Title Page
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Site conducted
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Conducted on
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Inspected by
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Location
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Plant ID
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Notification
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Work Order Description
Workplace Inspection
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Are all walkways, stairways & access/egress points clear from obstructions? E.g., temporary stored items, equipment.
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Is the area free of slip/trip hazards? E.g. no spillage, product build up or unlevelled ground?
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Are all items stored at an appropriate height? E.g., objects leaning against walls, stored at height, off balance?
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Are exit points readily accessible and free of obstructions in the event of an incident or evacuation?
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Is lighting in the area adequate for task being executed?
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Is there a high level of dust in the area and are dust masks readily available?
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Are there other work crews in the area and can all works be executed safely in conjunction with each other?
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Are isolations required to execute task?
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Have all required isolation points been identified and isolated?
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Have you confirmed a zero energy state?
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Has all required barricading been set up before commencing the task?
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I confirm that the Workplace inspection has been Inspected By (Signature) completed to an acceptable standard and in-line with the scheduled frequency. (Inspections are a legal requirement)