Title Page

  • Date

  • Site

  • Inspector

  • Sub Contractor name

  • Operatives on site (names)

  • Project Manager

  • Project Number

  • Specific Activity

  • Scope of works

1. RA's & MS's

  • Site specific and cover applicable hazards, signed by all

2. Training and Competence

  • Check competencies and cards ....

  • Advice Provided:

3. Access / Egress

  • Attendance register signed, ....

  • Advice Provided:

4. Housekeeping

  • Clean and clear site, no littering, backfill .....

  • Advice Provided:

5. PPE

  • Head protection, safety footwear / wellingtons....

  • Advice Provided:

6. Environmental

  • Spill kits available, plant nappies, drip trays, waste .....

  • Advice Provided:

7. Site security

  • Access secure, unauthorised access prevented ...

  • Advice Provided:

8. Inductions

  • All inducted and aware of "10 Golden Site Rules" ....

  • Advice Provided:

9. Documentation

  • Documents in use, RAMS, Permits, job pack .....

  • Advice Provided:

10. Technical Detail

  • Electrical Installation, Water Installation, Gas installation, Cable installation

  • Advice Provided:

11. Traffic Routes

  • Traffic management in place ....

  • Advice Provided:

12. Signs and Notices

  • Are appropriate signs in use ......

  • Advice Provided:

13. Welfare

  • Adequate toilets, washing facilities .....

  • Advice Provided:

14. Permits

  • Digging/ excavation, hot work ...

  • Advice Provided:

15. Lifting Ops

  • Banksman in use, lifting plan .....

  • Advice Provided:

16. Electrical Equipment

  • PAT completed, expired, checks done ...

  • Advice Provided:

17. CoSHH/ Asbestos

  • Assessments available ........

  • Advice Provided:

18. Vehicles

  • Inspection/ examination cert available ....

  • Advice Provided:

19. Work at Height

  • Barriers around open excavations ......

  • Advice Provided:

20. Equipment

  • Tested, serviced, certs in date?

  • Advice Provided

21. Lighting

  • Is there adequate lighting?

  • Advice Provided

22. Emergencies

  • Are the suitable and sufficient emergency arrangements in place?

  • Advice Provided

23. Plant

  • Is all plant suitable for the task? Have all checks been carried out? Are the service and maintenance records in date?

  • Advice Provided

24. Excavations

  • Is there safe access and egress? Is the support suitable and sufficient? Have checks been carried out?

  • Advice Provided

25. Material Storage

  • Are materials stored safely?

  • Advice Provided

26. Incident

  • Is the site incident free?

  • Investigate

27. Other

Sign Off

  • Person Informed

  • Signature

  • Select date

  • Name of Advisor

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.