SBRC Safe Work Instructrion

• Audit Title

• Client / Site

• Conducted on

  Date
• Location
  Address

• Personnel

• Name of SWI

• No. SWI

• Description of Work

• Potential Hazards

Personal Protective Equipment (PPE)

• Personal Protective Equipment (PPE) Required (Check the box for required PPE):

  Select Gloves Face Masks Eye Protection Hard Hat Appropriate Footware Hearing Protection Protective Clothing

  • Gloves
  • Face Masks
  • Eye Protection
  • Hard Hat
  • Appropriate Footware
  • Hearing Protection
  • Protective Clothing

• Other PPE

• Risk Score

• If Score is high - Supervisor approval required

• PRE-Operation:

• Operation:

• Post Operation:

• Note: Maintenance is to be carried out by authorised persons only. Any equipment found to be faulty must be tagged “Out of Service” and reported to your supervisor as soon as possible.

• Further Information and Related Documents:
  This SWI does not cover all possible hazards and must be used in conjunction with the following references:
  

• Office Use Only
  Issue Date: THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED Authorised By: Manager Human Resources
  Last Reviewed:
  Next Review Date:
  
  

• Name

  Sign