Title Page
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Document No.
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Site
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Date
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Auditor
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Signature
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Plant Item
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Process
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Doncasters Staff
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External Contractor
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Department
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Company
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Name
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Name
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Safety Glasses
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Hearing Protection
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Safety Footwear
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Mobile Phone
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Booked in on Visitors Register?
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Permit Complete on System?
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Is there a POW Risk Assessment
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Where can POW be found?
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Is there evidence of LOTO?
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LOTO Padlock No.?
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LOTO Comments
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Is Live Testing Involved?
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Where can POW be found?
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Live Testing Comments
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Is Working at Height required?
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If YES, is permit completed?
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Working at Height Comments
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Is Confined Space work required?
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If YES, is permit completed?
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Confined Spaces Comments
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Is Hot Work required?
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If YES, is permit completed?
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Hot Work Comments
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Is LOLER equipment used?
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If YES, LOLER tag in date?
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LOLER Comments
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Have all documentive/procedural measures been correctly completed?
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Have all hazards been identified and adequately controlled?
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Is all PPE is use and appropriate for the task/work?
