Information
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Document No.
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Sudent Name
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Client / Site
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Conducted on
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Prepared by
Site Setup
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Student chooses correct sign and puts them in place prior to work
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correct barricades are assembled and positioned
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Equipment is checked for date and compliance
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Understands documentation required for the task
PPE
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Does the student choose the correct PPE
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Can the student put the PPE on correctly
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Can the student remove PPE correctly
Tools and Equipment
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Chooses the correct Working at heights equipment
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Identifies isolation procedures
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checks tools for defects in accordance with policies
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Shows correct use of equipment
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Wears harness correctly
Cleanup
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Work area is made safe
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Removal of waste and damaged equipment is done in accordance with the Company Policy
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All tools are cleaned and put away
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Equipment is checked after use and tagged for service
Declaration
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I declare that the information included in this report is true and I have witnessed the student participate in the process of Working at Heights in accordance with the Legal requirements.
