• Select date

Safe Place of Work

  • Is there a safe access for all on site to reach their place of work ie good roads, gangways, passageways, hoists, staircases, ladders and scaffolds?

  • Is artificial lighting required on site?

  • Are there proper arrangements for the disposal of waste?

  • Other hazards

Working at Height

  • Is adequate types of access in place? Ie crawl boards/ladders etc?

  • Edge protection for materials/people?

  • Are there roof lights?

  • Are people working below requiring protection from falling objects?

  • Is scaffolding required?

  • Does the scaffolding require permits?

  • Is MEWP necessary?


  • Is there an electric underground cable near the work being carried out, has it been located and marked and precautions take to avoid contact?

  • Are there overhead lines within confine of site?

Mobile Plant

  • Has location been identified for the storage of onsite plant and equipment?

  • Would the equipment noise output have a significant impact on the surrounding environment?

  • Is general noise going to be a problem during site access/egress and on site?

Health Risks

  • Have harmful materials been identified?

  • Safety equipment required PPE?

  • Are protective measures required within the work areas?

  • Is confined space works required?

  • Is dust screening required?

  • HA vibrations?

Risks to the public

  • Does the work create risks to members of the public? Eg materials falling, site plant, access and egress

  • Is the site perimeter fencing adequate to keep out the public?

  • Is the site secure during non working hours and periods?


  • Are there toilets?

  • Are there wash basins, hot water, soap and towels?

  • Is there a room or area where clothes can be dried?

  • Is there a room where workers can shelter and have meals with facilities to boil water?

  • Is there a supply of drinking water provided?

Fire and emergencies

  • Are hot works going to be carried out?

  • Fire extinguishers required?

  • Additional escape routes?

Compressed gases

  • Are cylinders to be stored on site?

Traffic routes and vehicles

  • Does the work require traffic management?

  • Is there suitable parking for onsite vehicles?


  • Is a water course on site?

  • Is there flora or fauna protection of planted areas?

  • Is it a Cultural Heritage area?

  • Are there endangered or protected species?

  • Is the building listed or protected?

Existing Infrastructure

  • Are there existing structures close to the worksite that may be damaged by the works?

  • Is there existing cabling and equipment close to the worksite that may be damaged by the works?


  • Sketch detailing the proximity of worksite to existing infrastructure.

  • Additional information

  • Signature

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