Personal

Inspection Information

Work Description

Worksite Location:

Inspection Completed By:

Inspection date:
Persons On Site:

Contractors:

Contractors on worksite

Contractor name and induction card number:

Systems

1.0 Health and Safety Systems

1.1- Staff on site appropriately trained for task?

1.2- Staff appropriately trained for plant and equipment on site?

1.3- Risk assessment completed and sighted?

Enter JSEA & High Risk Work Order number

1.4- Permits obtained- Trench and shoring/ confined space entry/ road opening/ spotter

1.5- Traffic management:

Appropriate signage and barricades in place for traffic and pedestrians.

Footpaths and roads clean and free from debris?

Comments:

2.0 Housekeeping

2.1- Work areas free from rubbish and obstruction?

2.2- Stock/ materials stored safely?

Plant/Equipment & Excavations

3.0 Mobile Plant and Equipment

3.1- Plant and equipment in good condition

3.2 Weekly safety inspection procedures/ checklists/ SWL of lifting equipment inspected?

Comments:

4.0 Excavations

Excavations

4.1 Trench depth. M (if =or > 1.4m Notification to be submitted)

4.2 Trench safe i.e. top clear of materials, benched if required, supports suitable if required.

PPE & Manual Handling

5.0 Personal Protection

5.1 Employees wearing PPE - boots/ vests and done up/ helmets/ ears/ eyes?

Comments:

6.0 Manual Handling

6.1 - Mechanical aids provided and used?

Confined Spaces & Asbestos

7.0 Confined Space

Confined Space

7.1- Risk assessment undertaken/ Communication and rescue plan in place/ Safety equipment in good working condition?

7.2 Communication and rescue plan in place?

7.3 Safety equipment in good working condition?

Comments:

8.0 Asbestos

Asbestos material present

8.1 PPE worn as required?

8.2 AC wrapping correct?

8.3 AC carting correct?

8.4 Spoil sorted correctly?

Comments

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.