Hitech Electrical Automation Take 5

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Job Number

• Job Number

Work Description

• Describe the work being carried out.

Equipment

• Equipment being worked on

Licence Number

• Electricians Licence Number

• Site Induction for workers current

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Adequate PPE (including sun protection)

  Yes

  No

  N/A

• Adequate training in safe use, clean-up and inspection of PPE?

  Yes

  No

  N/A

Risk Assessment

• Has risk assessment been Carried out at the start of the job

  Yes

  No

  N/A

Changes to Work Site or Job

• Have there been any changes to the worksite or job since the Risk Assessment was carried out?

  Yes

  No

  N/A

Drawings

• Any drawings or sketches that apply to the job

  Drawing

• Any pictures that apply to the job

  Media

• Text

Sign Off

• Risk Assessment Filled Out By

  Sign

• Electrical Worker In Charge

  Sign

• Electrical Worker

  Sign

• Electrical Worker

  Sign

• Electrical Worker

  Sign

• Electrical Worker

  Sign

• Electrical Worker

  Sign

• Electrical Worker

  Sign

• Site Manager or Supervisor/ Representative if Available

  Sign