General
Weather (Previous 24hrs)
Weather (Current)
Who is Undertaking the activity?
Name of Contractor and Subcontractor:
What is the activity being observed?
Does the activity involve high risk construction work?
Observations from the activity
Please provide a brief description of what is happening?
Is there a Safe Work Method Statement (SWIMS) available for the activity?
Has the SWIMS been approved for use?
Does the SWIMS capture all hazards present at the time of the observation?
Does the SWIMS appear to be adequate?
Is any work being undertaken in or near a confined space? If so, are appropriate measures in place?
Is the work being conducted according to the SWIMS? If no, list the differences.
What positive observations have been made?
Comments and actions
General comments
Note name and position of personal spoken to as part of the observation?
Are they aware of any additional (e.g. site specific) hazards not covered in SWIMS?
Are control measures in place to minimize the risk from additional hazards?
Note Feedback and general comments
Confirm Feedback has been provided?