Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Area and day plan, was daily tailgate attended?

  • Operators name

  • Hazards - Winch assistance must be used when working on slopes over 30 degrees working on soft or wet ground conditions. ONE TICK IN THE RED AREA OR 3 TICKS IN THE YELLOW AREA SEEK ADVICE OF A COMPETENT PERSON.

  • Slope & Length

  • Ground conditions

  • Soil type

  • Duration of exposure

  • Environmental factors

  • Bush type

  • In stand vegetation

  • Is winch assist used today? If the answer is yes please answer the questions in the next section. If not this inspection is complete here, sign off below

  • Sign off

Winch assist

  • Daily winch machine / tethered machine checklist

  • Is the winch machine dug in correctly & tested?

  • Winch machine electrics & switches all in working order?

  • Remote controls working

  • Emergency stop tested and working?

  • Ropes, shackles & attachments all checked for wear?

  • All warning alarms & systems in working order?

  • Comments

  • Add photos here if required

  • Operator to sign off this section here

Winch shift section

  • Shift number?

  • Is the winch machine dug in correctly & tested?

  • Winch machine electrics & switches in working order

  • Remote control working

  • Emergency Stop tested and working

  • Rope, Shackles & attachments checked for wear

  • All warning alarms and systems in working order

  • Comments

  • Operator sign off here

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.