Title Page

  • Conducted on

  • Prepared by

  • Project Name

  • Location

Site Team

  • Project Manager

  • Site Manager

  • Site Supervisor

Minimum Requirement For Personal Protective Equipment

  • minimum ppe.jpg

Additional PPE Relating to Specific Task Today

  • Lifeline/Harness

  • Please make sure you carry out inspection before use and log information on correct sheet.

  • Over Goggles

  • Face Shield

  • Chemical Protection

  • Respirator

  • Please make sure you carry out inspection before use and log information on correct sheet.

  • Hearing Protection

  • Other

  • What other protection is required ?

  • List other PPE

  • Task Sequence
  • Job Steps

  • Take a picture to show works to be carried out

  • Are there any potential hazards

  • Please list all potential hazards

  • People At Risk

  • Current Risk

  • Critical actions to mitigate hazards

  • New Risk

  • Once task completed, take a picture to show area is clear

Acceptance Sign Off

  • Project Manager

  • Site Manager

  • Site Supervisor

  • If required ask the client to sign to agree to daily sequence

  • Client Representative

Operatives Sign On

  • We the undersigned have been fully briefed and understand the daily tasks and sequences.

  • Operative
  • Add signature

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.