Title Page

  • Job Reference

  • Site Address

  • Client

  • Description of the works

  • Date and Time

  • Prepared by

  • Location
  • Personnel

PLAN

  • RISK ASSESSMENTS AND METHOD STATEMENTS: Select standard RA/MS relevant to this task

  • CAPABILITY: Have you got the necessary skills, knowledge, experience and training to carry out the task safely?

  • LONE WORKING: Can the work at this property be carried out safely alone?

  • EQUIPMENT: Have you got the necessary equipment in good condition to carry out the task safely?

  • ASBESTOS: Have you got the necessary information about asbestos related to the job so that you can carry out the task safely?

  • WORK AT HEIGHT: Do you have the correct work at height equipment to carry out the task safely?

  • PERSONAL PROTECTIVE EQUIPMENT: Have you got the necessary personal protective equipment (PPE) in good condition to carry out the task safely?

  • WELFARE: Have you got access to the appropriate welfare facilities to carry out the task without risk to your health?

  • FINAL CHECK: Do you have everything you need to undertake the work without, so far as is reasonably practicable, exposing yourself or anybody else to a health and safety risk?

  • If you have answered NO to any of the above questions do not undertake the task

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.