PAIR Form - Work Site & Activities

• Inspection Type: (Work Site & Activities)

• Contractor:

• Team:

• Date:

  Date

• Prepared by:

• Project Title:

• ELR & Mileage:
  Address

• Weather & temp:

Work site & activities

• Access/Egress:

• Work site description:

• Work activities on site:

• Number of operatives and roles:

• Tools, plant, and equipment: (condition, and suitability for tasks)

• PPE: (condition, and suitability for tasks)

• Work activity compliance: (safe working practices)

• Method used to secure plant:

• Additional comments:

Actions to be entered into CMO:

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

• 1.

• 2.

• 3.

• 4.

• 5.

• 6.

• 7.

• 8.

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

  Sign