Sub-contractor details

Sub-contractor name

Sub-contractor service

Technician name(s)

Task carried out at the time of inspection?

Client details

Client name

Client contact name(s)

Site location
Health and safety

If at any time the answer 'No' is given, please add comments to the 'Notes' section stating any corrective action that followed.

Risk assessment and method statement and permit to work (where relevant) available?

Is the technician/engineer familiar with the risk and method statement / permit to work?

Are the procedures and control measures as stated in the risk and method statement / permit to work being followed?

Please ask the engineer to follow them and ensure that they are before allowing work to continue.

Please ensure that the engineer fully understands the risk and method statement, follows the safe system of work and risk assessment control measures, then allow them to continue with works.

Can the engineer / technician give an explanation as to why?

Please add the explanation below and if proof can be given that the identified control measures are now understood and are being followed, allow the engineer to continue.

Please ask the engineer to temporarily stop works and provide proof of training and communication of risk and method statement.
- If training and communication can be given ensure safe procedures are followed and allow engineer to continue.
- If training and communication can not be given, stop works and ask engineer to rearrange and return.

Overall safety score

Observations and any additional control measures recommended?

Evidence of inspection and safe procedures.
Sign-off information

I can confirm that I believe that the information given during the time of this inspection is accurate and true.

Inspector name and signature.
Select date
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.