Title Page
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Conducted on
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Company name
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Name
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Site Location
Take 5 sections
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Are you familiar with how to report hazards & incidents?
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Do you have the correct procedures and equipment to do the work safely?
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Is there appropriate separation of vehicles and people during the proposed work?
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Is all required electrical/mechanical equipment in a safe condition?
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Have you consulted with workers about the task and the safe way to do it?
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Do you have all necessary PPE?
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Have you got a safe way of getting in and out of your work area?
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Sign off
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Comments/ hazards
