Title Page

  • Site location
  • Day conducted

  • Prepared by

  • Gang ID number:

TO BE CHECKED BY COMPETENT PERSON

  • Is the relevant work stream manual on site?

  • Is the work area free from slip/trip hazards?

  • Has a daily check / visual inspection taken place on all plant to be used?

  • All SLG to code of practice? (Insert applicable C.O.P. page No)

  • One gang member holds the required NRSWA unit for the work activity?

  • Is all the relevant PPE to be used in good condition?

  • Are all control measures in place as per the generic based RAMS?

  • Is the material storage safe and the site security adequate?

  • Do operatives on site have the appropriate PPE?

  • Is an adequate safety zone in place for lifting operations?

  • Can the minimum separation to overhead power lines be maintained?

  • Is all lifting equipment certified and fit for purpose?

  • Are the GDU in calibration? Date:

  • Can the site be secured ? 360 guarded

  • Has a daily check / visual<br>inspection taken place on<br>all plant to be used?

  • Do operatives on site<br>have the appropriate<br>accreditation?

Lead engineer name

  • Add signature

Personal 1

  • Add signature

Personal 2

  • Add signature

Personal 3

  • Add signature

Additional information

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