Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Job Number

  • Job Number

Work Description

  • Describe the work being carried out.

Equipment

  • Equipment being worked on

Licence Number

  • Electricians Licence Number

Administrative Procedures

  • Have obtained permits (Excavation, Hot Works, Confined Space etc)

  • Site Induction for workers current

Note - All risk scores are determined using ECA Safety Connect Risk Matrix

  • A222C752-96D4-428B-ABCB-787877F289D6
  • Attach Risk Matrix

Job Steps and Risk Scores

  • Job Steps

  • Job Step
  • Details for Job Step

  • Enter Hazards for the job

  • Hazard
  • Hazards for Job Step

  • Add media

  • Enter Control Prompt

  • Control Prompt
  • Control Prompt in use

  • Add media

  • Further control measures put in place to manage hazards.

  • Risk Score before control measures?

  • Risk Score after control measures?

Other Corrective Actions

  • Enter any corrective actions that will be undertaken

Drawings

  • Any drawings or sketches that apply to the job

  • Any pictures that apply to the job

  • Text

Sign Off

  • Risk Assessment Filled Out By

  • Electrical Worker In Charge

  • All persons to sign on

  • Worker
  • Worker

  • Site Manager or Supervisor/ Representative if Available

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.