Information

  • Document No.

  • Location
  • Conducted on

  • Site scenario

  • Supervisor

  • Supervisor signature

  • Engineer inspected

  • Engineer signature

  • Compliance Key 1=Acceptable 2=Good practice/Breach of company procedures 3=Risk of improvement notice/Reportable injury 4=Risk of prosecution notice/Fatality major injury N/A

  • Hard hat and chin strap

  • High vis jacket

  • Safety footwear

  • Hearing protection

  • Eye protection

  • Respiratory protection

  • Gloves worn where required

  • First aid kit meets legal requirements

  • Plant, Equipment, Specifically Ladders and Tools are being used safely and are in acceptable condition.

  • Harness is being used correctly, stored safely and are in acceptable condition

  • Suitable barriers and signage is in place where required, position and clarity

  • Risk Assessment and Method Statement are completed prior to work commencing

  • Good house keeping and waste disposal

  • Asbestos precautions are being followed

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.