Pre-Start Checklist

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Site Related Hazards

• Slipping / Tripping Hazard

  Risk

  Safe

  N/A

• Workplace Noise

  Risk

  Safe

  N/A

• Working Remotely / Working Alone

  Risk

  Safe

  N/A

• Poor Emergency Access

  Risk

  Safe

  N/A

• Vehicles or Taffic

  Risk

  Safe

  N/A

Task Related Hazards

• Electrical Hazards

  Risk

  Safe

  N/A

• Manual Handling

  Risk

  Safe

  N/A

• Working at heights

  Risk

  Safe

  N/A

• Mineral Fibers (Asbestos)

  Risk

  Safe

  N/A

• Machinery (Moving Parts, Mobile Plant)

  Risk

  Safe

  N/A

Other Hazards

• Add Risk

Custom Risk

• Risk:

• Add Photo

  Media

• Likelihood: Before

  Rare

  Unlikely

  Possible

  Likely

  Almost Certain

• Consequence: Before

  Insignificant

  Minor

  Moderate

  Major

  Catastrophic

• Control Method:

  Select Elimination Substitution Isolation Engineering Controls Administrative Controls PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering Controls
  • Administrative Controls
  • PPE

• Control Method Notes:

• Likelihood: After

  Rare

  Unlikely

  Possible

  Likely

  Almost Certain

• Consequence: After

  Insignificant

  Minor

  Moderate

  Major

  Catastrophic

• Notes:

Sign Off:

• Sign:

  Sign

• Additional Worker

Additional Worker

• Sign:

  Sign