Title Page
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Document No.
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Company representative:
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Client / Site Representative:
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Conducted on
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Prepared by
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Location
General
GENERAL
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Have all electrical sources been identified for the project?
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Have risk assessments been undertaken where required?
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Have risk controls been implemented following the hierarchy of controls (Elimination, Engineering, Isolation, Substitution, Administrative, PPE)?
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Have workers been consulted and/or trained on electrical hazards and risk control outcomes?
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Have other relevant duty holders been consulted and/or trained on electrical hazards and risk controls?
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Is there a policy in place to ensure that electrical work will only be undertaken when de-energized?
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If No, list the controls that will be in place to address electrical risks for persons working on live electrical installations:
- Power isolated to specific circuit/s
- Warning tags installed to live circuits.
- Lock out of electrical service cupboard.
- All duty holders and workers informed of isolation period.
- All power isolated to property while work is being undertaken.
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Is there a nominated person to ensure that all inspections are undertaken as required (visual and testing)?
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Is all work defined as electrical work undertaken by a qualified person (licensed electrician)?