Information
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Contract Number(s)
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Site Details
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Conducted on
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Prepared by
Site & Access
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Site Access/ Housekeeping
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House Keeping
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Ladders
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Scaffolding
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SCAFFTAG Present?
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Hoist
Tools & Equipment
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Electric Tools
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Hand Tools
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Hard Hats
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Safety Shoes
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Gloves
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First Aid Kit / Safety Manual
Fitters
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Working Practices
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Attire
Signatures
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I agree that the information contained within this form is complete to the best of my knowledge
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Sub Contractors Signature
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Supervisor Signature