Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

  • Description of task being conducted

  • Are works being done safely and in accordance with relevant SWMS?

  • Is exclusion zone maintained to a good standard?

Fall Arrest Systems

  • Is there a safety net in place?

  • Is there an individual fall arrest system in place? (Harness, lanyards, horizontal life lines, etc)

  • Have they been inspected and tagged with current colour?

  • Are the workers performing work at heights attached to an authorized anchor point?

EWP

  • Type of EWP being used?

  • Does the operator hold a valid licence?

  • Has the pre-start check being done & logbook filled in?

  • Is the basket clean and tidy, free of trip hazards?

  • Are the tools connected to tool lanyards?

EWP Operator

  • Is the radio on the right channel? (previously agreed on during pre-start)

  • Has communication been checked? (Do the workers on EWP understand and answer back when talked to? )

  • Are the workers performing work at heights carrying the radio on them?

  • Are the operators wearing the relevant PPE for the task? (gloves, safety boots, hi-vis clothing, safety glasses, etc)

  • Comments

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.