Title Page
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Site inspected
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Conducted on
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Observed by
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Completed by
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Specific Location (include What3Words if necessary)
Positive Intervention Information
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What was observed? What was the positive intervention?
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Is there any photographic evidence?
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Who was it raised to?
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Was it escalated correctly?
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Did the operatives involved have the correct training in place, were they inducted?
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Were there Task Briefings / Lift Plans in place for the works? Do they require a review?
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Were the correct tools and equipment in place to undertake the works correctly?
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Were Daily Briefings completed and signed?
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Was a POWRA required?
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What were the environmental conditions like, did this impact what was observed?
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How will they prevent a reoccurence?
Signatures
Project Engineer/Site Foreman Signature
H&S Safety Signature
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Add signature
Project Manager Signature
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Add signature