Title Page

  • Site conducted

  • Date of Pre Site Assessment

  • Assessment completed by

  • Site Supervisor

  • Job Address

SITE

  • ● Have three or more re-estab pegs been located?

  • ● Is there an electricity pit on either boundary or center of the block?

  • ● Are overheads clear of powerlines so as not to require an elec permit to work?

  • ● Has all tree protection requirements been put in place if applicable ?

  • ● Has the owner provided a clean and clear site ready for work?

  • ● Has all footpath & crossover damage been recorded and photographed?

  • ● Is all boundary fencing restricting access from neighbours and pedestrians?

  • ● Has perimeter fencing been photographed and documented for damage?

  • ● Has a traffic management plan been put in place? (If required)

  • ● Is an LJH Coordination plan sign clearly visible and filled in on front fence?

  • ● Is an LJH advertising sign clearly visible and filled in on front fence?

  • ● Has adequate toilet amenities been organised?

  • ● Is a retaining wall required?

COMPLETION

  • Additional Comments

  • Name and Signature

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.