Information
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Site conducted
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Client / Contractor
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Address:
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Site Supervisor
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Conducted on
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Prepared by
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Add media
Site Safety Inspection
On-site Safety Documentation / Emergency Response / Supervision
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Is there an up to date Site Safety Plan on site
Site Specific Safety Plan & WorkSafe NZ Notification
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Has WorkSafe Hazardous Work notification been completed
Induction
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Site specific safety inductions completed / induction register up to date
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Date of last induction:
Sign In/Out
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Is sign in/out register in use and up to date
Toolbox Meetings
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Are toolbox meetings being held as per schedule
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Date of last toolbox:
Self Inspection
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Are self inspections being completed as per schedule (i.e. weekly / fortnightly)
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Date of last self inspection:
Task Analysis
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Is Task Analysis / SWMS being completed for critical work
Permits
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Are Permits systems in use and used as required
Contractor Management
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Are Contractors supplying adequate safety documents, ie TA / SWMS / Safety Plans / Training Records
Incident Reporting / Investigation
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Have all incidents been sufficiently reported, investigated and actioned
Site Establishment & Site Facilities
Site Security & Access
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Is site fencing / access and security adequate
Signage & Hazard ID
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Is site safety signage clearly visible and up to date
Facilities
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Are site facilities adequate for the work to be completed
Fire & First Aid
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First Aid and Fire Resources available
Personal Protective Equipment
PPE Use
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Do all personnel on site have adequate PPE
Housekeeping
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Is construction waste being adequately controlled, including clear accessways
Hazardous Substances
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Are hazardous substances and chemicals adequately controlled
Environmental
Environmental Controls
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Are environmental hazards being controlled (i.e. environmental plans, washout, spill response, silt control)
Electrical Hazards
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Overhead power lines adequately controlled
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Is Electrical gear safe to use
Plant & Equipment
Mobile Plant
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Is there mobile plant on site
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Is Mobile Plant Safe
Tools / Equipment
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Are tools and other equipment safe to use
Cranes & Lifting Appliances
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Are there cranes and/or lifting appliances on site
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Cranes have current test certification
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Evidence of daily / weekly checks
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Pre-lift plans completed
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Chains and slings tagged annually, up to date, and in good visible condition
Mobile Elevated Work Platforms (MEWP)
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Are there MEWP's on site
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Current certification displayed / Logs books in use
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Are harnesses being worn (boom lifts)
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Is the user competent to operate EWP
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Is the EWPs safe to use
Excavation / Earthworks
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Are there excavations / earthworks on site
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Have underground services been identified
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Are Excavations safely battered, benched or supported
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Have Demarcation / Exclusion zones been put in place
Height Safety
Ladders
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Are there ladders being used on site
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Are ladders being used safely
Harnesses
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Are there safety harnesses used on site
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Are harnesses safe to use
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Are users competent
Safety Nets
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Are safety nets in use
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Are safety nets correctly installed and adequate for the work
Scaffolds
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Are there any scaffolds on site
Scaffolds - General
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Does the scaffold comply with the NZ Scaffold COP
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Are the scaffold safety tags current
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Last date Inspected
Mobile Scaffolding
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Is mobile scaffolding safe to use
Height Safety - Edge Protection / Upper Floors / Lift Wells & Penetrations
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Edge protection configured correctly
Other
Other Items
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Comments / Notes
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