Site Information

  • Site Name

  • Site Address
  • Date

  • Site Auditor Name

  • Audit Reference Number

  • Site Contact name

  • Contact Phone Number

  • Principle Client / Contractor

  • Pure Power Engineer Name

  • Pure Power Job Number

Site Access Requirements

  • Site Induction Required

  • Site Induction Completed

  • Signed in with Site Security

  • Method & Risk Assessment Signed

  • Permits to Work

  • Hot Work Permit Required

  • Check Asbestos Register

  • Check Fire alarm Test date and time

  • Slip Trip Hazards Identified

  • Welfare Facilities Available

PPE

  • Hi Vis Jacket

  • Ear Defenders

  • Protective eyewear

  • Protective gloves

  • Safety Footwear

  • Safety Headwear

  • Protective clothing

  • Branded work shirt

First Aid / Accident Reporting / Fire and Emergency Assembly Measures

  • Engineer in possession of first aid kit

  • Engineer First aid kit expiry date

  • Engineer aware of location of first aid room

  • Engineer aware of accident reporting procedure

  • Engineer aware of fire and emergency assembly point

Engineer Appearance

  • Wearing Group Uniform

  • Uniform Clean

  • Uniform in good condition

  • Safety Foot Ware In Good Condition

Company Vehicle Checks

  • Vehicle External condition.

  • Vehicle Cabin Condition Clean.

  • Vehicle Pre Use Checks completed.

  • Tyre Condition

  • Materials Correctly Stored and secure

Electrical Tools and Hand Tools

  • Portable Electrical Tools PAT Test Valid

  • Portable Electrical Tools PAT Test Valid Date Valid

  • Electrical Tools In Good Working Condition

  • Hand Tools In Good Working Condition

  • Lifting Equipment in use

  • Lifting Equipment In Good Working Condition

Electrical Test Equipment

  • Electrical Test Equipment Brand

  • Electrical Test Equipment Model Number

  • Electrical Test Equipment Serial Number

  • Is the Electrical test equipment Calibrated

  • Electrical test equipment calibration Date

  • Electrical test equipment calibration required

  • Line Test Proving Unit accessible

  • Line Test Proving Unit Good Condition

Environmental and Waste Handling - - Waste Handling Number CBDU529812<br>

  • Arrangements for waste disposal

  • Housekeeping

  • Waste Oil Containment

  • Spill Kit Available

  • Noise Controls

  • Waste Note With Waste Oil

  • Waste handling note completed and attached

Competency <br>

  • Are the attending engineer/s trained and competent to carry out the tasks assigned?

  • Comments

  • 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.