Title Page

  • Site conducted

  • Audit Number

  • Conducted on

  • Prepared by

  • Area

  • Asset

  • Type of temporary works

  • Reason for temporary works

  • Description of work completed

  • Is all safety guarding still in place

  • Are all safety interlocks still operational

  • Are any additional hazards created by the temporary works

  • Have all operators and shift managers been made aware of the changes

  • Expected time frame for temporary works

  • Add images

  • Enter date for temporary works to be removed

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.