Title Page
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Site
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Employee Login
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Date and Time of Work
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Task Description
Checklist
General Information
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IS A PERMIT IN PLACE FOR THE WORK?
- Yes
- No
- N/A
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ARE WEATHER CONDITIONS ACCEPTABLE?
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HAS THE WORKER UNDERGONE ROOF TRAINING?
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HAS ALL REQURED PPE BEEN IDENTIFIED AND IS PROPERLY WORN BY WORKER?
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IS THE WORKER FULLY AWARE OF THE TASK REQUIREMENTS?
Access and Structure
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HOW WILL THE ROOF BE ACCESSED?
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ARE ANY STRUCTURAL DEFICIENCIES VISIBLE FROM THE ROOF UNDERSIDE?
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ARE ALL ACCESS POINTS IN GOOD CONDITION AND SAFE TO USE?
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ARE ANY MATERIALS OR TOOLS TRANSPORTED TO THE ROOF?
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Please comment HOW materials or tools will be transported to the roof
Walkways and Roof
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ARE WALKWAYS PRESENT ON THE ROOF?
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ARE THERE ANY OBSTRUCTIONS ON THE ROOF?
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ARE ALL ROOF EDGES PROTECTED/BARRIERED OFF?
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ARE GUARD RAILS PRESENT?
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ARE PRE-INSTALLED ANCHORAGES AVAILABLE?
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ARE HARRNESSES/LANYARDS AVAILABLE AND INSPECTED BEFORE USE?
Risk Assesment
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HAS A ONE MINUTE RISK ASSESSMENT FOR THE TASK BEEN COMPLETED?
Competion
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COMPLETED AND ACKNOWLEDGED BY (SIGNATURE)