Is PPE being used as required?
Type details of incorrect PPE
Compliance with JSA or other procedures confirmed
Type details of JSA or procedure failure here
Is appropriate behaviour shown
Type details of inappropriate behaviour here
Are Personnel adequately trained for task
Type details of training concerns here
Are tools appropraite for task
Type details of inappropriate tools here
Have tools/plant been inspected before use
Type details of failed inspections here
Is all gear maintained and serviceable? eg. slings, cables etc.
Type details of of all equipment that is not being sufficiently maintained
Are all Electrical tools or plant being used in good condition and safe to use? eg. tested, tagged
Type details of all electrical issues here
Is access and egress safe
Type details of access/egress issues here
Good Housekeeping? eg. are tools packed away, is site tidy and free of tripping hazards
Type details of bad housekeeping here
Are all noise, dust, odour, or discharge concerns being addressed in a safe manner?
Type details of any noise, dust, odour, discharge issues here
Is the environment being protected during the works? eg. fuels and chemicals stowed correctly, vegetation being considered
Type details of environment concerns here
Is the waste being managed correctly? eg. spoil, bitumen
Type details of bad waste management here
Is Job Analysis Complete and appropriate for task
Type details of no JSA or inappropriate JSA here
Are all procedures being followed
Type details of failed procedures here
For any works that requires an isolation, water or sewer, is the isolation effective?
Type details of failed or poor isolation here
Discuss the JSO with all personnel and note outcomes of discussion
After completing the JSO and having discussions with all personnel on-site, are you free of any follow up actions?
Type all actions required here. Include who will be responsible for those actions and when the follow up should be completed.