Title Page
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Site conducted
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Date and Time
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Task
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Work location
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Conducted on
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Prepared by
Material Loading/Unloading & Storage
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1. Will the load remain stable during transport?
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2. When a load restraint is removed, will the load remain stable?
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3. Are potential drop zones controlled to prevent unauthorized access by<br>pedestrians, truck drivers, etc?
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4. Are team members outside the line of fire if the load moves? i.e. load will<br>not hit or fall on them
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5. Is the equipment used to move material rated, safe for use and<br>appropriate for the task?
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6. Are all stacked materials stable and on a level surface?
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7. Are all stacked materials within height and load limits?
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8. Is all shelving and racking safe for use? i.e. inspected and free from<br>damage
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9. Are all securing and support devices (plastic wrap, strapping, pallets)<br>appropriate and safe for use?
Mechanical Integrity of Equipment at Heights
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10. Have equipment and fixtures (e.g. light fixtures, cable trays etc) in the<br>work area with the potential to fall been inspected and secured?
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11. Is equipment installed at height in a safe location? i.e. protected from<br>impact by equipment such as cranes or other work activities
Securing Devices
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12. Are securing devices adequate and safe for use? E.g. tie down straps,<br>lanyards, drop sheets/mats, kick rails
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13. Are all tools and equipment (including parts) secured to ensure they are<br>unable to fall?
Work Area Management
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14. Is the work area controlled to prevent all unauthorised access to the<br>potential drop zone of falling objects/materials at all levels? E.g. barricading,<br>segregation, spotter
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15. Have all other work activities in the area been checked to ensure they<br>are protected from falling objects? E.g. above, below, beside<br>
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16. Is the work area, including above and below, free from loose materials?<br>E.g. product build-up/carry back
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