Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Please tick all appropriate boxes

  • Please fill out all answers and sign then send to administration

  • Am I correctly trained or supervised for this task?

  • Have I checked my Safe Work Method Statement, JSA that are applicable?

  • Do I have the correct tools for this task?

  • Are my tools in good condition?

  • Have I check and eliminated the risk of objects falling from heights?

  • Have I checked and eliminated the risk of slips and trips in the area?

  • Do I have the right PPE for the task?

  • If using a scissor lift, EWP or forklift do you have the appropriate license?

  • Have I confirmed I am not working live?

  • Am I using appropriate Lock Out Tag Out equipment for isolations

  • Have you checked and eliminated the risk of Asbestos, Dangerous goods or other chemical risks in the area?

  • Am I/we working at a height of less than 3 meters?

  • Is the pitch of the roof less than 30 degrees

  • Do you have a harness and is it in good condition?

  • Have I communicated any hazards (if any) to my employer?

Signatures

  • All personnel working must sign

  • Person
  • Please sign off

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.