Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • high risk permit

  • work areas are barricaded to prevent non-authorised access IE: openings in floors and trenches are barricaded or covered

  • Access/egress is available for facility staff/ visitors around work area

  • Site /work area is free from rubbish and obstructions

  • Contractors are wearing identification badges

  • Personal protective equipment is being used

  • Is the job up to standard

  • Quality of work at completion of works

Electrical

  • Electrical

  • Electrical equipment - power tools,leads etc are tested and tagged

  • Leads,plugs,sockets and switches appear to be in good (no exposed wires,no mechanical damage)

  • Lock out / Tag out

  • Insulated ladders are used near live or exposed electrical equipment

Prevention of falls from heights (>1.8 meters)

  • Elevated work platforms have handrails and kick boards

  • Perimeter guard railing and screening is in place

  • Work positioning and fall injury prevention systems are in place

  • Safe access systems to prevent climbing falls (stairway or ladder)

  • Single , extension ladders and scaffolding are effectively secured

Chemical

  • Material safety data sheets (current) are able to be produced within the work area

Material Storage

  • Building materials are being stored within the confines of the work area

Additional information / notes

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  • Add signature

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