Title Page

  • Location
  • Conducted on

Site Access, Facilities, and Security

  • Access to work areas clear and safe

  • Safety fences secure and gate padlocked

  • Security cameras operational and footage available

  • Site facilities clean and hygienic

  • Adherence with Environmental Sustainability Plan

  • *Safety signage displayed clearly and up to date

  • Under ground and overhead services clearly marked

  • Site Map and Plans current and available onsite

  • QR Codes displayed and operational

  • Work areas tidy, organised, clutter/rubbish free

  • Slip, trip and fall hazards minimised

  • Loose materials secured

  • Waste disposed of correctly

  • *Signage includes entry, exit, hazard boards, hazardous substances, PPE requirements, restricted areas, danger and warning, directional, traffic

Personnel Onsite

  • All personnel onsite have completed an Induction

  • All personnel onsite have signed in

  • *All personnel are wearing required and appropriate PPE

  • All personnel are appropriately trained, and Competency register is up to date

  • **Daily Briefings and Weekly Toolbox Meetings held

  • *PPE must be clean and hygienic, fit for purpose, current, and worn correctly

  • **Minutes of meetings sighted

  • Adherence with Kaimahi Ora - Health, Safety, and Wellbeing Strategy

Plant, Equipment and Vehicles

  • SOP/JSA/Permit to Work approved (where applicable)

  • Vehicles, equipment, and tools correct for the task and being used safely

  • Vehicles, equipment, and tools onsite all well maintained and in good condition

  • Certifications, registrations, warrants, and servicing requirements current

  • Vehicle checks completed

  • All equipment and tools visually checked before use

  • Guards in place and in good condition

  • Equipment, and tools all stored correctly when not in use

  • Health hazards minimised (noise, dust, fumes)

Electrical

  • Hidden cables located and marked

  • Minimum approach distances (4m) maintained from power lines

  • All electrical leads tested with current tag, and checked before use

  • Damaged leads removed from site

  • Leads not presenting trip hazard

  • RCD used when required

Height Work

  • JSA completed and approved by site management (including identification of overhead services)

  • Notifiable work reported to WorkSafe and Emergency Response Plan in place

  • Personnel trained and competent to work at height

  • Fall protection or scaffold in place

  • Scaff - Temporary and fixed scaffolding safe for use, has current tag and is regularly checked

  • Scaff - Handrails, mid railing, gates, and kick boards in place

  • Scaff - Platforms safe (min 3 planks wide secured) and kept clear of trip hazards

  • *Scaff - Ladder access adequate and well secured

  • Safety nets in place, installed by competent person, safe, tagged and regularly checked

  • Exclusion zones in place

  • Harnesses checked and serviced to legal requirements, and checked prior to use

  • *Ladders (industrial, rated to 150kg only) in good condition, secured and stays used, operator minimum of 2 steps down

  • *Extension ladders ratio against structure (4:1) and at least 1 metre past platform level

Cranes and Lifting Equipment

  • JSA/lift plan completed and approved by site management (including identification of overhead services)

  • Notifiable work reported to WorkSafe and Emergency Response Plan in place

  • Personnel trained and competent

  • Cranes, MEWP, Hiab’s set up on stable ground and prestart checks completed

  • Exclusion zones and safety observer (dogman) in place

  • Crane/sling/chain/MEWP certification current and available

  • Lifting equipment in good condition

Excavation

  • JSA and permit to dig completed and approved by site management (including identification of underground services)

  • Notifiable work reported to WorkSafe and Emergency Response Plan in place

  • Excavations shored/benched/battered

  • Loads (including soil, equipment and vehicles) held at an adequate distance from the edge

  • Excavations fenced/barriered to prevent access and falls

  • Safe access and egress routes available

Hazardous Substances

  • Inventory and Safety Data Sheets readily available

  • Substances stored and labelled correctly

  • Fuel sources and combustibles removed from hot work areas

  • Signage displayed onsite

  • Only trained operators to access

Emergencies

  • Site emergency procedures up to date and displayed

  • First aid kits and fire extinguisher available in all vehicles onsite

  • First aid kits checked, current and fully stocked

  • First aiders onsite

  • Fire extinguishers serviced and within certification date

  • Incident register and investigations up to date

Sign-off

  • Inspector:

  • Signed:

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.