• Document No.

  • Conducted on

  • Site Name

  • Date and time

  • Location
  • Checklist Items

  • Contact site to pre-arrange a site induction for first time visit.

  • Contact the respective site and agree a specific date and time for the visit.

  • Will a Job Safety Analysis (JSA) be required?

  • Confirm at least one other person will be on site whilst visiting.

  • Contact site to request a person accompanies you whilst outside main Admin building.

  • Confirm correct Personal Protective Equipment (PPE) for site.

  • Perform a Personal Safety Assessment.

  • Do I understand what the task involves.

  • Have I got the correct tools and equipment to complete the task.

  • Can I complete the task without the help from others.

  • Have I identified what could go wrong.

  • How can I make it safe

  • Note: Ensure action is taken to address any items that are found to be unsafe.

  • Asciano Minimum PPE

    High Visibility Clothing
    Safety Glasses
    Long Sleeve Shirt
    Rubber Sole Boots

    Additional PPE Dependant on Site

    Steel capped, lace-up, ankle high boots
    Ear plugs
    Wide brim hats

  • Identified Hazards

  • Enter details of hazards

  • Take photo if required

  • Signature

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.