H&S Safety Monitoring

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Health and Safety Equipment

• Where items should be used select YES if compliant, select NO if not compliant. Select N/A if not required. If NO attach relevant photos and notes as evidence

• High-visibility Garment

  Yes

  No

  N/A

• Safety Shoes

  Yes

  No

  N/A

• Safety Helmet

  Yes

  No

  N/A

• Fall arrest Equipment

  Yes

  No

  N/A

• Palm-coated Gloves

  Yes

  No

  N/A

• Protective Goggles

  Yes

  No

  N/A

• Traffic Cones

  Yes

  No

  N/A

• Electrically insulated Gloves

  Yes

  No

  N/A

• Other Items

Item

• Enter item name

• Is item complaint?

  Yes

  No

  N/A

• Remarks

Completion

• Add personnel signature

Name

• Site visit personnel

  Sign

• H&S specialist signature

  Sign