A. Site Visit - Questions
1. What are the Safety Essentials and what does the term mean to you?


2. What task are you doing and what are the critical safety risks (things that could kill you) while you are doing this task?


3. What are the control measures you have in place that are keeping you safe while you are doing this task?


4. Are those control measures in line with the SHEWMS/Safety Essentials requirements and are they effectively implemented? What else could you do to reduce the risk?


5. What feedback or suggested improvements would you like to give to Visionstream that will possibly make your workplace safer?


B1. Safety Essentials Observed

Electrical Works

Working at Heights

Driver Alertness

Working in the vicinity of Utility Services

Excavation Works

Working in the vicinity of Vehicular Traffic

Mobile Plant

Remote or Isolated Location

Heavy Lifting (E.g. Cranes)

Exposure to Asbestos

B2. Environmental Aspects Observed

Cultural Heritage

Fire Management

Noxious Weeds / Pests

Vegetation Clearance / Reinstatement

Water Pollution / Sediment Control

Flora / Fauna

Noise / Air Pollution

Spill Management

Contaminated Land

Waste Disposal and Management

C. Positive Feedback - 'Good' SHE Behaviours and/or Conditions Observed


D. Areas for Improvement - 'At Risk' SHE Behaviours and/or Conditions Observed


Comments / Corrective Actions

Are there any further comments or corrective actions required? (Corrective actions must be assigned to action owner in Cintellate)

Comments / corrective actions

Person completing visit



This form is to be completed for each SHE Leadership Walk and Talk and put into Cintellate before the last day of each month.

1. Arrange visit with the Safety Manager/Coordinator
2. Obtain copy of Telecommunications Safety Essentials booklet, SHEWMS and clarify site PPE requirements
3. Arrive at site, engage with workers/subcontractors and discuss current work activities
4. Observe tasks to determine adherence with the Safety Essentials
5. Try not to complete the form at the time of conducting your LWT visit, but after speaking with workers (I.e. back in the car)
6. After the LWT visit, enter in Cintellate and assign any identified corrective actions to the Project Manager
7. The last action in Cintellate will be that you receive an email when all actions are closed out

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.