Information

  • Project Reviewed

  • Site Name

  • Conducted on

  • Auditor

  • Location
  • Site EHS Manager

General Information

  • Have all contractors received EHS&S orientation training?

  • Is the emergency phone number on the permit?

  • Do the people performing the work know the location of a phone or if using mobile phones have the site emergency number programmed into phone?

  • Are the work crew familiar with the risks of the job?

  • Are the safety data sheets (SDS) of chemicals used available?

  • Are the contractors wearing the appropriate PPE required for the task?

  • Are equipment and hand tools properly used/managed according to the task?

  • Was the workplace left clean and tidy after work completion?

Permit To Work

  • If the task requires a Permit to Work (PTW) are a valid General Work Permit and underlying secondary permits (ie. hot work, work at heights....) present?

  • Are all documents referred to in the Permit attached (JSA, method statement)?

  • Did the area owner or their designee visit where the task(s) will be performed to review the risks prior to handover approval?

  • Have all employees who perform the work signed the permit and do they know the risks and safety measures related to the permit?

  • If the permit requires are a safety function, is the person present at the work place (fire watch)?

  • When work is finished, did the area owner or its designee and persons in charge visit the workplace and sign the hand back section on the permit?

  • Are the safety conditions maintained in accordance with the provisions of the permit to work? If not, stop the work.

  • Comments:

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.