Site Hold Form

Are structural concerns the reason the site has been held

What are the structural concerns?

Insert photo of structural concerns

Are procedural concerns the cause of this site being held?

List the procedural concerns holding this site

What are the environmental conditions when to site was held? Describe the weather and others that contributed to your decision

Insert photo of environmental factors

What control measures did you consider leading up to the decision to hold the site? describe what risk controls you considered, this includes employing additional PPE, fall protection equipment, securing sign corners on wind affected side, abseiling to secure the skin etc.

What possible outcomes could have eventuates if posting this site have of continued?

Have you contacted a Coordinator regarding this site being held?

Contact a Coordinator immediately

Name of coordinator contacted

Coordinators response

Additional comments

Supervisors sign off
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.