Information
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Document No.
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USI Site Safety Inspection Checklist
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Client / Site
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Conducted on
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Prepared by
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Location
Site Information
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Site Brand Owner
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Site number
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Site address
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Visual size (if required)
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Overall material size (if required)
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Finish/edging (if required)
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What is the installation method on this site?
- standard ratchet site
- no special requirements
- special installation requirements
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Detail special installation requirements?
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Detail tools needed for site, is pull up rope needed? Any special tools required?
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Detail PPE requirements, standard PPE required? Abseil gear required? Anything else needed?
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Are there any hazards to pedestrians or road traffic on this site?
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Detail hazards to pedestrians or road traffic
Access and Safety Inspection Points
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Type of Structure
- Standard lightbox
- Monopole
- Wall Mount
- Bridge Mount
- Rooftop
- Freestander
- Spec Lightbox
- Other
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Describe other type of structure
Access issues
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Access to site
- Is safe
- unobstructed
- Secure
- Adequate Parking
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Insert photo of parking location
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Comments about parking location
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Installation Access Method
- Ladder/Catwalk
- EWP
- Abseil
- Ladder Only
- Free Climb
- Walk up
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Insert any comments about installation access method
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List any keys needed
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Detail any notice required to access site
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Hours of access to site
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Detail any permits needed for site
Safety Apparatus
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Fixed Ladder
- not needed for site
- Present and in good condition
- Present but in bad condition
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Detail condition of structural ladder
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Hand rails
- Not needed for site
- Present in good condition and secure
- Hidden handrail
- Handrail present but not in good condition
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Do you need a portable ladder to access this site?
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What size ladder do you need?
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Are there appropriate ladder brackets on site?
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Describe ladder brackets, are they in good condition and secure?
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Insert photo of ladder bracket
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Is the ladder footing adequate?
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Describe how the footing needs to be adjusted
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Insert photo of ladder footing
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Is there a static line on site?
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Describe the static line, is it appropriate thickness, in good condition, secure?
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What is the thickness of the static line?
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Is there a catwalk on site?
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Describe the catwalk, is it in good condition and secure?
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What is the width of the catwalk?
General Inspection Points
General Points to Inspect
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Is there cladding on this site?
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Site cladding, tick appropriate
- Cladding Present
- Cladding in good condition
- Cladding secure
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Insert additional comment if required
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Is there external lighting on this site?
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Tick appropriate for external lighting
- top lit
- bottom lit
- lights are working
- all covers present
- lighting secure
- external arms in good condition
- no exposed wiring
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Insert additional comment if required
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Is there a winch on this site?
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Does this site need a winch?
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Is the winch in good condition and working ?
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Does this site have side poles?
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Are the side poles in good condition and have safe fall device like cuff and chain?
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What is needed to make side poles suitable?
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Is the tracking on site in good condition and secure?
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What tracking needs to be replaced?
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Are there enough ratchets on site and are they in good condition?
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Detail ratchets needs for this site, how many are missing of damaged?
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Is there border capping on this site?
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Is capping in good condition and secure?
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Is there any vandalism on this site?
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Detail vandalism on this site like grafitti
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Detail the general condition of the structure. E.g. Any rust, dents or other visible damage?
Hazards and Controls
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Does power run into this site?
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Describe how power is avoided
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Are there Overhead Powerlines near this site?
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Describe installation method controls for this site?
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What is the distance to the Powerlines?
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What is the voltage of the Powerlines?
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Is this site at a service station?
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Is this a rail site?
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List controls needed like WPP or Level 3
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Are there radio transmission towers on site? E.g. Telephone towers
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Can they be avoided?
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Detail any other hazards and the appropriate control that may exist for this site
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Is a road closure required?
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Can they be avoided?
Light Box Specific checks
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Are entry gates or hatches in good condition?
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Detail condition of gates or hatches
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Can entry gates of hatches be locked send are all locks present?
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Detail condition of gates or hatches
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Is the lighting entry guard present and in good condition?
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Detail condition of lighting entry guard
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Is the electricians ladder secure?
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Is internal lighting working, have all covers present and no exposed wiring?
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Detail condition of internal lighting
Abseil Specific checks
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Is there adequate room to setup?
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Describe how to rectify
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Does a spotter have a good visual?
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Describe how to rectify
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Detail anchor point location
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Are anchor points present, in good condition and inside inspection date?
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Describe how to rectify
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Are anchor points in suitable location?
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Describe how to rectify
Travel Tower site checks
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Detail why this site needs a travel tower
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Is there adequate room to setup?
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Describe how to rectify
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Does a spotter have good visual?
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Describe how to rectify
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Is there clear access to post from the travel tower?
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Describe how to rectify
Sign offs
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Is this a new site being inspected?
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Is site satisfactory for installing on?
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Sign to confirm site is safe to post on
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Detail what this site needs to be safe to post on
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Sign to confirm inspection took place
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Is this site upgrade or modification?
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Detail modifications or upgrades to this site
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Is site satisfactory for posting on?
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Sign to confirm site is safe to post on
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Detail what this site needs to be safe to post on
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Sign to confirm inspection took place
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Sign to confirm general site inspection is correct as described and site is safe to post on
