Title Page

  • Job Ref

  • Document No.

  • Audit Title

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Job Details

  • Select date

  • Job Ref
  • Address

Job Start

  • Has the job started

  • Have all risks,hazards and control measures been identified and implemented?

  • Have you been adequately briefed before signing on?

PPE Adherence / Condition / Testing

  • Hard Hat

  • Safety Glasses

  • Long / Long work wear

  • Safety Boots

  • Hearing Protection ( if noisy ambient )

  • Fall Protection ( if working at heights )

  • Mechanical Gloves ( i.e if fleeting off duct from a drum )

Public Safety / Traffic Management

  • Is there a CAR ( Corridor Access Request ) on Site?

  • Is there a TMP ( Traffic Management ) Plan Onsite?

  • Has an STMS ( Site Traffic Management Supervisor) been assigned to the site?

  • Is there a level 1TC ( Traffic Controller ) onsite?

  • Are there Safety Cones,Barriers and signs predominantly displayed so that clear go and no go areas are clearly defined for the public?

  • When pedestrians are diverted off the footpath onto the carriageways are ramps installed on and off the kerbs?

  • Are temporary reinstatements executed in a manner so there are no trip hazards?

Environmental Safety

  • Have all riks,hazards and control measures been implemented to prevent the contamination of the air,soil and waterways?

  • Have all risks,hazards and control measures been implemented to prevent the contamination from waste management,noise control and dust suppression?

General

  • Actions taken to Acknowledge/Reinforce safe behaviours/Conditions.

  • Actions taken to confront/Correct unsafe behaviour/Conditions.

  • Add signature

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.