Information

  • Project/Job

  • Add media

  • Conducted on

  • Prepared by

  • Location
  • Personnel

WORK AREAS

  • A. General Housekeeping

  • B. Walking - Working Surfaces

  • C. Unprotected Edges or Holes

  • D. Materials Storage

  • E. Bin accessible and in close location to block work

PERSONAL PROTECTIVE EQUIPMENT

  • A. Hard Hats

  • B. Face Shield / Goggles

  • C. Respiratory Protection (If Required)

  • D. Hearing Protection

  • E. Clothing (Hi Vis)

  • F. Foot Protection (steel caps)

TOOLS EQUIPMENT AND ELECTRICAL

  • A. Power Tools

  • B. Inspected (in test date)

  • C. In Good Condition

  • D. Other:

  • E. Tag Out

  • F. Extension Cords

  • G. Lock box tidy

  • Add media

SCAFFOLD

  • A. Platform Deck 4 planks wide

  • B. Level Footing/Set up

  • C. Setup correct (pins secured correctly)

  • D. Not overloaded

  • E. General Inspection

  • F. Mobile scaffold setup correctly and safely

  • G. Ladder setup and being used correctly for scaffold access

Communication

  • A. MSDS on Site

  • B. SWMS on site

  • C. Has site foreman requested SWMS and MSDS from Head Office

  • D. Site plans (current up to date)

OTHER

  • A.

  • B.

  • C.

  • D.

Comments/Recommendations

  • Enter any corrective actions that will be undertaken

Sign Off

  • Site foreman

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

  • Bricklayer/labourer

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.