Title Page

  • Site Name

  • Date

  • Client Name

  • Permit Number

  • Name of Supervisor on Site

  • Name of Operatives on Site

Safety Checks

  • Are all supervisors on site wearing correct PPE? (Hi-vizibility clothing, Blue and yellow trousers, corporate workwear, safety boots (no rigger boots), glasses ect.

  • Are all operatives wearing correct PPE? (Hi-vizibility clothing, safety boots (no rigger boots), corporate workwear, hardhat, gloves, glasses, RPE, ect)

  • Is there a First Aid Kit available on site?

  • Is there a spill Kit available on site?

  • Is there a Fire Extinguisher available on site?

  • Is there a trained First Aider on site?

  • Plant on site

  • Water suppression available and being used?

  • Any PPE issued?

Traffic Management

  • Are drawings available on site?

  • Signage in place (suitable and sufficient as per TM plan)?

  • Barriers in place (suitable and sufficient as per TM plan, clipped together, sand bags, correct support)?

  • Diversions in place (suitable and sufficient as per TM plan, pedestrian diversions, temp areas)?

  • Cones in place (suitable and sufficient as per TM plan, correct spacing)

Quality of Work

  • Overall quality of work.

  • Completed works at the time of visit.

Signed Off

  • Name and signature of Supervisor/Operative on site

  • Name and signature of Inspector

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.