Information
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Project Week No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Personal Protective Equipment (PPE)
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Hard Hats
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Hearing Protection
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Respiratory Protection
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Operatives wearing work attire
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Safety footware
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Hand Protection
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Eye / Face Protection
Housekeeping
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Access & Egress Clear (Stairs, Walkways)
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Material Properly Stacked / Stored
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Debris / Waste Removal
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Nails - Bent / Removed
Ladders / Stairs
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Stair Railings / Hand Rails in place
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Ladder Condition
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Secured / Tied Off
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Extends Above Landing
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Scaff tag in place
Fall Protection
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Guardrail / Mid-Rail / Toe board
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Floor Hole Covers / Secure / Labelled
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Personal Fall Arrest / Fall Restraint / Proper design
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Lift Shaft Protection / Debris Removed
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Slips / Trips / Falls
Scaffolding / False Work / Shoring / Decking / Concrete
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Planks / Decks / Platforms Installed Properly
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Impalement Protection / Rebar Caps / Troughs
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Proper Access / Ladder / Inspection
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Proper Bracing / Re-Shore / Pads
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Inspected / Secured / Structurally Sound
Electrical
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Adequate Lighting - Task / Area
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Grounding / Inspection
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Cables elevated / Plugs / Inspected
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Lockout / Tagout (LOTO) / Energy Controlled / Rooms Secured
Fire Protection / Prevention
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Adequate Extinguishers (Area & Task) / Inspected / Nearby
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Flammable Materials Storage
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Proper Welding / Cutting Equipment
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Hot Work Permit / Firewatch
Tools - Hand & Power
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Good Condition / Inspected / PAT Tested
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Guarded / Guards in Place
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Use Properly / No Modifications
Site / Public Protection
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Hoarding / Fences / Pedestrian Canopy / Trip Hazards
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Adequate Signage / Lighting
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Traffic Management Plan
Emergency Preparedness / First Aid
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Trained Personnel
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First Aid Kits / Supplies
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Adequate Sanitation / Hand washing / Water
Programmes / Information
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Periodic Management Inspections
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Hazards Properly Identified and Rectified
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Site Manager Safety Passport
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Safety / Tool-box Talks
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Signage in place
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Adequate Potable Water
Equipment / Crane / Lifts / Hoisting
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Equipment Certifications / Daily Inspections / Alarms / Properly Parked
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Operator Certification / Qualifications / Seatbelts
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Lift Plan / Load Swing Planned / Radius Protection / Power lines Identified
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Rigger / Signal Person Qualifications / Banksman
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Ground / Area Survey / Stability / No Open Holes
Underground / Overhead / Confined Spaces
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Underground Utilities Marked / Protected Pot-holing / Material Controlled
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Confined Spaces - Identified / Training / Permits
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Excavations / Trenches - Shoring / Sloping / Access
Other / Misc.
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Other / Misc.
