Title Page

  • Conducted on

  • Prepared by

  • Location

Site Inspection

  • Is a valid externally certified management system, based on ISO45001 requirements or compliance on an externally quantified safety system accreditation available and displayed in offices?

  • Is a comprehensive scope of work available? (are all applicable contractual agreements and communications with Sasol available?)

  • Is the letter of good standing valid?

Working at Heights

  • Are those working at heights trained?

  • Has a fall protection plan been compiled by a competent fall protection plan developer?

  • Have competent and trained scaffold builders erected, dismantled or modified scaffolding?

  • Have harnesses and lanyards been inspected before use?

  • Have lifelines been installed where required and inspected before use?

  • Have handrails and gratings been reinstated on elevated platforms after work has been completed?

  • Are suitable containers being used to contain loose objects at height to prevent it from falling to lower levels?

  • Are all tools and equipment secured to lanyards or stored in containers while working at heights?

  • Are only spliced manila ropes and canvas bags used to lift or lower equipment up to a maximum of 20kgs?

  • Are effective barricading and signs in place where working at heights is taking place?

  • Are kick plates, handrails and knee rails installed?

  • Are access ladders on the inside of all scaffolds which are higher than 2 meters?

Road Safety

  • Do all drivers have a valid driver’s license for the specific types of vehicles?

  • Are vehicles licensed and road worthy?

  • Do site vehicles comply with the necessary inspections and safety requirements?

  • Are keys to all company vehicles (tractors, mobile cranes, forklifts, LDV’s and Buses) controlled to prevent unauthorised team members from gaining access?

  • Are any employees using a cell phone while driving or walking?

  • Permit to Work (PtW)

  • Do only trained and authorised personnel issue or receive at PtW?

  • Do employees understand the content of the PtW?

  • Do team members conducting a task, understand the process risks involved and how it was eliminated or controlled?

  • Are team members conducting gas tests competent?

  • Are gas monitors calibrated, maintained and fit for use?

  • Have all process risks been identified and eliminated or controlled?

  • Has the equipment and surrounding environment been made safe before work commences?

  • Has the permit issuer, the permit recipient and the task executor discussed any hazards that may be introduced during the execution of the task before work commences?

  • Has gas monitoring been done according to the permit requirements?

  • Have energy hazards been isolated and locked out?

  • Is the location, name and number of equipment to be worked on is clearly stipulated on the permit?

Lifting Operations

  • Are the team members performing mechanical lifting operations competent?

  • Have persons performing lifting activities received the necessary training on how to complete a pre-lift checklist?

  • Are only riggers with the necessary skill and experience conducting critical lifts?

  • Are all lifting devices and equipment (e.g. Cranes, slings, ropes, shackles etc.) registered, inspected, and certified fit for use?

  • When making a mechanical connection (D shackle) to a thimble, is it spliced into the rope?

  • Are all users doing ongoing visual inspections on all lifting devices and equipment for defects?

  • Are only spliced manila or polypropylene ropes and canvas bags used when lifting equipment or tools?

  • Is a rope only used to lift or lower a load if it weighs 20kg or less?

  • Is access effectively managed to the area and barricaded where it is practically possible?

Confined Spaces

  • Are only team members that have been trained in the use of an airline mask performing category B vessel entries?

  • Are all breathing apparatuses inspected and fit for use?

  • Are safety harnesses Inspected and found to be in a good working condition?

  • Are employees medically fit to work inside a confined space according to medical evaluation?

  • Is the correct PPE worn for the task and possible chemical hazards?

  • Is gas testing done before work starts and when interrupted?

  • Is there adequate lighting?

  • Is there a clear work surface free from anything that may cause slips or trips?

  • Are registers signed before entry and when exiting the confined space?

  • Is there barricading done to the entrance of confined space when no work is being done?

  • Is the area around and at the entry point clear?

  • Is the correct level of standby available?

  • Are there safe access and escape routes?

Ignition Sources

  • Is emergency equipment maintained, inspected and in good working condition at all times?

  • Are hot work permit conditions maintained and managed the risks of the activity, e.g. cocooning, gas tests, covering of drains, etc?

  • Is vehicle access controlled in classified areas?

  • Are all generators switched off and gas cylinders closed when not in use?

  • Are all hazards Managed and controlled where there are ignition sources to prevent combustible materials from igniting?

Lock-Out & Isolation

  • Are competent and authorised persons performing lock-outs and isolations?

  • Are only authorised and competent team members re-commissioning equipment?

  • Are all relevant employees equipped with approved lockout equipment (locks, tags and scissors)?

  • Are lock out and isolation registers completed once the task has been completed?

  • Is the lock out and isolation procedure being adhered to?

PPE (personal protective equipment)

  • Has everyone who participates in a task (Sasol or service provider team member) has been trained in the correct use, inspection, limitations, storage and maintenance of PPE?

  • Can employees explain the use, care and purpose of their PPE?

  • Is all PPE Inspected before work starts to ensure it is in a good condition and fits correctly (e.g. respirators)?

  • Is it understood what the PPE requirements are before we start with a task?

  • Is the task specific PPE identified in the task risk assessment?

  • Is PPE used according to its specifications and limitations?

  • Is contaminated PPE disposed of correctly in contamination bins?

  • Is only approved PPE used which complies with the relevant quality standards (SABS, ANSI, etc.)?

  • Hard hats according to standard – Class A ANSI Z89.1-1986?

  • Safety spectacles according to standard – EN166?

  • Ear muffs according to standard – EN 352-1, EN 352-3, OHSA 1910.95?

  • Earplugs according to standard – EN 13819-1, EN 13819-2, EN 352-2, EN 458?

  • Overalls according to standard – Flame retardant and acid resistant with reflective stripes – SANS 434, EN 471, EN 469, EN 533?

  • Safety boots according to standard – ISO 20345, ISO 20346, ISO 20344, EN 12568, EN 50321, EN 3376, EN 3377-2?

  • Are safety boots Laced up all the way to the top?

  • Is double hearing protection readily available at all times?

Alcohol & Drugs

  • Do Team members disclose the use of prescribed medication to their line managers and the possible adverse effects it could have?

Adherence to Procedures

  • Have team members and leaders ensured they receive instruction or training in the relevant procedures that will enable them to understand the hazards involved in their tasks?

  • Have these procedures been complied to?

  • Are safe work and operating procedures and other critical safety procedures (e.g. commissioning and decommissioning, safe making) available to team members?

  • Do these important procedures and instructions include the rules and preventative controls that team members require to conduct work safely?

  • Do team members report impractical and unsafe instructions and procedures to their line managers?


  • Is there any PPE laying around?

  • Are there consumables laying around?

  • Is there equipment laying around without an operator?

  • Liquid chemicals bunded at mixing area?

  • Liquid chemicals bunded in storage?

  • Has dry material been stored in a manner that keeps it save from moisture like rain?

  • Does everything have an allocated place where it is kept when not in use?

  • Are waste bins being used according to purpose?

Risk assessments and procedures covering intended scope of work

  • Are the task specific risk assessments for the activities/tasks as identified in the baseline risk assessment scope related?

  • Are all preventive and corrective controls are in place relating to the equipment / instruments / tools associated with the activity / task?

  • Are procedures / method statements related to all activities/task for the approved scope of work available?

  • Has communication of the task risk assessments and procedures / method statements to the work team taken place?

  • Does the training and competency address the activity / task as per the approved scope of work?

  • Has task specific PPE for the task risks been specified, in place and controlled?

  • Do employees know and understand the contents of the risk assessments?

  • Is the hierarchy of controls being followed?

  • Is a Fall protection plan where working at heights or where applicable available?

  • Do employees know the difference between a Gas (˄2,5 Sec˅2,5 Sec) alarm and fire(˄10 Sec ˅ 2,5 Sec) alarm?

  • Is proof of technical and safety competence of employees available and adequate?

  • Is a training matrix available?

  • Are training certificates verified?

  • Is there Proof from the training service provider that practical training was done for electrical equipment?

  • Are red seal qualification for refractory verified?

  • Have Sasol life saving rules and KUE training to be implemented?


  • Is a comprehensive equipment maintenance and inspection system implemented?

  • Can issuing, receiving and management of defective equipment be demonstrated?

  • Is there a Maintenance procedure?

  • Are Inspections for electrical equipment verified?


  • Is an incident management system implemented?

  • Is an Incident register available?

  • Is a Reporting and Investigation of Incidents procedure available?

  • Is Proof of training available?

  • Is a RMA Accident report template available?

  • Is a Flash Report template available?

  • Is a Statement template available?

  • Is an Incident investigation report available?

  • Are first aiders available?

  • Is an Incident Investigator appointed and competent?

  • Have previous incidents and accidents investigation reports verified the Root Cause Analysis, the corrective and preventative actions identified, implemented and the effectiveness thereof?

  • Have learnings and Insights from incidents and accidents been communication to employees?

Subcontractor management

  • Is a list of sub-contractors available?

  • Are OHS Act Sect 37.2 agreements available?

  • Is the procedure and process followed for the selection and competency verification of sub-contractors (SHE minimum requirements) available?

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.