Title Page
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Prepared by
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Conducted on
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Location
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Project Name
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Staff involved with the inspection
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Position of Inspecting worker
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Full Name
Items to be checked
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Access and Traffic Control- Clear, unobstructed, adequate, signage, lighting, housekeeping, stair handrails
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Comments and Suggested Corrective Action
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Project Signage, Fencing / Perimeter Hording – signage at all entries, structural integrity as per design,
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Comments and Suggested Corrective Action
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Amenities – location and ratio adequate meal room, water, toilet condition (bins emptied / hygienic / vermin), no inappropriate signage displayed
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Comments and Suggested Corrective Action
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First-aid – Signage, clean, stocked, locations adequate
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Comments and Suggested Corrective Action
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Work at Height – Adequate protection for falling objects / falling person
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Comments and Suggested Corrective Action
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Public Safety - Adequate protection for public safety
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Comments and Suggested Corrective Action
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Emergency Preparations – access for emergency services, signage, nurse-call, siren/alarm, rescue equipment
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Comments and Suggested Corrective Action
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Electrical leads – Raised on insulated means, tested monthly, industrial grade, max length, good condition
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Comments and Suggested Corrective Action
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Electrical Boards – Inspected monthly, signposted, insulated tie bar, clear access RCD trip tested & locked
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Comments and Suggested Corrective Action
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Construction wiring – isolated secure, elevated, tiger tails or labelling
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Comments and Suggested Corrective Action
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Excavations – Barricading 1m back spoil out of zone of influence, battered / shored / benched; access safe, access ladders 1m past landing,
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Comments and Suggested Corrective Action
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Fire extinguishers – Charged, signposted, raised, 6 monthly test, location adequate
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Comments and Suggested Corrective Action
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Formwork – Signage and isolation above / below, adequate edge protection, safe access, EPT signage and competency.
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Comments and Suggested Corrective Action
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PPE – Hard-hats, High-visibility clothing, safety footwear, other used
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Comments and Suggested Corrective Action
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Scaffold – Record of monthly inspection, adequate edge protection / handrails, tying, bracing, clear of materials, safe access, fit-for-purpose, planks secure or 300mm overlap
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Comments and Suggested Corrective Action
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Plant – Daily inspection, routine maintenance complete, warning signals, manual, competency / ticket available, using correctly, ROPS/FOPS
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Comments and Suggested Corrective Action
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Ladders / Trestles – Industrial grade, permit for work off step / builders, used correctly not 2nd last rung
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Comments and Suggested Corrective Action
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Hot Works – Fire extinguisher, flash shield, flashback arrestors and trolley used for oxy, area clear, PPE used
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Comments and Suggested Corrective Action
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Lifting Gear – WLL displayed on boxes / stands, identifiable / registered, no obvious defects
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Comments and Suggested Corrective Action
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Substances – SDS available, containers labelled, storage adequate / ventilated, PPE used / available
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Comments and Suggested Corrective Action
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Stressing – Area signposted, Bripak or stress area isolated, sharps isolated, pans covered, cable ends protected,
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Comments and Suggested Corrective Action
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General Housekeeping – Areas are clear and clean of debris, trip hazards, bins emptied.
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Comments and Suggested Corrective Action
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Environmental – sediment control in stormwater drains, significant runoff, dust, noise, odours, waterways, hazardous wastes; soil contamination, flora/fauna, and heritage issues controlled?
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Comments and Suggested Corrective Action
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Verification by Foreman/ Site Engineer (after all Not Satisfactory items have been closed or noted to be raised on a CAR)
Sign Off by Site Management
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Reviewed by Safety Officer (and/ or Project Manager), items closed or raised on a CAR