Chemical Reinstatement

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Self assessment

• Is it safe to exit my vehicle

  Yes

  No

  N/A

• Is the site safe and secure

  Yes

  No

  N/A

• Am I wearing the correct PPE

  Yes

  No

  N/A

• Am I inducted to this site

  Yes

  No

  N/A

• Are thereeffective excess control barriers in place

  Yes

  No

  N/A

• Are there No Entry signs in place

  Yes

  No

  N/A

• Are there Danger warning signs in place

  Yes

  No

  N/A

• Is there a Hazard Register Board visibly in place

  Yes

  No

  N/A

• Has Hazard Board been updated

  Yes

  No

  N/A

• Is there a "Sign in and Out" system in place

  Yes

  No

  N/A

• Is induction effective offered

  Yes

  No

  N/A

• Is SSSP available on site

  Yes

  No

  N/A

• Is SSSP used

  Yes

  No

  N/A

• Is SSSP content known on site

  Yes

  No

  N/A

• Is emergency procedures available on site

  Yes

  No

  N/A

• Are the emergency contact numbers available on site

  Yes

  No

  N/A

• Has power supply been isolated effectively

  Yes

  No

  N/A

• Has isolation point been tagged

  Yes

  No

  N/A

• Was a two stage effective isolation been established

  Yes

  No

  N/A

• Does the tag reflect the contact details of the certified electrician

  Yes

  No

  N/A

• Is there any special power supply arrangement in place in site

  Yes

  No

  N/A

• Are all leads tagged

  Yes

  No

  N/A

• Are power tools tagged

  Yes

  No

  N/A

• Are leads in good working order

  Yes

  No

  N/A

• Are power tools in safe good working order

  Yes

  No

  N/A

• Are all exposed wires capped and safe

  Yes

  No

  N/A

• Is there a RCD device in use

  Yes

  No

  N/A

• Are all leads tagged to requirements

  Yes

  No

  N/A

• Are all leads in good working order

  Yes

  No

  N/A

• Are all power tools tagged to requirements

  Yes

  No

  N/A

• Are all power tools in good working order

  Yes

  No

  N/A

• Does installation seem safe and secure

  Yes

  No

  N/A

• Is tagging to required standard

  Yes

  No

  N/A

• Base boards of correct size

  Yes

  No

  N/A

• Are base boards installed correctly

  Yes

  No

  N/A

• Are ladders secure

  Yes

  No

  N/A

• Is ladder interface with platform to standard

  Yes

  No

  N/A

• Are self closing gates installed correctly and working

  Yes

  No

  N/A

• Are guard rails installed to standard

  Yes

  No

  N/A

• Are working platforms secured to frame

  Yes

  No

  N/A

• Is edge protecting installed to standard

  Yes

  No

  N/A

• Is the site clean and neat

  Yes

  No

  N/A

• Are materials stored safely and neatly

  Yes

  No

  N/A