DI SAFETY

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

SAFETY CHECK

• Add location
  Address

• Select date

  Date

• Have start cards been filled out and completed by all employees/contractors?

  Yes

  No

  N/A

• Are all staff inducted?

  Yes

  No

  N/A

• Relevant SWMS and FSA packs have been signed by all relevant staff onsite?

  Yes

  No

  N/A

• Are barricades used correctly?

  Yes

  No

  N/A

• Has the site been set up as per traffic management set out in FSA Pack?

  Yes

  No

  N/A

• GAS detector, First Aid kit, Sharp Disposal Kit, MSDS, and other relevant safety gear in good working order and calibrated?

  Yes

  No

  N/A

• Are Stanley knives being used?

• Comments?

  Safe

  At Risk

  N/A

• Have amnesties been identified?

  Yes

  No

  N/A

PPE

• Has all relevant PPE been set in place as per SWMS?

  Yes

  No

  N/A

QUALITY CHECK

• Mandrels being used?

  Yes

  No

  N/A

• Is general house keeping being practiced?

  Yes

  No

  N/A

EMERGENCY RESPONSE

• First Aid Officer onsite?

• First Aid location?

  Yes

  No

  N/A

• Environmental Hazards being disposed off accordingly?

  Yes

  No

  N/A

IMAGES

• BARRIERS

  Media

• Traffic management

  Media

• Start Cards

  Media

Signatures

Safety Representative

• Add signature

  Sign

Employee/contractor

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign