Information

  • Conducted on

  • Project No:

  • Location
  • Foreman

  • Site Contact

  • Company/contractor

  • Prepared by

1. Public Safety

  • 1.1 Traffic and pedestrians taken into consideration

  • 1.2 Signage is appropriate for scope of works?

  • 1.3 Traffic management plan completed, submitted and maintained?

  • 1.4 Copy of speed limit form (Memorandum of Authorisation) with foreman/office?

2 Personal Protection Equipment

  • 2.1 In good order and being worn?

  • 2.2 Hi-vis vest/jacket done up?

  • 2.3 Head, eye or ear protection worn?

  • 2.4 Safety clothing / footwear adequate?

  • 2.5 Sun protection appropriate? Hat, long sleeves, long pants, sunglasses.

3 Plant

  • 3.1 In good order?

  • 3.2 Reversing signal, flashing lights in working order?

  • 3.3 Daily checklist or logbook complete?

4 First Aid Facilities

  • 4.1 Kit available and appropriate contents?

  • 4.2 Dates within use-by?

  • 4.3 Certified first aider on site?

5 Trenching

  • 5.1 CoGB trenching procedures complied with?

  • 5.2 is soil pile toe at least 0.5m from trench?

  • 5.3 Are supports over stressed?

  • 5.4 Are tension cracks appearing along the top of the tench?

  • 5.5 Are pipes, tools, spoil pile, mobile plant too close to the trench?

  • 5.6 Is anyone climbing the toms instead of using a ladder?

  • 5.7 Are safety helmets being worn at all times in and around trenches?

  • 5.8 Is anyone working alone in a trench?

  • 5.9 If trench is more than 1.5m deep has it been stepped out?

  • 5.10 Are trenches barricaded from traffic and pedestrians?

  • 5.11 Services locations and protection identified (including spotters and any permits required)?

6 Chemicals

  • 6.1 MSDS register on site?

  • 6.2 Is MSDS register up to date?

  • 6.3 Dangerous goods storage appropriate (including fuels)?

7 Other

  • 7.1 Are staff amenities appropriate?

  • 7.2 Is on site storage available?

  • 7.3 Power leads and tools tagged?

  • 7.4 Site induction carried out? Including subcontractors?

  • 7.5 JSA/SWMS available & completed?

  • 7.6 Emergency procedure in place?

  • 7.7 Licences and registrations current?

  • 7.8 Confined space procedures in place?

  • 7.9 Fall from height controls or procedures in place?

  • Comments/Additional safety items:

  • Items requiring attention referred to:

  • For action by:

  • Auditor signature

  • Auditee 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.