Critical Safety Inspection

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

PERSONNEL INVOLVED

• Name the Personnel Involved In This Inspection

WORKING AT HEIGHT

• Do I have the correct WAH equipment and am I trained in its use?

  Yes

  No

  N/A

undefined

• Can I maintain 100% hook up when Working at Height?

  Yes

  No

  N/A

• Is the Ladder / Work Platform / MEWP I am using inspected and suitable for the task?

  Yes

  No

  N/A

• Are the Ground Conditions Suitable for the Ladder / Work Platform / MEWP?

  Yes

  No

  N/A

• Is an Exclusion Zone in Place?

  Yes

  No

  N/A

VEHICLES

• Do I have Safe Access to my Work Area?

  Yes

  No

  N/A

• Is there a Banksman in place for Moving Vehicles in my Work Area?

  Yes

  No

  N/A

• Are Moving Vehicles in my Work Area a Safe Distance from Personnel?

  Yes

  No

  N/A

• Do Moving Vehicles in my Work Area have Flashing Beacons and Reverse Beepers?

  Yes

  No

  N/A

DROPPED OBJECTS

• Are Personnel protected from Cranes Lifts via Banksman / Exclusion Zone?

  Yes

  No

  N/A

• Are Dropped Object Protection Measures such as exclusion zones, overhead gantries, catch platforms, signs, warning devices and traffic controllers in place?

  Yes

  No

  N/A

• Are any Potential Dropped Objects restrained from falling?

  Yes

  No

  N/A

ELECTRICAL ISOLATION AND EQUIPMENT

• Has All Equipment been Inspected and Pat Tested if Applicable?

  Yes

  No

  N/A

• Has the equipment I am about to work on been Isolated and Confirmed Dead?

  Yes

  No

  N/A

• Have I signed onto an Authorised Isolation Permit?

  Yes

  No

  N/A

• Has any Electrical Isolation been Confirmed Dead by an approved Voltage Detector?

  Yes

  No

  N/A

SUMMARY

• What needs to be done to rectify any Non-Compliances?