Site Safety Inspection Checklist - PDS

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. Working at Heights

• 1.1. Fall risks of 2m or more? (including voids, pits, and trenches)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 1.2. Lack of edge protection?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 1.3. Unsafe or incomplete edge protection?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

2. Plant and Equipment

• 2.1. Unsafe or damaged plant/equipment? (including missing or damaged guards)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 2.2. Incorrect plant /equipment for job? (e.g. grinding discs for cutting)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 2.3. Unsafe or incompatible attachments used with plant/equipment?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 2.4. Unlicensed operators?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 2.5. Lack of safe work instructions?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 2.6. Lack of training in safe operation, clean-up and maintenance?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 2.7. Lack of LOTO procedures for cleaning, servicing and maintenance?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 2.8. Lack of inspection regime? Ie logbook

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

3. Scaffolds

• 3.1. Unlicensed persons erecting scaffold above 4m?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 3.2. Unsafe or incomplete scaffold?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 3.3. Lack of inspection protocol for scaffold?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 3.4. Incompatible scaffold components? Unlabelled or do not meet AS?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 3.5. Safe Work Load (SWL) exceeded? (tools, stored materials, number of persons)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

4. Lifting Equipment

• 4.1. Unsafe or damaged plant?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 4.2. Loads lifted over persons, close proximity to obstacles incl. overhead power lines?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 4.3. Lack of maintenance, testing and inspection?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 4.4. Lack of SWL information displayed?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 4.5. Lack of daily inspection protocol?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 4.6. Unsafe or damaged lifting equipment, including ropes, slings, chains, hooks?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 4.7. Lifting equipment unlabelled, does not meet AS, no SWL displayed?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 4.8. Unlicensed operators?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 4.9. Lack of LOTO procedures for cleaning, servicing and maintenance?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 4.10. SWL of plant or any lifting equipment exceeded?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

5. Harness and Equipment

• 5.1. Unsafe or damaged harness or equipment?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 5.2. Incompatible hooks/equipment?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 5.3. Unlabelled or does not meet AS?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 5.4. Unsafe or uncertified anchor points?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 5.5. Lack of inspection protocol for equipment?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 5.6. Lack of or inadequate formal training for operators?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

6. Ladders

• 6.1. Unsafe or damaged ladders?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 6.2. Unsafe positioning of ladders?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 6.3. Ladder not properly secured?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 6.4. Ladder unsuitable for job? (e.g. metal ladder used for electrical work)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

7. Hazardous Manual Tasks

• 7.1. Lack of identification hazardous manual tasks?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 7.2. Lack of assessment of hazardous manual tasks?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 7.3. Inadequate risk controls? (examples: no job rotation, lighter loads, trolleys, lifting equipment, etc)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 7.4. Lack of training in risk controls and safe lifting/ team lifting techniques?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

8. Hazardous Chemical

• 8.1. Unsafe storage location? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 8.2. Incompatible chemicals stored near each other?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 8.3. Inadequate spill containment equipment?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 8.4. Safety Data Sheets not accessible on site?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 8.5. Lack of emergency procedures for injury/spills/fire etc?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 8.6. Excessive quantities stored on site or in vehicles?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 8.7. Insufficient ventilation?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 8.8. Insufficient, or incorrect, PPE?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 8.9. Unsuitable storage containers? (unlabeled or stored in food containers)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

9. Emergency Response

• 9.1. Lack of, or no emergency plans for site?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 9.2. Emergency procedures not displayed at site?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 9.3. Lack of training and rehearsal of emergency plans?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 9.4. Lack of, or inadequate first aid kits aid equipment for site?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 9.5. Insufficient access to formally trained First Aiders for all shifts?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 9.6. Unsuitable or inadequate communication equipment?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

10. Traffic Management

• 10.1. Lack of, or inadequate, Traffic Management Plan (TMP) in place?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 10.2. Lack of training in TMP for all persons on site? <br>(contractors and visitors)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 10.3. Inadequate controls for TMP? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

11. Personal Protective Equipment (PPE)

• 11.1. Lack of, or inadequate PPE (including sun protection)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 11.2. Lack of system to issue, inspect, replace and monitor PPE?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 11.3. Lack of training in safe use, clean-up and inspection of PPE?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

12. Work Environment

• 12.1. Lack of/or inadequate amenities? (toilets, wash areas, lunch rooms, etc)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 12.2. Insufficient lighting?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 12.3. Inadequate housekeeping?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 12.4. Lack of, or inadequate noise/ vibration control?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 12.5. Site signage displayed?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 12.6. Site secure?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 12.7. Fire fighting equipment - serviced, tagged, signage, location, access?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 12.8. First aid - facilities, location, trained personnel?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 12.9. First aid treatment - recording?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

13. Electrical Hazards

• 13.1. Unsafe electrical leads? (damaged, out of test date or untested)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.2. Lack of RCD protection?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.3. Contact with underground assets?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.4. Contact with overhead electrical lines?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.5. Overloading outlets?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.6. Leads placed on ground or on metal structures?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.7. Electrical equipment near water?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.8. Electrical equipment near flammables?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.9. Electrical equipment near chemicals that could cause damage?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.10. Electrical leads that may be damaged from contact with moving machinery parts?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.11. Electrical leads on work surfaces?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.12. Lack of Lock-out/tag-out (LOTO) procedures for electrical equipment?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 13.13. Temporary DB's - secure, lockable lid, RCD, tested and tagged?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

14. Environmental Hazards

• 14.1. Lack of/or inadequate Environmental Management plan (EMP)?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 14.2. Lack of/or inadequate, dust suppression system?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 14.3. Lack of/or inadequate systems to prevent contaminants entering stormwater drains?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 14.4. Lack of water re-use systems?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

15. Administrative Procedures

• 15.1. Lack of/or inadequate Site Safety Plan?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 15.2. Failure to obtain permits (Council, EPA, WHS, also Hot Works, Confined Space etc)

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 15.3. Lack of, or inadequate, induction for workers, contractors, visitors?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 15.4. Lack or, or inadequate, supervisory arrangements?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 15.5. Lack of/or inadequate training, licenses, skills, experience?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 15.6. Lack of/or inadequate Safe Work Method Statements (SWSM) for high- risk work?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 15.7. Lack of, or inadequate system to review SWMS as needed?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 15.8. Lack of/or inadequate incident notification procedures?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 15.9. Lack of, or inadequate, routine inspections, monitoring, audits?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

• 15.10. Lack of/or inadequate consultative arrangements?

  Safe

  At Risk

  N/A

• Risk

• Corrective actions

• Priority

  Extreme

  High

  Medium

  Low

• Responsible Party

• Completed by next inspection?

  Yes

  No

  N/A

Additional observations

• Additional observations

Additional safety observations

• Observations

• Corrective actions

• Responsible Party

• Priority

  Extreme

  High

  Medium

  Low

• Completed by next inspection?

  Yes

  No

  N/A

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• On site representative

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• Auditor's signature

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