Information

  • Document No.

  • Audit Title

  • Client / Site

CLIENT/SITE/JOB INFORMATION

  • Client Name:

  • Job number:

  • Overview of job:

SIGNIFICANT HAZARDS

  • Work at height

  • Working from ladder

  • Working from scaffold

  • Working from EWP

  • Electricity

  • Confined space

  • Overhead hazard

  • Underfoot hazard

  • Heavy/awkward lifting

  • Noise

  • Excavations

  • Floor openings

  • Poor housekeeping

  • Dust/fumes

  • Other trades/members of the public

  • Over head power lines

  • Other

PERSONAL PROTECTIVE EQUIPMENT

  • Eye protection

  • Hearing protection

  • Hi-visibility vest/clothing

  • Hard hat

  • Safety footwear

  • Isolation lock/tag

  • Other

CONTROLS IN PLACE

  • Fall protection in place

  • Ladders safe and secured

  • Scaffold tagged and secure

  • EWP maintained/checked/fit for purpose

  • Electrical supply isolated/locked/tagged

  • Electrical safety device (RCD)

  • Portable electrical equipment tested/tagged

  • Clear/safe underfoot

  • Clear/safe underfoot

  • Floor openings covered

  • Excavations identified/covered

  • Protection from overhead hazards

  • Signs/cones/barriers

  • Overhead lines made safe/shrouded

  • Material safety data sheets on site

  • Fire extinguisher available

  • First aid kit availiable

  • Special instructions delivered/received

Your sub contractos

  • Are sub contractors being used (List)

  • Is their SSSP on site

  • Working safely

  • PPE being worn

ASSESSED BY

  • Assessor,

  • Add signature

  • Briefed operative list:

  • Briefed contractors list:

  • Select date

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.