Title Page

  • Project Name/ #

  • Location
  • Weather Conditions

  • Prepared by

  • Supervisor in charge

  • Conducted on

Details/ Emergency/ Checklist

  • Instructions:
    -------------------------------------
    1. Fill out the details needed and answer "Yes", "No", "N/A" for the questions below.
    2. Add photos and notes by clicking on the paperclip icon.
    3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF, Word, Excel or Web Link.

Details

  • Summary of work activities:

Emergency Response

  • Location of evacuation assembly point:

  • Location of first aid kit:

  • Sufficient spill kits/ rescue kits as per site plan

  • Location of emergency equipment / fire extinguisher:

  • Nominated First Aider name:

  • First Aider’s phone number:

  • Closest Hospital:

  • Emergency phone number/s:

  • Location of SDS:

Daily Site Inspection Checklist

  • Access clear, paths are free from trip hazards

  • Adequate access lighting in confined spaces

  • Barricades and Signs as required

  • Dust Controls

  • Earth Leakage supplied

  • Fire Extinguisher accessible

  • First Aid Kit Accessible

  • SDS for all chemicals onsite

  • Chemicals safety stored

  • Environmental controls in place, eg. mesh

  • All staff are authorised onsite

  • Manual Handling techniques used for tasks

  • Noise controls

  • Housekeeping, Bins supplied.

  • Rubbish/ Waste Removal plan

  • Correct tools and machinery used for tasks

  • PPE worn and in good condition

  • Required Permits are onsite

  • Trenches secured

  • Equipment inspected with current test & tag

  • Plant and Machinery inspected & maintained

  • Car parking is safe for pedestrians/ emergency access clear

  • Please proceed to the next section.

Risk Identification

Potential Hazards

  • Are there Potential Hazards Identified (Q/S/E)?

  • Potential Hazards: (Click "Add Hazard")

  • Hazard
  • Specify Hazard:

  • Task:

  • Risk Rating:

  • Control Measures

  • Risk Rating after control measures:

  • Is there another potential hazard identified?

  • Please scroll back and click "Add Hazard".

  • Complete the inspection by signing below.

  • COMPLETED BY:

  • STAFF SIGN OFF: (Click "Add Staff")

  • Staff
  • I UNDERSTAND MY ROLE AND SAFETY OBLIGATIONS AND SHALL COMPLY WITH THE SAFETY, HEALTH AND ENVIRONMENTAL WORK METHOD STATEMENT.

  • Hours Worked:

  • Click + icon to add another staff, if you're done please mark this Audit as complete.

  • Is there another potential hazard identified?

  • Please scroll back and click "Add Hazard".

  • Complete the inspection by signing below.

  • COMPLETED BY:

  • STAFF SIGN OFF: (Click "Add Staff")

  • Staff
  • I UNDERSTAND MY ROLE AND SAFETY OBLIGATIONS AND SHALL COMPLY WITH THE SAFETY, HEALTH AND ENVIRONMENTAL WORK METHOD STATEMENT.

  • Hours Worked:

  • Click + icon to add another staff, if you're done please mark this Audit as complete.

  • Complete the inspection by signing below.

  • COMPLETED BY:

  • STAFF SIGN OFF: (Click "Add Staff")

  • Staff
  • I UNDERSTAND MY ROLE AND SAFETY OBLIGATIONS AND SHALL COMPLY WITH THE SAFETY, HEALTH AND ENVIRONMENTAL WORK METHOD STATEMENT.

  • Hours Worked:

  • Click + icon to add another staff, if you're done please mark this Audit as complete.

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.