• Document No.

  • Audit Title

  • Work Order Number

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Planning (does the person....)

  • Ensure the people are competent to do the task

  • Inspect the area, tools and equipment before use

  • Identify and communicate any hazards or risks to fellow workers

  • Look at SWP or work instruction where available

  • Undertake a pre-start check

  • Identify permit requirement

  • Complete a Take-5/SWMS for the task

  • MSDS Available and has awareness of substances to be used

  • Identify the correct tools and equipment to carry out the task at hand

Body Posture (does the person....)

  • Position their body such that they avoid being struck, sprayed, crushed, pinned or in contact with a release of stored energy

  • Take care in looking where they are moving, walking or driving

  • Concentrate on the job at hand

  • Consider the general secure layout of the work area

Manual Handling (does the person....)

  • Lift correctly using their legs

  • Maintain balance, no over stretching or twisting whilst handling equipment

Driving and operating (does the person....)

  • Wear seat belts provided

  • Drive to the conditions of the roadways

  • Use the horn, indicators and lights as required

  • Use flagpole/whip aerial

  • Check to ensure emergency stop switches are working

Personal protecting clothing and equipment (is the equipment....)

  • In a good, clean state of repair

  • Worn as required and in line with identified inherent hazards

  • The correct type for the job at hand

Isolation and tagging (has the person....)

  • Applied positive isolation where required

  • Applied a danger/out of service tag as required

  • Used barrier tape or physical barriers where required

  • Additional behaviours to be observed:

  • Positive Feedback given to acceptable behaviours:

  • Feedback and action items raised to eliminate At-Risk Behaviours:

  • These items should be raised in the next toolbox meeting:

  • Signature of Observer:

  • If serious At-Risk Behaviour (eg breach of procedure) has been observed, refer matter to the Area/Depot Manager

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.