Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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high risk permit
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work areas are barricaded to prevent non-authorised access IE: openings in floors and trenches are barricaded or covered
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Access/egress is available for facility staff/ visitors around work area
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Site /work area is free from rubbish and obstructions
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Contractors are wearing identification badges
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Personal protective equipment is being used
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Is the job up to standard
Electrical
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Electrical
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Electrical equipment - power tools,leads etc are tested and tagged
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Leads,plugs,sockets and switches appear to be in good (no exposed wires,no mechanical damage)
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Lock out / Tag out
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Insulated ladders are used near live or exposed electrical equipment
Prevention of falls from heights (>1.8 meters)
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Elevated work platforms have handrails and kick boards
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Perimeter guard railing and screening is in place
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Work positioning and fall injury prevention systems are in place
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Safe access systems to prevent climbing falls (stairway or ladder)
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Single , extension ladders and scaffolding are effectively secured
Chemical
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Material safety data sheets (current) are able to be produced within the work area
Material Storage
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Building materials are being stored within the confines of the work area
Additional information / notes
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