Clarendon HSE

• Document number

• Job Number

• Address

• Conducted on

  Date

• Prepared by

Working At Heights

• Is the scaffold tag fitted to the front of the scaffold?

  Yes

  No

  N/A

• Handrails and brick guards are in place?

  Yes

  No

  N/A

• No open penetrations could be found in the work platform?

  Yes

  No

  N/A

• Are all lapboards secured?

  Yes

  No

  N/A

• Is the stair void system installed and ladder secured?

  Yes

  No

  N/A

• Are fixed guard rails in place for door openings and balcony protection?

  Yes

  No

  N/A

• Is roof rail/edge protection in place and adequate for the work platform?

  Yes

  No

  N/A

Temporary Power

• Have you mechanically trip tested the meter board RCD?

  Yes

  No

  N/A

• Date of Test

  Date

Trades

• At the time of inspection were trades working safely?

  Yes

  No

  N/A

• List contractors on site

Site cleanliness

• Is the waste enclosure installed and correctly utilised?

  Yes

  No

  N/A

• Is the property free from excess waste and safe for access and egress?

  Yes

  No

  N/A

Environmental

• Is "all weather access" adequate to prevent runoff and council fines?

  Yes

  No

  N/A

• Is sediment control adequate to prevent run off and council fines?

  Yes

  No

  N/A

Temporary Propping of Structures

• Are structures supported by engineered supports?

  Yes

  No

  N/A

Fencing Security and Site Signage

• Is the security fence in place and in-tact?

  Yes

  No

  N/A

• Is the site sign installed and filled out?

  Yes

  No

  N/A

Actions taken to rectify the non compliance

• Working at Heights

• Temporary Power

• Trades

• Site cleanliness

• Environmental

• Temporary Propping of Structures

• Fencing security

• Add signature

  Sign

• Site Photo

  Media