Title Page

  • Inspection Type: (Site Documents)

  • Contractor:

  • Team:

  • Date:

  • Prepared by:

  • Project Title:

  • ELR & Mileage:
  • Weather & temp:

Key summary and findings

Site documents

  • Work activities on site:

  • Work package plan?

  • SSOW: Mileage and date correct? Cards checked and all signed-in? Safe system suitable for work at site and access to site? Briefed to the team? How is the SSOW maintained? (photos)

  • SSOW pack suitable?

  • Task Brief: Mileage and date correct? All tasks on site contained within? Personnel, equipment, and plant correct? Emergency information correct? Signed and briefed? (photos)

  • Task brief suitable?

  • Risk Assessments: POWRA completed? Site specific hazards listed with appropriate mitigations? Correct date? Signed and briefed? (photos)

  • Work at Height Form? (ADB/DDD Projects)

  • Line Block Approval Form? (if applicable)

  • Risk assessments?

  • ALO form?

  • Daily/weekly work plan?

  • Tool & equipment check sheets?

  • Tool & plant service records?

  • Lift Plans? (if applicable)

  • HAVS forms?

  • Written Third party agreements?

  • Bird nesting form?

  • Ecology recommendations?

  • Operative competencies?

  • First aid competency?

  • LOLER certificates?

  • Additional comments?


Actions to be entered into CMO:

  • Enter an Action, an Action Owner, and an Action Date.
    If N/A, enter “No actions”.

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  • 5.

  • 6.

  • 7.

  • 8.

  • All actions have been assigned correctly, and Close Calls recorded where required.

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.