Title Page

  • Conducted on

  • Prepared by

  • Location

Details

  • Inspector

  • Date

  • Site

  • Staff Present

  • Description of works

Health & Safety

Site Specific Risk Assessment

  • Is the SSRA correctly filled in?

  • Have Covid-19 / Infectious disease arrangement and control measures been considered?

  • What measures should be put in place?

Manual Handling

  • Are good manual handling techniques being carried out?

  • Reason?

Method Statement

  • Is this correctly filled in?

  • Have Covid-19 / Infectious disease arrangement and control measures been considered?

  • What should be considered?

Site Organisation

  • Fuelling Station - 4m away from work zone?

  • Reason?

  • Drip tray / plant nappy being used?

  • Reason?

  • PPE – available, used correctly etc.

  • Reason?

  • PPE - related to Covid-19 / Infectious Disease available, used correctly etc.

  • Reason?

  • Correct cordoning

  • Reason?

  • Traffic Management

  • Reason?

  • Chipper location/ conversion of debris – suitable & safely undertaken?

  • Reason?

  • General Organisation – tidiness, communication

  • Reason?

Tools and Equipment

  • Are the safety procedures for the Compact Tractor being carried out?

  • Reason?

  • Are the safety procedures for the Rotavator being carried out?

  • Reason?

  • Are the safety procedures for the Stone Burier being carried out?

  • Reason?

  • Are the safety procedures for the Mover being carried out?

  • Reason?

  • Are the safety procedures for the Herbicide Sprayer being carried out?

  • Reason?

  • Are the safety procedures for the Strimmer being carried out?

  • Reason?

  • Are the safety procedures for the Seeder being carried out?

  • Reason?

  • Are the safety procedures for Hedge Cutting being carried out?

  • Reason?

  • Are all manufacturers handbook available?

  • Reason?

  • Further action required

Vehicles

  • Vehicles checked and serviceable

  • Vehicles loaded and secured correctly

  • Is a fire extinguisher present, correctly stocked and in date?

  • Action required

  • Is a First Aid Kit present, correctly stocked and in date?

  • Action Required

  • Is Eye Wash present, correctly stocked and in date?

  • Action Required

  • Are all vehicle safety features in place and being correctly used

  • Reason / Action Required

  • Are Covid-19 / Infectious Disease management currently in stock and in date. ie. Santiser or hand washing facilities etc. ?

  • Reason?

Environmental Considerations (EC’s)

  • Have all EC’s been taken into account? – Fuels /oils stored correctly?

  • Is there a spill kit on site and an environmental emergency plan?

  • Biosecurity- has this been considered adequately, if applicable

  • Certification

  • Employees adequately qualified for tasks being undertaken?

  • Driver correctly licensed for vehicle combination?

  • General Comments

  • Signed

Quality Checks

  • Staff understand specification, drawing or instruction?

  • Action required

  • Works carried out reflect specification, drawing or instruction?

  • Action required

  • Staff courteous, polite, smart in appearance and clean vehicles

  • Has work been completed?

  • Site left clean, tidy and safe?

  • Client happy and satisfied with completed works?

Progress of Work

  • Has expected amount of work been completed?

  • Reason?

  • Are there any issues which have slowed work?

  • Details

Other

  • Other site notes/observations

  • Actions Required

  • Completed confirmation (Name)

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.