Title Page
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Project Name
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Location
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Onsite Principal Contractor(s)
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Conducted on
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Prepared by
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Any member of the Development Team visiting the site may complete this form. Please provide further comment where a hazard is observed during this site visit; if necessary a corrective action may be raised from findings
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Note: NA- can include not applicable and / or not seen at the time of visit
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1. Has site fencing been established; does it appear to be maintained? (e.g. intact, not falling or crushed by shrubbery)
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2. Is signage in place for the following:
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Emergency Assembly point?
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First Aid (including contact information)?
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Construction Signage (PC Contact information including a/hours)?
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No trespassing?
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Site Office, Amenities including directional signage, where required?
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3. Are all workers wearing hi-vis , hard hats and safety boots
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4. Is work occurring in areas with inadequate lighting?
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5. Are solid barriers installed around open or exposed edges? (e.g. edge of deck, floors, holes, formwork, elevator shafts)
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6. Are access ways and walk areas clear of rubbish/materials
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7. Are plant (e.g. forklift, cranes) operational zones and people on the ground separated ?
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8. Are there protruding objects not easily seen that could cause a trip hazard?
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9. Do all fixed scaffolds have a scafftag current within 30 days
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10. Do all scaffolds have adequate edge protection? (E.g. handrails/mid-rails/toe boards)
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11. Mobile scaffolds are on firm even ground?
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12. Are workers standing on the top rung of aluminum or step ladders or leaning off work benches?
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13. Are EWP’s (Scissor lift) used with gates closed and not moved whilst platform is extended
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14. EWP (boom) operators are secured with a harness
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15. Are there sharp edges not protected? (E.g. reinforced bar ends or tie wire)
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16. Are electrical tools are tested and tagged in current period?
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17. Are electrical leads lying on the floor?
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18. Is there any SERIOUS and IMMINENT Risks? Discuss with WHS
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Close down work area until rectified:
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Issued By:
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Role:
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Signature of issuer:
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Issued To:
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Company:
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Signature:
