SBO - Downer Worksite Assessment

• Document No.

• Client / Site / Contract

• Work site Assessment

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Site photos

  Media

Hazard ID

• Hazards and controls are relevant to the work being undertaken.

  Yes

  No

  N/A

• Hazard ID is on site and completed by team before commencing work.

  Yes

  No

  N/A

• Emergency Procedures in place for operation

  Yes

  No

  N/A

• Environmental controls in place for the operation

  Yes

  No

  N/A

• First aid on site

Personal protective equipment

• PPE-The correct Personal Protective Equipment being worn and in good condition

  Yes

  No

  N/A

Traffic management

• TMP. Is set up according to those TMP approved in the CAR.

  Yes

  No

  N/A

• STMS CONTACT details recorded on site.

  Yes

  No

  N/A

• Equipment and plant setup inside the TMP zones?

  Yes

  No

  N/A

• Image of the TMP Signage and setup on site.

  Media

Summary, Sign off & Follow-up Actions

• Summary

• Follow-up Actions

• Site Supervisor

  Sign

• Auditor

  Sign