Title Page

  • Inspection Date

  • Location

  • Enforcement Number:

  • Proposed Work Inspecting

  • Inspecting Officer/s

  • Property Owners

  • Owners Contacts

Risk Reduction Measures (internal)

  • Potential dangerous person or animal on site:

  • DO NOT ATTEND SITE

  • All inspecting officers wearing PPE?

  • Jacket or vest

  • Boots

  • Council Identification

Arrival Details:

  • Arrival time;

  • Site Hazards; are there any site specific physical hazards you can identify at the premise that risk reduction measures need to be implemented for, including potential dangerous dogs?

  • What is the risk?

  • What risk reduction measures have you implemented

  • Is anyone onsite?

  • Left business card

Caution

  • Identify yourself as Council Permit Authority and Show ID

  • Caution required?

  • CAUTION: in relation to any questions that I ask you, you have the right to remain silent.
    This means you do not have to answer any question that I ask unless you wish to do so. Anything you say may be later used as evidence.

  • Name of person/s onsite and caution provided too (if applicable)?

  • Phone number:

  • Email:

  • ID provided:

  • Person on site the owner

  • Name

  • Relation to owner

  • Phone number

  • Email

Planning items on site

  • Any recent removal of trees and shrubs

  • Any vehicular crossing updates

  • Any recent earth works undertaken

Structure 1

  • Type of Structure

Measurements

  • Height

  • Width

  • Length

Setbacks

  • Front

  • Rear

  • Right side

  • Left side

Decks

  • Is there a deck onsite

  • Highest part of deck

  • Lowest part of deck

  • Does the deck have a privacy screen

  • What is the height of the privacy screen

Habitable buildings

  • Is the building being used for habitable purposes?

  • Is there dwelling on site

  • Is the habitable floor area over 60m2

  • Are smoke alarms visible

  • Does the building have its own car parking space/s

Notes

  • Notes

  • Additional Photos

Structure 2

  • Is there another structure onsite

  • Type of Structure

Measurements

  • Height

  • Width

  • Length

Setbacks

  • Front

  • Rear

  • Right Side

  • Left Side

Decks

  • Is there a deck onsite

  • Highest part of deck

  • Lowest part of deck

  • Does the deck have a privacy screen

  • What is the height of the privacy screen

Habitable Buildings

  • Is the building being used for habitable purposes

  • Is there a dwelling onsite

  • Is the habitable floor area over 60m2

  • Are there smoke alarms visible

  • Is there any direct access to an adjoining storage/shed area

  • Does the building have its own car parking space/s

Notes

  • Notes

  • Photos

Permit Authority

  • Time inspection concluded

  • Permit Authority Signature

Notes

  • Notes

  • Photos

Permit Authority

  • Add signature

Habitable Building

  • Is the building being used for habitable purposes

  • Is there a dwelling on site

  • Is the habitable floor area over 60m2

  • Is there smoke alarms visible

  • Is there any direct access to an adjoining storage/shed area

  • Does the building have its own car parking space/s

Permit Authority

  • Time inspection completed

  • Permit Authority 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.