• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Job details

  • Location

  • Asset

  • Type

  • Proposed Work

  • Weather

  • Work is

  • Reason for work

Safe Job Planning

  • Task requires any of the following permits

  • Add media

  • Is this task classified as 'High Risk'

  • Is there a SWMS for this task

  • Were employees required to be logged onto 'Lone Worker'

  • Was a JSA required


  • Were all staff involved in constructing the JSA

  • Does the JSA identify all the job steps

  • Is the JSA detailed and avoids generic terms

  • Are all staff signed onto the JSA

  • Copy of JSA


  • Are all staff wearing the required P.P.E

  • Were staff required to wear hard hats

  • Did staff have a wide brim or legionnaires flap attached to their hard hat

  • At any stage did you have to remind staff to put on their P.P.E


  • Was the equipment used appropriate for the task

  • Do staff have the appropriate level of training

  • Was the equipment inspected prior to use

  • If FIPS gear was used, was the equipment within 10 years of its date of manufacture

Work Site

  • Is the area free from slips, trips & falls

  • Are exclusion zones in place

  • Is signage in place

Manual handling

  • Are staff taking regular rest breaks

  • Are staff job sharing/rotating

  • Are staff utilising 2 man lifts for heavy equipment


  • General observations

  • Add media

  • Add media

  • Add media

  • Add media


  • Add 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.