Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
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Task / Activity Description
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Persons Involved
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Is the employee/contractor performing the task trained and authorised in the use of the tools and equipment?
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Are all the correct tools and equipment available to perform the task?
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Are the correct tools and testing devices for the job at hand being used and safe for use?
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Are the tools/equipment safe to work on and in good condition?
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Are the tools/equipment checked prior to use?
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Are tools/equipment used according to procedure?
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Is the correct PPE being used while using the tools/equipment?
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Is the work area in clean and safe condition?