Title Page

  • Date & Time

  • Team Leader

  • Second Operative

  • Third Operative

  • Fourth Operative

Site & Vehicle Observations

  • Has a daily and/or a site specific R.A. been completed?

  • Are Service Plans available and legible?

  • Is a Team Safety Pack available and complete?

  • Are all qualification cards/ID cards available and in date?

  • Are all operatives qualified for work they will be undertaking?

  • Have relevant Permits & authorisations been acquired?

  • Is the Operative Lone working ?(if so is a lone worker procedure being followed)?

Plant & Equipment

  • Is locating equipment calibrated?

  • Fire Extinguisher acceptable?

  • Lifting Equipment in good order & Tested?

  • Gas Detection Unit (GDU) calibrated?

  • Is Plant & Machinery in good working order Tested and in date?

  • Is Plant & Equipment securely stored on the trailer?

  • Is Scaffolding being used if so has it been checked?

Excavations

  • Safe Access/Egress into excavation?

  • Excavation adequately supported?

  • Is Spoil from the excavation stored safely?

  • Has a full Cat & Genny Survey been conducted ie services clearly marked out?

  • Are the types of barriers used adequate for the work been undertaken?

  • Exposed utilities adequately supported?

Welfare

  • Is a First Aid Kit & Eye wash available?

  • Is all PPE available and worn in accordance with the requirements?

NRASWA

  • Is the Signing lighting and guarding correct? (NRSWA)

Environment

  • Are spill kits readily available?

  • Is all chlorination equipment available?

  • All containers correctly labelled?

  • Are the teams aware of how to dispose of waste?

  • Can operatives describe what the procedure is in the event of a pollution incident?

Quality

  • Quality of workmanship on site

  • Backfill and Reinstatement

  • Profile and Structure

  • Quality of SAP feedback

Team Leader Sign-Off

  • Team Leader Signature

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.