Title Page

  • Site conducted

  • Conducted on

  • Description of the Task/Activity

  • Project Name:

  • Project Ref:

  • Site Address/Location
  • Project Start Date

  • Project End Date

  • Personnel Involved:

  • Person
  • Name and Surname

  • Role/Trade

  • Works Supervisor:

  • Role:

  • Contact Number:

  • Key Plant and Tools Required:
  • undefined

  • Key Materials Required:
  • undefined

  • Other Essential Equipment:
  • undefined

  • Specific Identified Residual Hazards:

  • Specific Staff Training Requirements:
  • undefined

  • Sequence of Operations:
  • undefined

  • Temporary Supports and Props needed to facilitate the works:

  • Method of Access and Egress to the work area:

  • Fall Protection Measures:

  • Required Personnel Protective Equipment:

  • Please specify

  • Emergency Procedures:

  • Name of on-site First Aider:

  • First Aid Box Location:

  • Nearest Hospital:

  • Nearest Hospital:
  • Other Information & Comments, Ex: 1. All workers are responsible for taking care of their PPE. 2. Whenever possible use mechanical lifting equipment and keep manual handling to a minimum. 3. Ensure all tools are inspected upon use.

  • Prepared by

  • Designation

  • Select date

  • Reviewed by

  • Designation

  • Select date

  • gff

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.