Title Page

  • Project Name:

  • Location
  • Onsite Principal Contractor(s)

  • Conducted on

  • Prepared by

Site Security

  • Has site fencing been established; does it appear to be maintained?

  • Is there Construction Signage, which should include PC Contact information?

  • Is there 'No Trespassing' Signage?

  • Site Office, Amenities including directional signage, where required?

Emergency Preparedness

  • Is the Emergency Assembly point clearly visible?

  • Is the First Aid Location clearly signposted (including contact information)?

Plant

  • Are Contractor operational zones segregated?

  • Are mobile plant working in the danger zone of overhead powerlines

On Site Hazards

  • Is edge protection established for any open excavations?

  • Are there shear faces to any excavations that could engulf a person?

  • Are there any areas where risk of fall is unprotected?

  • Are there any unprotected water bodies on active sites?

  • Is there any SERIOUS and IMMINENT Risks?

Immediate Actions

  • Time for Corrections to be actioned

  • Close down work area until identified items are rectified?

Issued for Corrective Actions:

  • Corrective Action Issued?

  • Issued By

  • Position

  • Issued to

  • Company

  • Received

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.