Title Page

  • Site Name

  • Project reference

  • Conducted on

  • Location
  • Prepared by

Site Access

  • Is there safe pedestrian access.

  • Is there safe level access into the building for vehicles/Plant.

  • Size of entrance.

  • Is the work area easily isolated from normal operation.

Floor Condition.

  • Is the floor in good condition generally.

  • Are floor joints present.

  • Are they known and surveyed.

  • Is the floor excessively uneven.

  • is there excessive cracking in the floor.

  • Are there any pits/holes etc... in the floor.

General Conditions

  • Environment.

  • is there adequate lighting.

  • Is there a dedicated storage area for materials.

  • Is there Adequate power for tools.

  • Is there Adequate power for plant charging.

  • Are there adequate Welfare facilities.

  • Should we provide.

  • Site contact

  • Phone number.

  • Site working hours.

  • Any site specific PPE.

Work practices

  • is the build sequence established.

  • is the method of build understood.

  • Is the drawing approved and current.

Comments

  • Any other comments.

Enquiry

  • Racking type.

  • Pallet Storing Orientation WxD

  • Pallet Weights

  • FLT Type

  • FLT Turning Circle (mm)

  • Decking Type

  • In-rack Sprinklers required

  • No of levels

  • In rack, flue or both

  • Supports required

  • Floor slab details WxD

  • Delivery time restrictions

  • Restricted times:

  • Will we have dedicated use of an FLT with driver for unloading of materials.

  • Additional notes

Completion

  • Survey Completed

  • 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.