Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
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Contracting Company Name
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Technician Name
Section 1 - Take 5 & SWMS
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Has the Contractor completed an onsite hazard identification process? (for example Take 5, JSA etc.)
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Do all the environmental and/or work area safety issues identified (including identification of High risk Construction Work) have controls determined? Provide Photo
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Does the contractor have SWMS in place for all high risk construction work and has been acknowledged and signed by all workers?
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Has all applicable housekeeping (including barricade where appropriate) been completed and is the work zone free from obstructions that may result in slips, trips or falls?
