Title Page

  • Conducted on

  • Prepared by

  • Location
  • 1 Steps and ladders, inspected, tagged, used appropriately?

  • 2 Tower scaffold, PASMA, used appropriately?

  • 3 MEWP, IPAF, 6 month check, harness?

  • 4 Working At Height - safe, edge protection in place?

  • 5 Epix work sheet completed, RAMS book present & referred to?

  • 6 All work equipment listed on the work equipment register?

  • 7 Tools PAT tested and / or calibrated within the last 12months?

  • 8 Vibration and noise controls held, understood and adhered to?

  • 9 Is the operative clean shaven with tested/suitable RPE in place?

  • 10 Are suitable controls in place for asbestos?

  • 11 Has the engineer read the asbestos survey report and can they accurately identify where it is located?

  • 12 Has the engineer suitably controlled all risks from the task / workplace?

  • 13 Is the engineer working safely?

  • 14 Does the operative have current company ID card with training in date?

  • 15 Is the engineer suitably competent for the works being undertaken?

  • 16 Is the first aid kit present and in date?

  • 17 Is the engineer well presented and courteous? Is the correct PPE being worn incl. task specific PPE, such as hard hat, gloves, RPE etc.

  • 18 Any reports of Near Miss submitted by engineer?

  • Signature

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