Temporary Toilet Unloading/Loading

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Toilet Type

  Select 16 Pan 5 Star Deluxe Disabled Single Urinal 6 Star

  • 16 Pan
  • 5 Star
  • Deluxe
  • Disabled
  • Single
  • Urinal
  • 6 Star

• Sex

  Male

  Female

  Combo

  Unisex

• Driver Name

• Appropriate Licenses (Crane, CI Card)

  Safe

  At Risk

  N/A

• JSA on record/completed

  Yes

  No

  N/A

• SWMS on record

  Yes

  No

  N/A

• Unloading/Loading Method

  Tilt

  Crane

• Overhead/Underground Services Checked

  Safe

  At Risk

  N/A

• Inspection of Equipment Completed

  Safe

  At Risk

  N/A

• Adequately Tested & Tagged

  Safe

  At Risk

  N/A

PPE

• Hi Vis Clothing

  Off

  On

• Gloves

  Off

  On

• Helmet

  Off

  On

• Steel Cap Footwear

  Off

  On

Images

• Add image

  Media

Signature

• Add signature

  Sign