Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Project No

  • Project Title

  • Supervisor / Project Manager:

  • Attendees

  • At least one corrective action shall be assigned to all non-satisfactory items. Once a selection of "NO" is made please ensure to select the action option and fill out. Corrective actions will be collated in the final report PDF.

HOUSEKEEPING / GENERAL

  • Has a Pre-start been completed and signed onto

  • Have workers completed CDO and site-specific induction

  • Has a risk assessment been conducted for the works (SWMS/UTake5)

  • Is there regular disposal of waste and trash

  • Are materials stacked safely

  • Is the correct type and amount of safety signage used

  • Are openings in floors / ground protected and barricaded

  • Is the floor area clear of trip hazards

  • Are stairwells lit, free from waste and handrails in place

  • Is temporary fencing secure, are hoardings maintained

  • Have an adequate number of bins / skips been provided and are they being used

PPE

  • Is the PPE appropriate for the task

  • Is the PPE being used correctly

  • Is there adequate sun screen available?

HYGIENE

  • Are washing facilities adequate

  • Are lunchrooms/toilets sufficient

  • Are staff amenities kept clean

ELECTRICAL

  • Are all electrical equipment and cords tagged and tested (In date)

  • Are RCDs being used for all power tools

  • Is there a certificate of electrical compliance for completed electrical works? (e.g. Lunch Rooms)

  • Are temporary boards adequate and safe

PUBLIC SAFETY

  • Is the site secure

  • Is there sufficient public separation

  • Is the project sign displayed at the entry gates

SCAFFOLDING

  • Have appropriate SWMS been produced for the scaffold erection

  • Is the perimeter protection sufficient

  • Is sufficient PPE being worn while working at heights

  • Are ladders secured/tied off, angle 4:1, 1m above the landing

  • Are W@H exclusion drop zones in place and effective

  • Is the ScaffTag in place and legible

CHEMICALS

  • Are SDSs being supplied and filed on the project

  • Is the general storage of chemicals sufficient (bunded) & adequately labelled

  • Is chemical waste being appropriately disposed of

  • Are fuel tanks and associated fittings in good condition and free from any leaks?

  • Are spill kits available, appropriate and complete

TEMPORARY WORKS DESIGN

  • Has a detailed design been developed, approved and issued by a suitably qualified engineer?

  • Has the design been verified for the integrity of the detailed design

  • Has an appropriate inspection and/or monitoring program been developed by the project to ensure the structure remains fit-for-use

MOBILE PLANT & EQUIPMENT

  • Are Plant daily inspection checklists being performed

  • Is plant appropriately maintained and fit for purpose

  • Are operators trained and have they been verified as competent

  • Are warning lights and reversing alarms operational

  • Does plant have an operational UHF

  • Does plant have a plant hazard assessment?

  • Is the plant inducted (Damstra)

  • Are there adequate traffic control measures in place

EXCAVATIONS

  • Has Dial Before You Dig been performed & copies available

  • Has an excavation permit been completed and being followed

  • Are trenches braced and have adequate shoring or properly battered/benched

  • Is the excavation barricaded (prefer hard type)

CRANAGE/LIFTING

  • Lifting equipment has unique serial numbers/registers & are in date

  • Mobile Crane Pre-Lift Check/ Pick and Carry Lift Plan/ Mobile Crane Pre-Lift Check been completed

  • Is the safe distance from overhead power lines being maintained

  • Has the ground condition been assessed for stability

TRAFFIC MANAGEMENT

  • Is an approved traffic management plan in place?

  • Are daily checks being completed and documented?

  • Are the people performing the traffic management trained and competent?

  • Is signage/delineation in good condition and easily readable

  • Are truck movement records up to date and being recorded by drivers?

  • Is there adequate LV/HV vehicle and pedestrian separation

  • Are park up areas set up in such a way to prevent the uncontrolled movement of parked vehicles

EMERGENCY MANAGEMENT

  • Is an evacuation plan in place and available

  • Are emergency contact details detailed, available and correct

  • Are there correct fire extinguishers provided?

  • Are the fire extinguishers regularly tested / tagged and up to date?

  • Emergency access and Egress paths free from obstruction?

  • Are first aid kits fully equipped and content in date?

  • Is there a first aid register of treatments given and first aid supplies used

  • Is there a defibrillator and is it in date and easily accessible

  • Is there a clearly defined Emergency Evacuation Point

CONFINED SPACE

  • Has a confined space permit been completed and being followed

  • Are workers trained

  • Are there are means of rescue

HOT WORK

  • Has a hot work permit been completed and being followed

  • Is a flash back fitted to Oxy/acetylene equipment

  • Area free from fire hazards (Debris/flammable liquids etc.)

WORKING NEAR WATER

  • Has a SWMS been developed for the works

  • Is the relevant PPE available and being used

  • If vessels are being used are they in current survey

WORKING AT HEIGHTS

  • Have appropriate SWMS been produced

  • Has a working at heights permit been completed and complied by?

  • PPE Equipment has unique serial numbers & register

  • Are ladders secured/tied off, angle 4:1, and 1m above the landing

  • Is perimeter protection sufficient

  • W@H exclusion drop zones in place and effective

  • Is there a secondary securing mechanism (Lanyard) affixed to hand tools or equipment?

  • Has the ground conditions been assessed for EWP use

  • SIGN OFF (WHEN COMPLETE)

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.