• Developer:

  • Site Name

  • Developers ABN:

  • Inspection Conducted By:

  • Conducted on

  • Location


Principle Contractor

  • Principle Contractor:

  • Principle Contractors ABN:

  • Principle Contractors Contact Person:

  • Phone Number

  • WC Certificate of Currency?

  • WC Policy Number:

  • Consistent with WIC

  • Number of Employees:

Scaffolding Contractor

  • Scaffolding Contractor:

  • ABN:

  • Contact Person:

  • Phone Number:

Scaffolding - Planning & Documentation

  • Handover Certificate for completed scaffold R225(2)

  • Regular Scaffold Inspections R225(3)

  • Engineered design - Cantilevered needles, suspended systems etc

  • Scaffolders HRWL

Scaffold - Design & Use

  • In good condition, erected plumb, level and square on solid foundation

  • Safe entry and exit to all working platforms

  • Edge protection provided where a person could fall

  • Decks are fully planked

  • Gap to building does not exceed 225mm

  • Has containment sheeting been considered as part of the design?

Electrical Hazards

  • Are there any overhead power lines within 4 meters or less of site?

  • Electrical switchboards in good condition with RCDs fitted and tested

  • Main switch (point of supply) clearly identified and labeled

  • Construction Wiring run in solid conduit to prevent mechanical damage and labelled “Construction Wiring”

  • Electrical tools and extension leads tested and tagged (within last 3 months)

  • Tigertails installed on low voltage overhead power lines near the site (if cranes, pumps, excavators or other machinery exists)

  • Evidence of consultation with electricity supply authority (advice letter) if workers and/or machinery working near overhead power lines ( eg: Loading Zones – Crane use)

  • Valid Dial Before You Dig Plans exist for excavation/digging/trenching work on or near public property

Formwork Contractor

  • Formwork Contractor:

  • ABN:

  • Contact Person:

  • Phone Number:

Formwork - Planning & Documentation

  • Engineering plan- sequence, propping, cure time, back propping etc.

  • SWMS- erecting, altering, stripping etc

  • Engineers signoff prior to pour

Formwork - Equipment & Workers

  • In good condition

  • Suitable access & egress to work areas

  • Adequate fall protection- edges, penetrations, voids, joist spacing etc.

  • Adequate supervision/instruction of workers

  • Limiting access by other trades on incomplete decks and during pours

Inspector Observations:

  • <br>In your observations are the PCBU and/or workers aware of the risk factors when working with formwork?

  • In your observations do the PCBU and/or workers understand the correct method in erecting/ dismantling formwork? (either conventional/engineered)

  • Is the PCBU or Workers aware of practical solutions and controls currently available? (Eg: Proprietary handrails, penetration covers, portable stair systems etc.)

  • In your opinion does the PCBU and workers think SafeWork NSW is a reliable source of information?

  • Overall - what status of controls for hazards associated with formwork did you observe?

  • In your opinion does the PCBU and workers think SafeWork NSW is a reliable source of information?

Any Additional Comments

  • Any Additional Comments:

  • Is this site recommended for a FOI Project Visit?

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.