Inspected By:

Also Present:

General Checks

This list of questions is not exhaustive and any other good or bad practice of note should be recorded in the observations section.

01 - Have personnel completed a Take 5 Risk Assessment for works being undertaken?

02 - Do personnel have the appropriate authorisation / PTW for the work being undertaken, e.g. Hot Work Permit?

03 - Are access and egress arrangements safe, including working at height access (Ladders, scaffolding tagged, etc.)?

04 - Is housekeeping / tidyness acceptable in the work area, and is it free from slip, trip and fall hazards?

05 - Are all personnel wearing the correct PPE for work being undertaken? (As a minimum, Safety footwear, protective overalls, eye protection, Safety Helmet).

06 - Are all hazards suitably controlled and appropriate measures taken to ensure the health and safety of Burgess Marine personnel and others who may be affected by their activities?

07 - Do personnel have the relevant instruction and training to carry out the work safely?

08 - Is all plant, equipment and tools (powered or manual), in good visible condition and displaying the appropriate maintenance tag/label?

09 - Does the work group have a First Aider amongst them, or if not, access to a customer trained First Aider?

10 - If working at height (i.e. next to an exposed edge), are the following control measures in place: action taken to prevent falls (e.g. hand rails, fall restraint harnesses or catch nets)?

11 - If carrying out hot work (e.g. burning, welding or grinding), are the following control measures in place: Hot work permit, Fire Watch, firefighting equipment?

12 - If carrying out confined space work, are the following control measures in place: Personnel trained in confined space working, entry permit in place, communications in place, escape sets and gas monitors present and in use, Topman present, rescue arrangements in place?

13 - Please confirm that the work being undertaken does not pose any risk to the environment, and if not are suitable control measures in place (e.g. Spill kits, booms, dust containment, etc.)?

14 - Is all waste / rubbish being captured and controlled for removal from site?

Observations and Recommendations

Please make a note of any general observations including Good or Bad practice.





Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.