Title Page
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Date of Inspection including arrival time
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Job Name
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Location
Current Temp °C
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Forecast Conditions
- Fine
- Cloudy
- Sunny
- Showers
- Rain
- Thunderstorm
- Fog
- Snow
- Smoke Haze
- Windy
Current Conditions
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Observed site condtions
- Fine
- Cloudy
- Sunny
- Showers
- Rain
- Thunderstorm
- Fog
- Snow
- Smoke Haze
- Windy
STOP! HOLD POINT!
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Have you completed a Take 5 Risk Assessment?
Job Activities
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Is there traffic management in place?
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Do they have a MOA/TGS?
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Is the signage set out as per TGS?
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What works are taking place?
- Earthworks
- Pavement placement
- Concrete
- Asphalt
- Sealing
- Structures
- Other
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Describe what earthworks are taking place
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What material is being placed?
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What concrete works are taking place?
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What asphalt works are taking place?
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What sealing works are taking place?
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What structure construction is taking place?
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Are any ITPs or HPs released?
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Please explain reason for not releasing ITP/HP?
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Notes, conversations and other discoveries?
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Please note any conversations and or other discoveries?
Leave Site
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Date and time of departure from site?