Project: Date:

Rev 19-May-21
Employer administrative duties Construction Pag Page 1 of 2
activities e

Matrix Reference
1 2 3 4 5 6 7 8 9 10 11 12 13 14 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 50 51
15 47 48 49 52

Workers Employed

Letter of goodstanding
All detailed documents and close

ID copies & next of

out reports to be emailed to the

37(2) & Contractor

Health and safety
Copy: OHS Act

Assessment
Stacking & storage

Assessment
Cairnmead health & safety

assessments
Appointment &

work / Constr

employees' facilities
Bulk mixing plant
goodstanding

Temporary electrical

Lifts & escalators

Induction &
consultant managing the project

vehicles & mobile

Not of constr

equipment Fall
Demolition work

Portable electrical
contents Hand
Fire precautions
appointment

Explosive actuated
Work Permit

Recording
competency

protection plan
expiry date

Welding & flame

Deviatio
fastening device
incidents
or to Cairnmead admin at

works Tower
Medicals

Health & Safety

Contract

Management

Site Statistics
Letter of

Actual
First aid box

Vessels under
& Reg

Client Audit
rep checklist
admin@[Link].

policies

Temporary

COVID - 19

Ideal
Construction

Suspended
plan &

machinery

Excavation
Construction

Explosives

Fall arrest

installations
Scaffoldin
Risk

platforms
Toolbox

Ladders

(STATS)
kin

pressure
of

n
Driven

Traffic
cutting

Audits

Lifting

tackle
crane

tools
talks

work

Date
plant

tools

Plan
Document Frequency

g
Company R R O O O R R O O R R R R R M W D D D D D D D D D D D D/6M/Y
D D D D D/6M/Y
D W W W M M M M M M M M M 6M 3Y R M M/R
Trade Remarks

2 1 4 1 4 1 4 2 4 2 4 2 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 See report attached 6 3 3

test 4 page 2

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

Inspection Frequency Legend Compliance Legend

Once at start of O Compliant 1 Site Evaluation : 6 3 3
Project Non compliant - first 2
Total Workers on audited
Repeat as required R audit
Daily D audit 3 Print Name Sign Print Name Print Name Sign Print Name Sign files % 50%
0
Weekly W Not applicable 4
Monthly M Not audited 5 Safety Officer/Rep Date 00-Jan-00 Construction Date 00-Jan-00 Construction Manager Date 00-Jan-00 Safety Consultant Date 00-Jan-00 Monthly Man
Supervisor Hours
Three Monthly 3M
Near Mises
Six Monthly 6M
First Aid Cases
Yearly Y
Medical Treatment
Lost Time
Incidents
Total Man
Hours - Project

This audit is done according to the minimum legal requirements listed on the audit sheet. It is a level one audit, confirming the frequency of use and not necessarily the contents of the evaluated document. A count of the applicable elements sets the ideal to
achieve. the result is calculated by
adding the allocated values on a line and stating the difference between the ideal and achieved mark as the deviation. A certificate of achievement to the principal contractor, his health & safety co-ordinator / officer and each appointed contractor audited will
be issued upon full documentation compliance achieved in the required frequency of audits. On the principal contractors line each element is split in two, the first indicating the principal contractors own activity and the second the principal contractor
management function of the appointed contractors.
Copyright by Cairnmead Industrial Consultants