Title Page

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Team

Location

  • Circuit

  • Site No.

  • PMT

  • Description of works.

Risk Assessment/Paperwork

  • Has a risk Assessment been filled in?

  • Quality of risk assessment. 0 = Poor and 10 = Excellent

  • Do all staff have onsite up to date work permits?

  • Has all other paperwork been filled in and present on site?

  • Comments if above answered no.

PPE

  • Are all staff wearing correct PPE for the task?

  • Condition of PPE. 0 = Poor and 10 = Excellent

  • Pictures of any non conformities.

  • Comments

Vehicles/Plant

  • What vehicles are on site?

  • Condition of vehicles. 0 = Poor and 10 = Excellent

  • Comments

  • What plant is on site?

  • Condition of plant on site. 0 = Poor and 10 = Excellent

  • Comments

Small Tools and Insulated Rods

  • What tools are onsite?

  • Condition of tools on site. 0 = Poor and 10 = Excellent

  • Photos of any damaged items.

  • Comments

  • Are insulated rods on site?

  • Condition of insulated rods. 0 = Poor and 10 = Excellent

  • Are they in date?

  • Pictures of any damaged poles.

  • Comments

Site Setup

  • Is the site Setup correct?

  • Picture of site.

  • Comments

  • Condition of site. 0 = Poor and 10 = Excellent

Company Image

  • Are all staff wearing company branded clothing?

  • Have all staff got their ID cards with them on site?

Feedback/Corrective Action

  • Feedback

  • Corrective Action

Sign Off

  • Auditor

  • Team Leader

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.