OHS Checklist

FRANCHISEE DETAILS

• Franchisee

• Date

  Date
• Location
  Address

• FSE Code

• Vehicle Make & Model

• Vehicle Rego

• Rego Photo

  Media

• Trailer Rego

• Trailer Photo (No.1)

  Media

• Trailer Photo (No.2)

  Media

• Trailer Photo (No.3)

  Media

GENERAL

• Fire Extinguisher

  Yes

  No

• Expiry Date

  Date

• Full Finger Gloves

  Yes

  No

• Hearing Protection

  Yes

  No

• Safety Glasses

  Yes

  No

• First Aid Kit

  Yes

  No

• Traffic Cones

  Yes

  No

• Amount

• OHS Manual

  Yes

  No

• Up to Date?

  Yes

  No

• Warning Signs

  Yes

  No

• Mowing In Progress

• Spraying In Progress

• Rectification Date

  Date

• Sun Screen (30+)

  Yes

  No

• SWMS

  Yes

  No

• Rectification Date

  Date

• Blank Document

• Completed Document for Listed Services

• Blank Injury Report Form

  Yes

  No

UNIFORM

• Hi-Vis shirt

  Yes

  No

• Hat

  Yes

  No

• Steel Cap Boots

  Yes

  No

SERVICES PROVIDED

• Mowing

  Off

  On

• Brush Cutter Guard

  Yes

  No

• Edger Guard

  Yes

  No

• Cracks in Case

  Yes

  No

• Gardening

  Off

  On

• Chainsaw/Pruning

  Off

  On

• Hard-Hat/Hearing Protection & Visor Combo

  Yes

  No

• Chaps

  Yes

  No

• Working Chainsaw Break

  Yes

  No

• Gutters

  Off

  On

• Single Storey

  Off

  On

• Industrial Rated Ladder (>120Kg)

  Yes

  No

• Ladder Lock

  Yes

  No

• Double Storey

  Off

  On

• Rated Harness

  Yes

  No

• WorkSafe Qualification (Working at Heights)

  Yes

  No

• Expiry Date

  Date

• Spraying

  Off

  On

• Commercial Spraying Licence

  Yes

  No

• Expiry Date

  Date

• Chemical Resistant Gloves

  Yes

  No

• Respirator

  Yes

  No

• Chemical Resistant Googles

  Yes

  No

EMPLOYEES

• Does Franchisee have employees?

  Yes

  No

• Name

• Induction Training Record

  Yes

  No

• PPE

  Yes

  No

• Record of Safety Meeting

  Yes

  No

• Jims Mowing Hi-Vis Shirt

  Yes

  No

CONCLUSION

• Franchisee Signature

  Sign