Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

More than one auditor?

  • Additional auditors

  • Can the work be undertaken from the ground or from a solid construction?

  • If not can the work be undertaken using a passive fall prevention device? (Tick applicable)

  • Scaffolds

  • Perimeter screens

  • Step platforms

  • Perimeter guard railing

  • Elevating work platforms

  • Guard railing edges of roofs

  • Mast climbing work platforms

  • Protection for trenching works

  • Work boxes

  • Safety mesh

  • Can the work be undertaken using a fall arrest system? Tick applicable

  • Travel restraint systems

  • Industrial rope-access systems

  • Can the work be undertaken using a fall-arrest system?

  • Safety harness systems (other than travel-resistant systems)

  • Catch platforms

  • Working at Heights (WAH) permit, SWMS / JSEA in place

  • WAH permit, SWMS / JSEA reviewed and signed by all involved in the task

  • Fall prevention equipment inspected and suitable for task

  • Fall prevention systems insatlled and inspected by a competent person

  • Personnel trained in the use of equipment

  • Tools and equipment secured by lanyards (hard hats secured by chinstraps)

  • Spotter being used for all WAH activities at all times

  • Exclusion areas (below) defined and controlled by barricading, signange and spotter

  • Wind speed is acknowledged and operations are halted during strong winds as determined by risk assessment and/or plant (EWP) manufacturer's operations manual?

  • Rescue plan in place and adequate

  • Have the following common WAH hazards been assessed?

  • Signed PoMC Representative:

  • Action required?
  • Action

  • Allocated to

  • Action due

  • Signed Principal Contractor Representative (optional):

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.