None Working PICOW Checklist

• Site ID

• Site Name

• Conducted on

  Date

• PICOW Name

• Location
  Address

• Names and company names of all parties on site

ADMINISTRATION

• RAMS on site

  Yes

  No

• Have RAMS been viewed, completed, signed and match the works that are to be carried out onsite?

  Yes

  No

• Has a dynamic risk assessment been filled out and signed by all onsite?

  Yes

  No

• Does contractor have appropriate certificates or licensing to carry out works onsite?

  Yes

  No

• Does mobile plant or equipment operator have all relevant documentation such as Service history, operators manual, risk assessment & SWMS, daily checklist and certificate or licensing. If yes, plant & equipment checklist must be completed.

  Yes

  No

WELFARE

• Has vehicle parking locations been identified or explained?

  Yes

  No

• Has first aid kit locations and first aiders been identified?

  Yes

  No

• Have toilet locations been identified?

  Yes

  No

SITE H&S

• Is TM/PM set up as per TM plan and suitable for works?

  Yes

  No

  N/A

• Has nearest hospital and medical centre locations been identified?

  Yes

  No

• Has emergency assembly point location been identified?

  Yes

  No

• Has site specific hazards been identified and detailed in the dynamic risk assessment?

  Yes

  No

SIGN OFF

• Is the scaffolding built as per design and suitable for the proposed works?

  Yes

  No

  N/A

• Has all works been completed?

  Yes

  No

• What works are outstanding?

  Yes

  No

  N/A

• PICOW to ensure completion pictures are taken before leaving site

  Yes

  No

• Person conducting Site Induction

  Sign