Title Page
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Conducted on
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Prepared by
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Location
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Site Name :
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Todays Scope of Work :
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Staff on Site Names :
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SWMS Sign on Page (Attach Photo) :
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SWMS ID/Numbers :
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Permits required for todays work ? (Attach Photos of each permit)
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Permit Photos (If applicable) :
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JSA Front Page (Attach Photo) :
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CRQ/CMART Logged In
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MSDS Folder (Attach Photo) :
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Site Folder (Attach Photo) :
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Overall site set-up with exclusion zones (Attach Photo) :
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First Aid Kit (Attach Photo) :
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Fire Extinguisher -Tag Visible (Attach Photo) :
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Site Signage set-up (Attach Photo) :
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Rescue Kit (Attach Photo) :
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Rigging Equipment inspection tagged ? Test and Tag current ?
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Is there Plant on site ? (Attach Photo) :
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Plant Photo (If applicable) :
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RADMAN/Gas Detector (Attach Photo) :
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Rescue Plan Prepared ? (Attach Photo) :
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Rescue Plan Photo (If Applicable) :
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DOES YOUR SITE COMPLY WITH ALL OF THE ABOVE ?
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Insert your name and press the pen to sign on.
