Medium Rise Construction Report

Issued: 18 October 2022

Version 2

CISR Descriptor Code – CONMRB – CONSTRUCTION MEDIUM RISE SUBURBAN BUILDINGS

If there are multiple visits to a site, complete this form for each site visit.

1. Date of Site Visit: Time:

2. Principal Contractor:
3. CISR References: Project No. N/A Assessment No.
4. Principal Contractor’s Industry
HIA - QMBA Yes None -
Association Membership
5. Sub-Contractors:
6. Site Address:
7. Project Visited Previously: Yes/No No. Times
8. Inspectors Attending Site:
9. Description of Project:
10. Summary of Inspector Activities:
11. Site Supervision Daily Yes Weekly - Other -
12. No. of Sites Supervision
Responsible For:
13. Stage of Construction: Percentage (%) Status
14. Health & Safety Representatives
N/A
(HSRs) Names:
Yes/No If no, explain why you didn’t meet with HSRs
15. Met with HSRs?

If yes, provide details (i.e. when and why)

16. Return Visit/s Required?

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 Medium Rise Construction Report
Issued: 18 October 2022
Version 2

Assessed During Site Visit

Category Issue
Yes/No Comments
Planning/Management Plan
Supervision
Deliveries
17. Systems of work
SWMS
Consultation/Coordination
Cooperation
Clearance Certificates
Exclusion Zones
Risk assessments
Control measures
Information/Worker Training
18. Overhead
Asset Owner Advice
Electric Lines
SWMS
Scaffolding
Slab Heights
Environmental – Wind/Rain
Delineation People/Plant

19. Operating plant Traffic Control

HRW Licence/s

20. Scaffold Access Issues

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 Medium Rise Construction Report
Issued: 18 October 2022
Version 2

21. Formwork
22. Work at heights
23. Site security
Test and Tag

24. Electrical Temporary Power Boards

Compliance with AS/NZS 3012

25. Housekeeping
26. Access & Egress
27. Amenities Toilets
Lunch Rooms
First Aid
Water
28. Lighting General
Emergency
29. Emergency Documented
Procedures
Tested
30. Hazardous
Chemicals
31. HSRs
32. WHS Committee
33. Falling objects

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 Medium Rise Construction Report
Issued: 18 October 2022
Version 2

34. Site signage Yes

Service identification (dial
before you dig)
35. Excavations Stability N/A

Falls

36. Other

37. Notices

Immediate Compliances Notices Issued Other actions

No. Details of non-compliance Rectified while inspectors were taken
on site?
Y/N If yes, how? Notice Number Notice Type Issued to
Name Role (PC/SC)
1.
2.
3.

38. Additional comments

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 Medium Rise Construction Report
Issued: 18 October 2022
Version 2

Name Date
Completed by:
Reviewed by:

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