Title Page

  • Location
  • Division

  • Conducted on

  • Completed By (Name)

Questions

1. Signing In

  • 1a. Have all Supplier employees signed in on the locations visitor register?

  • 1b. Have all operatives carrying out intrusive works consulted the Asbestos Registers as necessary?

2. Monitoring & Control

  • Please state the name of company conducting the works

  • 2a. Is there a safe system of work in place for the tasks being undertaken? (RAMS)

  • 2b. Have the RAMs been suitably verified and authorised?

  • 2c. Is the work area suitably barriered off? (i.e. public areas)

  • 2d. Is there adequate signage in place warning of works being undertaken?

3. Hazards

  • Please give details of the task in hand e.g. what works are they doing?

  • 3a. Does the task include working at height?

  • 3b.What type of working at height? Aluminium towers, fixed scaffolding, ladders/ step ladders, mobile elevated work platforms (motorise/pop-ups), podiums (towers/steps).

  • 3c. Are there any unsafe working at height practices?

  • Brief description of unsafe practice:

4. Fire

  • Are any hot works being conducted?

  • 4a. Are there appropriate control measures in place for Hot Works? (e.g. work permit)

  • 4b. Are there adequate fire fighting media available? (Min 2x Fire Extinguishers and Welding Fire Blankets etc)

5. Occupational Health

  • 5a. Is there adequate dust controls in place? (e.g. dust masks with correct face fit testing)

  • 5b. Does the operative show the correct manual handling techniques?

  • 5c. Are there manufactures data sheets available for Substances Hazardous to Health (COSHH)

  • 5d. Do operatives have adequate welfare provisions?

6. Safe use of tools

  • 6a. Are all electric tools <=110 volts?

  • 6b. Are all battery chargers in a safe condition?

  • 6c. Are other tools fit for purpose?

  • 6d. Are relevant Calibration certificates available for tools?

7. Personal Protective Equipment (PPE)

  • 7a. Are operatives wearing appropriate PPE as per the Code of Conduct or as stated within RAMS?

8. Competency

  • 8a. Do operatives have evidence of Skills, Knowledge, Experience, Training?

9. Other notes and observations (best and poor practices)

  • 9a. Any other notes and observations (best and poor practices)

Sign-off Section

Sign-off

  • Site Facilities Manager Name:

  • Site Facilities Manager Signature:

  • Operatives Name:

  • Operatives 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.