Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Daily Work Summary

  • What type(s) of work are being performed today? Select all that apply.

  • What do you expect to achieve by the end of the day?

  • Any issues or concerns?

  • Is this scaffolding designed / TG20?

  • If designed, what is the design number?

  • DELIVERIES / COLLECTIONS -

Today's Task Breakdown

  • Break today's work into individual step-by-step-tasks below. Assess each task for hazards and controls

  • Work Task
  • Describe this task

  • What category does this task fall under?

  • Select potential hazards that may be encountered while completing this task today.

  • Describe the other potential hazards that may be encountered while completing this task today.

  • What categories of hazard control will you apply to this task?

  • What specific controls will you apply to the above hazards for this task?

  • Describe any other specific controls will you apply to the above hazards for this task.

Final Checks

  • Does every member of the on-duty crew have adequate and appropriate PPE for today's work tasks?

Crew Sign Off

  • Each present team member to sign name and signature acknowledging the above tasks, hazards and controls.

  • Team Member
  • Name & 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.