Title Page

  • Conducted on

  • Prepared by

  • On behalf of :

  • Weather conditions

  • Team 1 Site Location/ ELR and Mileage

  • Team 2 Site Location/ ELR and Mileage

  • Team 3 Site Location/ ELR and Mileage

  • Site Hours

  • Any lost time/hours

  • Possession Start time or Shift time

  • Possession End Time or Shift time

Planned Works V Actual

  • Planned Works

  • Actual Work Team 1

  • Actual work Team 2

  • Actual Work Team 3

  • If Shortfall, reason why

  • Reason for delay to task

Resources

  • How Many team's on site today

  • Members of staff on site

  • Members of staff on site Team 1

  • Members of staff on site Team 2

  • Members of Staff on site Team 3

  • Delivery Team or Team's

  • PPE

  • What Welfare is being used

Plant & Equipment

  • RRV's /Plant / Attachments and Van's

  • Small Plant

  • Breakdowns

  • Lost time on plant down

  • Equipment suitable for the works

  • Lighting sufficient for the task

Photos

  • Photos Team 1

  • Photos Team 2

  • Photos Team 3

Any Issues

  • Technical Queries

Inspections

  • Is lighting Sufficient for the task

  • House Keeping

  • Welfare

  • First Aid kits on site

  • Paperwork on site

Defects

  • Defects found

Close Calls / Good Working Practices

  • Close calls

  • Comments

  • Good Working Practices

Signatures

  • AIW Representative

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.