it completed correctly for the worksite? dHas it been signed & dated each day? eDoes it address pedestrian safety? fDoes it address vehicle safety? gDoes it address plant safety? h IfDangerousGoodsareinuse,arethere adequate safety controls in place? iIs the Supervisor nominated? jIs the First Aider nominated? kIs the muster point nominated and is it suitable? lAre environmental considerations addressed? mAre all nominated controls in place?Mandatory Incident Report for NO nAre all nominated controls effective?Mandatory Incident Report for NO 3Safe Work Method Statement (Please write document and Rev no) SF-050.____Rev.____ (Check Rev) aIs there a SWMS available on site?Mandatory Incident Report for NO bIs it site specific? cDoes it address all tasks & associated hazards?dHave the non relevant steps been crossed out? e Havetherelevantlegislation/standards/codesof practice been highlighted? f Havetherelevantworkinstructions/forms/risk assessments been identified? g Aretherelevantworkinstructions/forms/risk assessments on site? hDoes the workforce have the necessary training? iHas plant and equipment been identified? j Haveenvironmentalconsiderationsbeen addressed? k HastheSWMSbeensignedbyallpersonnel involved in the task? lAre all required controls in place?Mandatory Incident Report for NO mAre all required controls effective?Mandatory Incident Report for NO This checklist is to be utilised to identify, review and correct any conditions or hazards that may endanger personnel, contractors or members of the public.Incident/Hazard reports are to be completed on SF-001 CONSTRUCTION SITE CHECKLIST SF-037 SS0066Jul 2012 Rev 14Page 2 of 4 Tick Result Task or Condition YESNON/A Actions to Address(If result is NO, then include an action) 4Licences/Authoritiesa Areallplantoperatorslicensedorauthorisedto operate the equipment? Mandatory Incident Report for NO b HaveallpersonnelrelevantStateOHS Induction? Mandatory Incident Report for NO c ArePersonnelAuthorisedbythe Authority/Client? 5Forms/Documentation aIs there a copy of the Management plan on site? (Requiredfor all Jobs >$250,000) bIs a PowerServe contact details sign displayed? cIs the job file available on site? dIs there a certified/current Drawing on site? eIs there a job Specification on site? fAre the Authoritys Safety Rules available?6Work/Access Permits aIs an appropriate permit on issue for this work? bAre all permit recipients authorised?Mandatory Incident Report for NO c Are DBYDs and/or Excavation Permits complete andon-siteandhavealloverheadand underground services been identified? Mandatory Incident Report for NO d If applicable, is a State Roads permit onsite and current? Mandatory Incident Report for NO e Ifapplicable,isacouncilpermitonsiteand current? Mandatory Incident Report for NO 7Manual Handling a Havethemanualhandlinghazardsbeen identified? bAre manual handling aids available? 8Personal Protective Equipment (PPE) aPPE as per Daily Risk Assessment b Areallsafetyharnesses&lanyardswithintheir testdaterange?(Every3Months)andtagged. (Red Jan to Mar, Green Apr to Jun, Blue Jul to Sep, Yellow - Oct to Dec Power only) cIs other safety apparel in good condition? 9Tools/Equipment a Are all electrical tools within their test date range and tagged? (As per state requirements) Check the following Equipment for condition, compliance and tagging:- bLadders (every 3 mths) cCalibrated Test equipment within test date? dGas Bottles (10 Years) e Liftingequipment(Slings&chains)(every3 months) (Red Jan to Mar, Green Apr to Jun, Blue Jul to Sep, Yellow - Oct to Dec Power only) 10First Aid and Emergency Contacts a IsthereastockedFirstAidkitavailableonsite and is it in date and accessible? Min. Type B CONSTRUCTION SITE CHECKLIST SF-037 SS0066Jul 2012 Rev 14Page 3 of 4 Tick Result Task or Condition YESNON/A Actions to Address(If result is NO, then include an action) bAre the First Aid requirements adequate? cAre there emergency contact details available? dIs there emergency communication available? 11Traffic/Pedestrian Management a If required, is there a traffic management plan in use and a copy of the plan on site? bIs the site set up as per Traffic Control Plan? cDoes the plan address pedestrian safety? dCan vehicles/pedestrians pass the site safely? If in use do the following personnel have tickets in:- eTraffic Controller (Blue) fApply Traffic Control Plans (Yellow) gSelect/modify Traffic Control Plans (Red) hDesign & inspect Traffic Control Plans (Orange) i If managing pedestrians is there a PMP in place? jIs the site set up as per PMP 12Vehicles & Plant a Doesallplantandhighriskequipmenthavea current risk assessment? bIf required, is the prestart inspection completed? c Warningdevicesfittedandinworkingorder? (flashinglights,reversingalarm,siteflag, warning signage) d Whererequired,hastheoperatorcompleteda competency for the plant. eIf required, is an emergency stop fitted? f Is all of the equipment carried adequately secured? 13Fire Hazards/Procedures/Bans aAre hot work restrictions been complied with? bIf required, has the hot work permit been issued? c Is there Fire Fighting equipment available, and is it accessible and adequate? dIs it maintained (serviced every 6 months) e Ifoperatingwithinafirebanperiod,isa permit/exemption on site? 14Hazardous Substances / Dangerous Goods a IfHazardousSubstances/DangerousGoods are in use, is there an MSDS available? b Arethereadequatesafetycontrolsinplace,as outline in the MSDS? c Hasariskassessmentbeenconductedfor hazardous substances? d IfDangerousGoodsareinuse,arethere adequate safety controls in place? CONSTRUCTION SITE CHECKLIST SF-037 SS0066Jul 2012 Rev 14Page 4 of 4 15Excavations & Trenches a Are all Excavations isolated to prevent accidental access? Mandatory Incident Report for NO b If the excavationsare deeper than1.5 metres is there shoring or benching in place? cIs there safe means of access to & from?d Isthereadequateprotectiontopersonnelinthe excavation from falling material? 16Environment aAre there effective erosion controls in place? bIs any existing flora protected from damage? cIs any existing fauna protected from damage? dIs effective waste/spoil management in place? eAre liquids stored to prevent spillage? f Isthereaspillkitavailableandisitaccessible and adequate? gIf required, is weed control in place? hAre vehicles free of mud/dirt when leaving site? IHave any issues with dust been addressed? jIs the site in a clean and tidy state? kAre bunds litter free and empty? 17Emergency Preparedness.Select a member of the workgroup and confirm if they are aware of:- aThe nominated first aider? bThe emergency contact list and its location? cThe evacuation procedure and muster point? dLocation of spill kit? Additional Comments/Findings: Inspected By: (Print Name)Signed: Reviewed By:Print Name:Signed: Field Co-ordinator/Leading Hand/ Site Supervisor: Project Manager/Supervisor: Subcontractor Representative: If different to site supervisor. Subcontractor Company: NOTE: Retain a copy of this form in the CEMP records folder