Title Page

  • job pack

  • Engineer's on site

  • Conducted on

  • Prepared by

  • Location
  • Street works number ( provided on permit board )

On site S.L.G

  • Are courtesy boards displayed .

  • Is correct permit number visible and are compliant to permit conditions

  • Are correct signs displayed

  • add photo of site set up

  • Are Traffic / Pedestrian segregation barriers fitted ?

  • Are barriers set up as per red book.

  • Is work area suitable size for working safely.

  • Is all equipment within working area

  • Is site free of trip hazards were possible

  • Are footway covers and ramps fitted with rubber edging

  • Are pedestrian control sign's in place

  • Is there safe walkway for pedestrians ( min 1.2m )

  • have provisions been made for wheel chair access

  • Are gdu's displayed .

  • Have roller bars been used .

  • Are adequate gate guards used.

  • Have adequate amount of sandbags been used.

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.