Project details PID or W/O Project title No. Site Location of project Location at site Details of project Brief Description of work Planned start date Planned end date Name: Mobile: Project Manager Email: Principal Contractor Y N Contractor or company (PC) appointed? Name: Role: Contractor representative Email: Mobile: Criteria Complete? Comments Section 1 Pre-start requirements – Contract kick-off meeting held and minutes completed (). Y Section 2 High-risk work requirements – The following high-risk work activities have been identified and will require Projects involving high-risk work approvals (select relevant activities below) activities will require increased levels of on-site supervision and monitoring. Y N/A High-risk work permit requirements, processes, roles and responsibilities Y N/A understood by all parties. Section 3 Safety documentation – Safety Management Plan reviewed by the WHS Team Contractor’s (mandatory where project value is >$250K or where Seqwater has appointed a Y N/A Principal Contractor) JSEA / SWMS reviewed and endorsed by WHS Team (SWMS mandatory for Y N/A all activities that involve high risk construction work) Section 4 Site access / handover & hand back requirements – Site access approval secured for work Y Insert SAA number/s Handover date: access to site only access Contractor’s site requirements site to be handed over to PC Planned hand back date: Description of the site, equipment or plant being accessed or handed over: Map of the Work Area/s attached? Y N N/A Access arrangements confirmed (e.g. arrangements for accessing work area Y documented, restricted areas defined) Emergency management responses are confirmed and integrated with the site IERPs as necessary (e.g. emergency alarms, evacuation process, first aid Y response. Site familiarisation has occurred with the Contractor (required prior to Y handover)? If yes, identify the additional Do additional security arrangements need to be put in place to protect Y N security risk controls and Seqwater's business interests and public safety? responsibilities. Are Seqwater access keys, swipe cards or buzzers required? Y N
Project details Project title PID or W/O No. Location of project Site Location at site Details of project Brief Description of work Planned start date Planned end date Project Manager Name: Mobile: Email: Contractor or company Principal Contractor (PC) appointed? Y N Contractor representative Name: Role: Email: Mobile: Criteria Complete? Comments Section 1 – Pre-start requirements Contract kick-off meeting held and minutes completed (). Y Section 2 – High-risk work requirements The following high-risk work activities have been identified and will require approvals (select relevant activities below) Y N/A Projects involving high-risk work activities will require increased levels of on-site supervision and monitoring. High-risk work permit requirements, processes, roles and responsibilities understood by all parties. Y N/A Section 3 – Safety documentation Contractor’s Safety Management Plan reviewed by the WHS Team (mandatory where project value is >$250K or where Seqwater has appointed a Principal Contractor) Y N/A JSEA / SWMS reviewed and endorsed by WHS Team (SWMS mandatory for all activities that involve high risk construction work) Y N/A Section 4 – Site access / handover & hand back requirements Site access approval secured for work Y Insert SAA number/s Contractor’s site access requirements access to site only site to be handed over to PC Handover date: Planned hand back date: Description of the site, equipment or plant being accessed or handed over: Map of the Work Area/s attached? Y N N/A Access arrangements confirmed (e.g. arrangements for accessing work area documented, restricted areas defined) Y Emergency management responses are confirmed and integrated with the site IERPs as necessary (e.g. emergency alarms, evacuation process, first aid response. Y Site familiarisation has occurred with the Contractor (required prior to handover)? Y Do additional security arrangements need to be put in place to protect Seqwater's business interests and public safety? Y N If yes, identify the additional security risk controls and responsibilities. Are Seqwater access keys, swipe cards or buzzers required? Y N
FRM-00777%20Corporate%20Safety%20%E2%80%93%20Project%20Works%20Permit%20Form.docx