Title Page

  • Contract

  • Location

  • Operation / Activity

  • Operatives Name

  • Employers Name

  • Conducted on

  • Prepared by

  • Location
  • Have you received a site induction?

  • Have you been briefed on a method statement for this job and did you understand it?

  • Is the operation being carried out in accordance with an approved, documented method statement?

  • Do you understand the risks and hazards associated with this job, and the necessary controls?

  • Is there a suitable and sufficient risk assessment in place for the activity?

  • Have you received any formal training in relation to this job?

  • Have you been told which types of PPE you are to wear for this job?

  • Are you doing this job in with the relevant health, safety and environmental procedures?

  • As far as you know, is the job being carried out in line with the contract service level agreements and key performance indicators?

  • Do you understand the workmanship / service delivery standards required for the job?

  • Are there adequate controls in place to protect the environment? For e.g. spillages and waste management etc

  • Have you had a 'Tool Box Talk' about this type of work? Was it recent?

  • Is there a record of Tool Box Talks delivered with signatures of attendees?

  • Have any Safety Alerts or similar communications been discussed with you recently? If so which ones were they?

  • Do you know the name of your supervisor on site?

  • Tell me about the 'Behaving Safely' plan for this site or contract

  • Check carried out by

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.