Title Page

  • Project Name

  • Location
  • Outline of Proposed Works

  • Work Commencement Date

  • Work Completion Date

  • Site Supervisor Name and Contact Details

  • Details of Subcontractors Involved in the Works Name(s) and Contact Details

  • Plan Prepared By

Arrangements

  • Are there specific site access arrangements ?

  • Site Access Arrangements

  • Are there specific arrangements for parking ?

  • Parking Details

  • Is there a specific site contact for reporting arrivals, departures, accidents and other site related issues ?

  • Reporting Arrangements Arrival/Departure/Accidents/Issues

  • Is there arrangements in place for a site induction ?

  • Details of Site Induction Requirements

  • Are there specific site security arrangements ?

  • Site Security Arrangements

  • Are there arrangements in place for staff welfare, including toilets, washing facilities, first aid etc.?

  • Welfare Arrangements Toilets/Washing Facilities/First Aid/Other

Minimum PPE Requirements

  • Safety Boots

  • Safety Goggles

  • Gloves

  • Dust Masks

  • Details of any Other Required PPE

Key Risks

Asbestos

  • Has the site Asbestos log been viewed ?

  • Is the Asbestos log up to date ?

  • Comments.

Working at Height

  • Will the project include a requirement to work at height ?

  • Details of Height Access equipment to be used.

  • Details of users/certification

Other Risks

  • Is there a risk from Electrocution ?

  • If 'Yes' to the above, provide details of controls.

  • Is there a risk from any type of gases ?

  • If 'Yes' to the above, provide details of controls.

  • Is there a risk from any type of dust ?

  • If 'Yes' to the above, provide details of controls.

  • Does the project include personnel going into an excavated area ?

  • If 'Yes' to the above, provide details of controls.

  • Are the public or other site users being kept safe and not at risk ?

  • If 'Yes' to the above, provide details of controls.

  • Are there any other significant risks not covered by the above ?

  • Please detail any other significant risk not covered by the above.

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.