Page 1: Initial questions

  • Conducted on

  • Location

Page 2: Main checklist

  • Van Pictures all around

Hazards

  • Personal Protective Equipment (Please Specify) Harness, Safety boots, Safety gloves, Hard hat

  • Any Excavation work being carried out

  • What is the road speed limit?

  • Work location(busy road, school, country road) Please specify Road Speed Supermarket/University

  • Occupational Health (Manual Handling, HAVS, Noise and dust, Vibration

  • Confined Space or working at height

  • If Yes upload site setup pictures

  • Protection of works/Pedestrians and vehicle

  • All gate guards in place with GDU?

  • Safety warning notices in place? (Chapter 8) Footway closes signs Road closed

  • Work location(busy road, school, country road) Please specify Road Speed Supermarket/University

  • Control Measures (Please specify)

  • Picture before commencing work

  • Equipment in good condition? Petrol Generator Cobras GDU Water Pump

Page 3: Untitled Page

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.