• SWMS Title/Number:

  • Conducted on


  • Client site: Barwon Water - Black Rock WRP 400 Black Road Connewarre

  • Agfab project No: 22884

  • Name of persons supervising works activity:

  • Select date

SWMS Content - Does the SWMS contain the following ?

  • Principal Contractor/Subcontractor Name :

  • Task specific information ( not generic)

  • Task Sequence appropriate to the activity:

  • Activity Hazards relevant to the Sequence of activities:

  • Activity controls relevant to Hazards identified:

Personnel sign off

  • Are all personnel involved in the activity signed onto the SWMS:

  • Do the employees have a depth of knowledge of the SWMS to be able to discuss the content demonstrating the required level of understanding:

Pre start activities

  • Are Start Cards completed for activity prior to the beginning of the day ( minimum number to be determined on site site relevant to the complexity of activity)

  • Is there evidence of pre start meetings where relevant Sequences of the SWMS have been discussed in order to safely commence the days activities:

SWMS Field Compliance

  • Is the SWMS Sequence being followed:

  • Are Controls being fully implemented:

  • Does the SWMS effectively address the SEQ Hazards on site:

SWMS Review

  • Is there evidence that the contractor undertakes regular reviews of the SWMS to ensure they represent the tasks/ hazards/controls on site at that time:

  • Is there evidence that the SWMS have been reviewed and updated if required in the past week:

Inspection completion

  • At the time this inspection was completed the SWMS documentation and controls implemented complied with the Regulatory and Contractual minimum requirements:

  • Name of the person completing the checklist:

  • Signature of the person completing the checklist:

  • Name of the Workplace Manager:

  • Signature of the Workplace Manager:

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.