General
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Site
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Document No.
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Prepared by
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Date
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Start Time
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Finish Time
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Address
Risk Assessment
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Have all workers been inducted to this site?
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Are you able to carry out site inspection?
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Are you in need of traffic control?
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Located Services (Gas, Electricity, Water, etc.)
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Is site free from rubbish and dangerous objects?
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Will you be working in confined spaces?
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Will you be working at heights?
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Will you be conducting any excavation?
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Is a safety helmet required?
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Is safety footwear required?
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Is eye protection required?
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Is hearing protection required?
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Are sun hats, sunscreen, and sunglasses required?
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Will you be using any hazardous substances?
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Do you have a copy of all SDSs used on site?
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Do you understand the First Aid and PPE requirements of all SDSs?
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Weather Conditions
- Yes
- No
- N/A
Jobs Performed
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What jobs have you completed?
Job
Personel
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Supervisor
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Add additional personnel
Crew Member
Vehicles
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What vehicles were used?
Vehicle
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Rego
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Rego
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Driver
Incident Register
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Are there any incidents to report?
Indicent
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Category
- Injury
- Incident
- Theft
- Altercation
- Near Miss
- Equipment Damage
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Who was involved?
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Details of incident
Site Issues
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Site Issues
Issue
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Description
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Supply a photo if nessessary
Client Section
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Was the job completed to the customer's satisfaction?
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Are there any future client requests?
Completion
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Is the Risk Assessment completed?
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Supervisor
