Title Page

  • Conducted on

  • Conducted by

  • Designation

  • Location
  • Contractor

  • Foreman

  • Weather

Section 1 - Communication

  • Safety Instructions/Incident Learnings

  • PDO Second Alerts/ HSE Flash

  • Work Stoppages

  • Super Wednesday

  • Work Instruction/Toolbox Talks/Reflective Learnings, and 4CAAP

  • Safety signs/Policies/Authorised use

Section 2 - Welfare

  • Toilets and wash facilities, working condition, correct soap available, hand drying available, cleanliness and barrier cream

  • Refreshment/Rest area, drinking water (filters) and cups available, cleanliness, number of seat, availability for religious activities. Etc

  • Housekeeping, all work areas, walkways kept clean and tidy, service pits secure

  • Offices, all required equipment available, good lighting, display screen equipment assessments

  • Waste management, no build of waste, waste bins/skips available

Section 3 - Equipment & Machinery

  • Guards, condition and utilised

  • Safety Inspections/certificates for Hand held, fixed, portable and lifting equipment

  • Tool and equipment condition, casing, wiring, plugs, airlines, gauges no handmade tools

  • Hands off tools, available and used where required

  • Welding/cutting equipment certified and in good condition

  • Equipment registers in place and up to date with all required equipment identified

Section 4 - PPE

  • Correct type of Gloves for operation (Impact/Normal)

  • Hard Hats/Bump Caps

  • Eye Protection

  • Ear Protection

  • Coveralls

  • Safety Footwear

  • Hi Viz vest

  • Face/Dust Mask

Section 5 - Facilities

  • Buildings

  • Wash down

  • Electrical panels

  • Lighting

  • Ventilation/A/C’s

Section 6 - Store Management

  • Tyres protected from sunlight

  • Tyres, hazardous materials and cylinders segregated

  • Racking secure, and suitable

  • Storage management - Heavy items at the bottom etc

  • Battery storage - Ventilated, flash proof lighting

  • Lifting equipment controlled, certified and quarantined

  • Gas cylinders - Segregated, ventilation, and secured

  • COSHH(data sheets) available for all substances, substances locked away

Section 7 - Fire & Emergency

  • Fire Warden

  • Fire alarms- tested and inspected

  • Fire Extinguisher

  • Assembly points identified

  • Doors and exits unobstructed

  • First Aiders available

  • First aid Provisions/Defibrillator

  • Eye wash stations

  • Spill Kits

  • Bunds available, used and appropriate

  • MSDS/SHOC available

  • 5555 PDO awareness

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.