• Work Order number

  • Site

  • Conducted on

  • Prepared By

  • Location
  • Personnel on site


  • Work Type

  • Site Conditions

  • Is the site safe for duties being performed?

  • Location Type

  • Equipment Required

Hazard Assessment

  • Have the Pre Start Checks been undertaken on all machinery? *List any issues*

  • Are your tools, equipment and chemicals safely stored while not in use on site?

  • Unsecured equipment can be stolen or be a safety issue.

  • Pedestrian Control

  • Pedestrians and users of the area should be aware of your activities and be safe while in the area.

    no label
  • Vehicular Traffic

  • Be aware of vehicles on the road and within parks.

    no label

Toolbox Discussion

  • Is there more than one worker on site?

  • If more than one worker on site list who is performing what duties in the notes.


  • Have SWMS been read and understood by all on site?

  • Emergency numbers
    Police/Fire/Ambulance. 000
    Supervisor. 0412496345
    Manager. 0434567724

  • Name:

  • Name:

  • Name:

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.