Title Page
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Audit Title
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Client / Site
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Conducted on
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Do i clearly understand what if required?
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Am i trained to do the work and familiar with the equipment/task?
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Are the tools and equipment is safe condition?
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If the task involves working with or near Hot Works, Working at Heights, or Excavation? Do you have the required permits? (Leave blank if no permits required)
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Do i have the appropriate documents for the task?
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Am i safe from other activities/ tasks in the area?
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Have I informed others who may be affected by my works?
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Are precautions in place to stop others entering my work space if necessary? (Barricades, signs, ect......)
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Have I implemented appropriate traffic management? (Leave blank if not required)
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Do I have the correct PPE for the task?
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If you answered "YES" to all of the above, all attending site to sign below and proceed with works,
***IF "NO" to any, take action to correct & complete below
Hazard
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hazard description
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risk rating? (Before Control)
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Control
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Control
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risk rating? (After control)
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Hazard description
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Risk Rating? (Before Control)
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Control
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Risk Rating? (after Control)
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Are there any other risks you can think of?
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Are all the risks adequately controlled?
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Have all the hazard controls been implemented?
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Have all potential problems been discussed and understood by all?
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Can the task proceed safely?
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If "NO" to any, do not proceed and complete a JSA/SWMS.
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Team Members on site.
- Jayden
- Mark
- Sid
- Alex
- Blake
- Frankie
- Raj
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Any other staff?
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Team leader to sign off
