Title Page

  • Conducted on

  • Prepared by

  • Location
  • Date:

  • Project

  • Client:

  • Project Number:

  • Contractor:

  • Time:

  • Site Conditions:

Safety:

  • Is all machinery fitted with flashing lights?

  • Are TTM’s in place?

  • Is signage in place and clear?

  • Are there any underground or overhead services?

  • Are stockpiles safe and stable?

Environmental:

  • Is an Environment Protection Agreement in place and is it being followed?

  • Are sediment controls in place and working?

  • Does sediment pond require pumping?

  • Is a procedure in place for testing and dosing before releasing

  • Is dust suppression sufficient?

  • Have stockpiles been temporarily grassed?

  • Are stockpiles clear of natural drains?

Clearing:

  • Have retained trees been fenced off?

  • Has all debris, trees etc been removed?

  • Has any timber fallen on neighbouring property?

  • Has the cleared material been disposed of in a satisfactory manor?

  • Has topsoil been stripped to bottom of grassroots zone?

General:

  • Are there any soft spots?

  • Are there any rocks protruding from the finished surface level?

  • Has topsoil been stripped to bottom of grassroots?

  • Does topsoil stockpile exceed 2.5m in height?

  • Does batter exceed 2:1?

  • Is blasting required?

  • Has unsuitable material been removed?

  • Has there been an NCR raised?

Compaction:

  • Has density testing been carried out and does it pass?

  • Is moisture content correct at time of compaction?

  • Does compaction comply with standard spec?

Subgrade:

  • Has the floor been cut to designed grade line?

  • Is there any unsuitable material?

  • Has remaining material in floor been ripped?

  • Is subgrade affected by moisture?

  • Is proof rolling required?

  • Has the subgrade been affected by moisture?

Testing:

  • Has correct frequency of testing been adhered to?

  • have test points been taken from correct area?

  • Are test results within tolerances given in standard spec?

  • Are there any non conforming areas?

  • Extra comments:

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.