Title Page

  • Supervisor name

  • Project Manager

  • Client / Site

  • Conducted on

  • Task

  • Location
  • Site unique ID/CGI reference number

Part 1 : Get Safe for Work

Before you start Answer the below, if you answer No to any of the Following, please ensure that you inform the Responsible Persons and resolve Prior to Starting.

  • Do you have the right documentation for the job? Risk Assessments, Permits and Method Statements. <br><br>

  • Are the power tools, leads tested and detection equipment within calibration?<br><br>

  • Do you have the right PPE for the job?<br><br>

  • Are scaffolds, towers and ladders inspected?<br>

  • Is there safe access to and within your working area?<br>

Part 2 : Think - Act

If you Think the Task Requires additional controls - Select At Risk, Describe what is needed prior to commencing work. Implement the Controls and Continue

  • Slips, trip or fall on the same level hazard?

  • Falls From Height

  • Falling or flying objects Hazard?

  • Chemical/Harmful Substances

  • Heat/Fire/Explosion/Hot works

  • Asphyxiation / Drowning

  • Risk to Plant<br>

  • Stationary objects Contact Risk

  • Overturn/Collapse

  • Manual handling<br>

  • Insecure load<br>

  • Vehicle risk<br>

  • Contractor/ public risk<br>

  • Confined spaces <br>

  • Dust/Fumes<br><br>

  • Noise<br><br>

  • Vibration<br><br>

  • Electricity<br><br>

  • Gas

  • Contamination<br><br>

  • Poor lighting<br><br>

  • Temperature<br>

  • Pinch/ Trapping Points<br>

  • Others Please specify

  • If you have answered at risk to any of the above, please specify details

Part 3 : Review

  • Has the works created any new hazards from initial inspection?<br>

  • Details are any lessons that have been learnt?<br>

  • Are there any further safety suggestions or concerns regarding the the days proceedings that you would like to communicate to management?

  • Please ensure that you download and email to the PM you have named 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.