Title Page

  • Site Name:

  • Site Number:

  • Add location
  • Region:

  • Grounds Number:

  • Contractor Maintaining Site:

  • Prepared By:

  • Date:

Grass Areas

  • Lawns Mowed to Standard?

  • Action Required:

  • Type of Action Required:

  • Edges Cut to Standard?

  • Action Required:

  • Type of Action Required:

  • Leaf Litter & Tree Branches removed? (<100mm Removed from Site)?

  • Action Required:

  • Type of Action Required:

Fence Lines

  • Internal Fence Line Clear to 1m (minimum)?

  • Action Required:

  • Type of Action Required:

  • External Fence Line Clear to 1m (minimum)?

  • Action Required:

  • Type of Action Required:

Access Ways - Paths & Driveways

  • Leaf Litter/Vegetation Cleared from Base Rail of Fence?

  • Action Required

  • Type of Action Required:

  • Chainwire/Barbed Wire Clear of Vegetation?

  • Action Required:

  • Type of Action Required:

Access Ways - Paths & Driveways

  • Paths/Walkways clear of any Overhanging Foliage/Growth?

  • Action Required:

  • Type of Action Required:

  • Weeds in Pathways Controlled?

  • Action Required:

  • Type of Action Required:

  • Driveways/Access Roads Clear from any Overhang?

  • Action Required:

  • Type of Action Required:

  • Weeds Along Driveway Controlled?

  • Action Required:

  • Type of Action Required:

Hardstand Areas

  • Gutters/Drains & Stormwater Pits Clear of Leaf Litter & Silt Buildup?

  • Action Required:

  • Type of Action Required:

  • General Hardstand Areas Clear of Weeds & Litter?

  • Action Required:

  • Type of Action Required:

Trees on Site

  • Trees > 3m In Height in Good Condition?

  • Action Required:

  • Type of Action Required:

  • Trees < 3m in Height Crown Listed & Being Maintained in Good Condition?

  • Action Required:

  • Type of Action Required:

Overall Standard

  • Is the Facility Adequately Maintained?

  • Action Required:

  • Type of Action Required:

Prepared By

  • Add signature

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.