NC0005

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General overview of added Hazards

• Add media

  Media

• Is PPE available for equipment operations?

  Yes

  No

  N/A

• Are there controls for working at heights? Eg roof access instructions in use, safety equipment available or ladder brackets in place?

  Yes

  No

  N/A

• Is there contractor safety management practices apparent on site? Eg hazard register clearly displayed where there is a hazard on site or attendance register with safety sign on site?

  Yes

  No

  N/A

• Are there measures to reduce risk of pedestrian injury from vehicle? Eg speed limit signage at start of driveway or 'look out for pedestrians' signage where applicable?

  Yes

  No

  N/A

• Is there a roof access system, is there annual certification and clear instruction for use?

Access system

• Record date

• Record type

CHEMICAL HAZARDS

• If present, are flammable materials correctly stored within property?

  Yes

  No

  N/A

• Is there any evidence of chemical dangers within property?

  Yes

  No

  N/A

• Are biological or medical dangers nullified or absent from property? Eg waste from medical or dental practice.

  Yes

  No

  N/A

• Is the property low risk for dangerous fumes? Eg Monoxides from Carpark.

  Yes

  No

  N/A

MECHANICAL HAZARDS

• Is property free from mechanical hazards, protrusion, piercing, cutting, or overhead hazards etc? Eg broken fencing or gates.

  Yes

  No

  N/A

• Is property free of risk from plant and machinery?

  Yes

  No

  N/A

ELECTRICAL HAZARDS

• Does the site have current protection on common power?

  Yes

  No

  N/A

• Is property free of risk from poor electrical installation? Eg meter board, ariel wiring.

  Yes

  No

  N/A

• Is equipment tested and tagged?

  Yes

  No

  N/A

• Is the electrical plant facility free of need for a thermal scan?

  Yes

  No

  N/A

INSURANCE RISK ASSESSMENT

• Is property free of risk of possibility of water leaks (flooding) causing damage? - drain, sump, broken gutters, retentions.

  Yes

  No

  N/A

• Is lighting adequate in common areas where a slip, trip or fall may occur?

  Yes

  No

  N/A

• Is property free from surfaces that may cause a slip, trip or fall?

  Yes

  No

  N/A

• Is property free of risk from combustible opportunity?

  Yes

  No

  N/A

• Is property free of risk of flood damage from burst pipe? Eg bad corrosion or signs of leaking from pipes.

  Yes

  No

  N/A

• Is property free of risk of cutting by glass? Eg broken windows or dumped window panes/broken glass.

  Yes

  No

  N/A

• Is property free of risk of impact damage by vehicles or pedestrian traffic? Eg bollards protecting buildings and fittings such as downpipes.

  Yes

  No

  N/A

• Are steps well defined and of consistent height?

  Yes

  No

  N/A

• Is balustrade higher than 1000mm or 850mm on stairs? Is there a ladder effect with horizontal beams or large gaps which may be climbed over or fallen through by a child?

  Yes

  No

  N/A

• Is property free of risk from protruding hazard tags that may pierce and cause harm?

  Yes

  No

  N/A

• Is property free of risk of falling objects? Eg branches from large trees or building pieces loose.

  Yes

  No

  N/A

• Is the property free of structural damage that may deteriorate or worsen over time? Eg cracks in dwelling or other structures such as fences or retaining walls.

  Yes

  No

  N/A

ADDITIONAL NOTES ON PROPERTY

• Is the property free of any other faults or issue not listed above?

  Yes

  No

  N/A

• Additional Notes

• Sign here and date

  Sign