Daily JSA

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Daily Site Inspection

• Inspection carried out at the following time

  Date

Alcohol and drugs

• Do you believe any one employed or contracted by Lifestyle windows is affected by the use of alcohol or drugs

  Yes

  No

  N/A

• If yes to the above has that person been excluded from site and transport

  Yes

  No

  N/A

• Is there any reason you believe one of your fellow workers should not be on site today

  Yes

  No

  N/A

• Have you reported this to your area supervisor

  Yes

  No

  N/A

• Is there any reason you believe one of your fellow workers should not be on site today

  Yes

  No

  N/A

• List reason here

Site conditions

• Has site conditions changed from the last visit

  Yes

  No

  N/A

• Is the site access safe and free of trip hazards

  Yes

  No

  N/A

• Is the work area safe and free of any hazards

  Yes

  No

  N/A

Notes

• Please add any notes to the black place provided below and make sure any hazards or concerns are listed and dealt with before work starts

Acknowledgements

• Assessment carried out by

  Sign

• Name