IPD Consulting Prestart Checklist

• Document No.

• Task

• Internal Job Number

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Other Personnel

Overview of works

• Please provide a brief overview of purpose on site

Please if any of the following risks are present. Are there:

• Members of the public?

  Off

  On

• Overhead lines? (power, telecommunication)

  Off

  On

• Underground structures?

  Off

  On

• Live excavations?

  Off

  On

• Unstable ground conditions?

  Off

  On

• Confined spaces?

  Off

  On

Please indicate if any of the following risks are present. Is there:

• Hot Works?

  Off

  On

• Working at heights?

  Off

  On

• Open trenches?

  Off

  On

• Manual handling?

  Off

  On

• Demolition of load bearing structures occurring?

  Off

  On

• Possible disturbance of asbestos?

  Off

  On

• Use of a temporary structure to prevent collapse?

  Off

  On

• Use of explosives, harmful chemicals or pressurised gas?

  Off

  On

• Bodies of water?

  Off

  On

• Machinery and/or vehicles operating in the area?

  Off

  On

Please indicate if you consider yourself to be at risk of any of the following hazards.

• Heights

  Off

  On

• Electricity

  Off

  On

• Sharp objects

  Off

  On

• Wet or slippery surfaces

  Off

  On

• Gasses

  Off

  On

• Dust

  Off

  On

• Underground utilities

  Off

  On

• Overhead obstructions/lines

  Off

  On

• Hazardous substances

  Off

  On

• Working in isolation

  Off

  On

• Ignition sources

  Off

  On

• Manual handling

  Off

  On

• High pressure

  Off

  On

• Machinery

  Off

  On

• Ground openings

  Off

  On

• Animals or pests

  Off

  On

• High voltages

  Off

  On

• Confined spaces

  Off

  On

• Adverse weather conditions i.e. sun rays

  Off

  On

• Pollution

  Off

  On

• Other hazards/

Please indicate any Control measures in place

• UV Protection

  Off

  On

• Designated work areas

  Off

  On

• Useage of PPE

  Off

  On

• Signage, screens and barricades

  Off

  On

• Isolation

  Off

  On

• Spotters

  Off

  On

• Lighting

  Off

  On

• Fall arrest

  Off

  On

• Fire blankets and extinguishers

  Off

  On

• Gas detection

  Off

  On

• Supervision of public

  Off

  On

• Other control measures

Please indicate to show the following steps have been completed.

• Are there any other hazards? Are there safety and environmental hazards? If yes leave description in notes, take photos and provide action items.

  Off

  On

• Is the job safe to proceed? If no alert supervisor.

  Off

  On

• Have all controls been communicated to necessary site personnel?

  Off

  On

• Add any important job-site photos

  Media

Further comments

• Please add any further comments

Sign off

• Team member 1

  Sign

• Team member 2

  Sign

• Team member 3

  Sign

• Team member 4

  Sign

• To be signed by auditor, deeming the job site to be safe for inspection.

  Sign