Information
-
Document No.
-
Team Leader Name
-
Conducted on
-
Site Number and Location
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
