Title Page

  • Conducted on

  • Prepared by

  • Location
  • Customer:

  • Brief Scope of Work:

  • Inspection performed by: Date:

  • SITE AREAS INSPECTED:

  • INSPECTION SUMMARY AND IMPORTANT NOTES:

SAFETY ITEM CHECKLIST

Safety Item

  • 1. Site Entry

  • Corrective action taken

  • Details

  • 2. Transport

  • Corrective action taken

  • Details

  • 3. Fire Precautions

  • Corrective action taken

  • Details

  • 4. First Aid & Welfare

  • Corrective action taken

  • Details

  • 5. Site Conditions

  • Corrective action taken

  • Details

  • 6. Hazardous Materials

  • Corrective action taken

  • Details

  • 7. Safety Signs and Barriers

  • Corrective action taken

  • Details

  • 8. Personal Protective Equipment

  • Corrective action taken

  • Details

  • 9. Scaffolding & Workplace Access

  • Corrective action taken

  • Details

  • 10. Lifting Equipment

  • Corrective action taken

  • Details

  • 11. Asbestos Handling

  • Corrective action taken

  • Details

  • 12. Porttable Appliance in date

  • Corrective action taken

  • Details

  • 13. Electrical Apparatus fit for use

  • Corrective action taken

  • Details

  • 14. Machine Guarding

  • Corrective action taken

  • Details

  • 15. Abrasive Wheels & Discs

  • Corrective action taken

  • Details

  • 16. Compressed Gas Cylinders

  • Corrective action taken

  • Details

  • 17. Highly Flammable Liquids & Gases

  • Corrective action taken

  • Details

  • 18. Welding & Flame Cutting

  • Corrective action taken

  • Details

  • 19. Cartridge Tools

  • Corrective action taken

  • Details

  • 20. Confined Spaces

  • Corrective action taken

  • Details

  • 21. Permits to Work

  • Corrective action taken

  • Details

  • 22. Site Documentation

  • Corrective action taken

  • Details

23 other

  • Discription

  • Corrective Action

Sign off

  • Inspectors Signature:

  • Time completed:

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.