Daily Pre-Start Safety Inspection

• Client

• Site code

• Conducted on

  Date

• Prepared by

Daily Work Summary

• Describe the works to be undertaken today

Identify structure type

• Structure present on site

  Rooftop

  Roadside

  Climable tower

  Non-climable tower

• Access method to structure

  Select Climable EWP Scaffold Ground level worksite - n/a Safe access to roof available - n/a

  • Climable
  • EWP
  • Scaffold
  • Ground level worksite - n/a
  • Safe access to roof available - n/a

• Is a scaffold tag attached and valid?

  Yes

  No

• Please stop work and contact your manager. Do not continue to use the scaffold.

• Is the main scaffold secured correctly?

  Yes

  No

• Please stop work and contact your manager. Do not continue to use the scaffold.

• Do you feel comfortable and competent working from this scaffold?

  Yes

  No

• Please stop work and contact your manager. Do not continue to use the scaffold.

• Is the footing of the scaffold on solid, level ground?

  Yes

  No

• Please stop work and contact your manager. Do not continue to use the scaffold.

• Is the safety system valid?

  Yes

  No

  N/A

• Please provide comments on safety system for review

• Are the weather conditions appropriate to climb?

  Yes

  No

• EWP type

  Select Crane Scissor Lift Boom Cherry Picker

  • Crane
  • Scissor Lift
  • Boom
  • Cherry Picker

• Check EWP is in good working order

  Yes

  No

• Please provide comments on EWP condition for review

Today's Task Breakdown

• Use this section to describe the work planned for today and assess the risks, hazards and controls.

Work Task

• Describe this work to be completed today

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

  Select Fall / Gravity Radiation Equipment Issues Electricity Sharp Objects Slippery / Wet Surfaces Dust Overhead Obstructions Hazardous Substances / Chemicals Manual Handling Animals / Pests Weather Conditions Members of the Public Noise OTHER

  • Fall / Gravity
  • Radiation
  • Equipment Issues
  • Electricity
  • Sharp Objects
  • Slippery / Wet Surfaces
  • Dust
  • Overhead Obstructions
  • Hazardous Substances / Chemicals
  • Manual Handling
  • Animals / Pests
  • Weather Conditions
  • Members of the Public
  • Noise
  • OTHER

• 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?

  Select Elimination - Remove the hazard Substitution - Replace the hazard Engineering - Isolate people from the hazard Administrative - Change the way people work PPE - Protect workers with personal protective equipment

  • Elimination - Remove the hazard
  • Substitution - Replace the hazard
  • Engineering - Isolate people from the hazard
  • Administrative - Change the way people work
  • PPE - Protect workers with personal protective equipment

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

  Select Trained and Competent Team Members Application of PPE RF Monitor Fall Arrest Spotters Fall Restraint Fire Extinguishers & Rescue Kit Antenna Outage Requested Re-certifying Safety System Designated Work Areas - Barriers Signage OTHER

  • Trained and Competent Team Members
  • Application of PPE
  • RF Monitor
  • Fall Arrest
  • Spotters
  • Fall Restraint
  • Fire Extinguishers & Rescue Kit
  • Antenna Outage Requested
  • Re-certifying Safety System
  • Designated Work Areas - Barriers
  • Signage
  • OTHER

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

Final Checks

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

  Yes

  No

• Are there any new hazards on site not covered under the SWMS?

  Yes

  No

• Please confirm you have updated the SWMS

  Yes

  No

Crew Sign Off

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

Team Member

• Name & Signature

  Sign