Downer Record Of Safety Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Safety Helmet

• Make :

• Serial Number

• Date of Issue:

• Manufacture Date:

• Passed

• Comments / actions

Safety Harnes

• Make :

• Pole Strap Date:

• Replacement Date:

• Serial Number

• Passed

• Comments / actions

Extension Ladder

• Fibreglass

• Wooden

• Combination

• Manufacturer

• Ladder length

• Manufacture Date:

• ID Number

• Passed

• Comments / actions

Extension Ladder 2

• Fibreglass

• Wooden

• Combination

• Manufacturer

• Ladder length

• Manufacture Date:

• ID Number

• Passed

• Comments / actions

Step Ladder

• Fibreglass

• Wooden

• Metal

• Manufacturer

• Ladder length

• Manufacture Date:

• ID Number

• Passed

• Comments / actions

• Inspector:

• Add signature

  Sign

• Select date

  Date

• Owner:

• Add signature

  Sign

• Select date

  Date