Audit

Lone Worker

Office notified and aware of return time

Mobile phone available

Other

Personal Protective Equipment

Hearing protection used

Safety boots used

Safety eye wear used

Hard hats worn

Safety vest worn and zipped up

Gloves used

Other

Manual Handling

Team lifting undertaken where applicable

Lifting equipment used

Manual Handling Training completed

Lightweight equipment used

Other

Dangerous Goods/Hazardous Substances

MSDS available and understood

SWMS relating to use prepared and understood

Safety eye wear worn

Half mask respirator worn

Gloves worn

Other

Environmental/Weather

Sunhat worn

Sunscreen

Sunglasses worn

Shelter from weather

Wet weather gear

Gumboots worn

Long sleeves worn

Other

Snakes/Spiders/Insects

Awareness of snakes/spiders/insects (refer to IRD-16, Guidelines for outdoor safety)

Gloves worn

Spider/insect repellent

Other

Traffic

Vehicle hazard lights

Witches hats

Safety vest worn

Parked in designated location/parking spot

Other

Public

Pedestrian warning signs

Site taped off

Other

Slips, Trips and Falls

Access to area via safest route, avoiding wet, muddy areas taken

Area kept clean and tidy

Other

Confined Space Associated

Permit

Permit number

Gas detector calibration expiry date

Call in process to OCC

Other

Plant & Equipment

Awareness of plant in vicinity

Tools & Equipment checked

Hard hats worn in vicinity of plant

Other

Other Works in Vicinity

Awareness of other works in vicinity which may have an impact

Contact made with others to ensure they are aware of you

Other

Electrical Cabinets

Understanding of what can and cannot be handled within

Call in process to OCC advising that access is required

Other

Fall from Heights

Barricades in position

Fall arrest harness used

Lad Safe system used

Lad Safe/harness system certified/current

Second person required

Gas detector used - opening wet well/MH

Fall protection device located in manhole

Other

Sign off

Are there other hazards?

If yes, what are they?

Is the job safe to proceed (if no, notify supervisor immediately)

Are all risks and controls communicated to attending personnel?

Add signature
Add signature
Add signature
Add signature

Notes