Title Page

  • Site conducted

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

  • Personnel

Daily Work Summary

  • What type(s) of work are being performed today? Select all that apply.

  • Describe the other type of work being carried out today

  • Any issues or concerns with your working areas?

  • What information from the start rite meeting has to be passed on

  • Areas that are in commissioning today

  • Have the relevant daily pre start checks/ sheets been completed

  • VISITORS-any expected today?

  • DELIVERIES / COLLECTIONS

Today's Task Breakdown

  • Break today's work into individual step-by-step-tasks below. Assess each task for hazards and controls

  • Today’s planned works
  • Work task

  • Select potential hazards that may be encountered while completing this task today.

  • Describe the other potential hazards that may be encountered while completing this task today.

  • What categories of hazard control will you apply to this task?

  • What specific controls will you apply to the above hazards for this task?

  • Describe any other specific controls will you apply to the above hazards for this task.

  • Items of PPE required for the task

  • Describe any other PPE that is required

Final Checks

  • Does every member of the on-duty crew have adequate and appropriate PPE for today's work tasks?

  • REMEMBER, if you feel anything is unsafe or you are unsure of the process. STOP and ASK

Crew Sign Off

  • Each present team member to sign name and signature acknowledging the above tasks, hazards and controls.

  • Team Member
  • Add signature

Sign off

  • Name

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.