Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

General Site Access & Conditions

  • Chain/Lock system operational & maintained

  • Adeequate site signage in place and readable

  • Site maintained ( eg long no long grass )

  • Has this been raised to the land lord or equivilent to address

  • Adequate lighting/Ventilation to carry out works

  • Access track structurally sound

  • Airconditioning working at cool temperature

  • Building entries sealed

  • Site free from vermin damage/dropping/activities

  • No hazards identified above (rooftops or towers)

  • What actions are required to carry out works safely

  • Site Clean

Induction and Access to Site

  • Site visitors inducted and signage available on SWIMS/Vistor Induction

  • Pre start carried out and available on site

  • Emergencey Proceedures in Place?

  • Barricades/cones/tape/temp fencing in place to prevent public or general access

  • Warning Signs in Place?

  • PPE signs in place

  • Overhead work area secured from public access

Management System

  • Work Health and Safety Management Plan available on site

  • SWIMS adequate and relevant tasks being carried out

  • Personell on site working in compliance with the SWIMS

  • If Not what actions/ recommendations are recommended

  • Pre start meetings carried out and records available

  • Permits/Approvals to work obtained (ie Hot works, Confined spaces, etc)

  • Assessment checklist undertaken for high risk works

  • Where has this been captured

  • Assesement checklist undertaken for high risk works

  • Adequate Supervision for all the tasks perfomed

Working at heights

  • Traditional step and single ladders used appropriately as a means of access or exit from a work area

  • Platform ladders Platform ladders available on-site and used appropriately and secure

  • Fall arrest/restraints system applied and including harnesses, lanyard and anchorage implemented ?

  • Rescue / Retrieval procedure/kit readily available ?

  • Exclusion zones implemented for workers and general public ?

  • Outdoor works without overhead shelter have suitable scaffolding or netting installed to protect workers and public when overhead works conducted ?

  • SWMS and Present capture essential need for simultaneous works with overhead works while works carried out within exclusion zones

Elevated Work Platform (EWP)

  • EWP SWMS acceptable for work being carried out ?

  • Vehicle maintenance log valid ?

  • Barricades / Cones / Temp fencing and signage in place to prevent public access ?

  • Ground or foundations appear to be stable/solid for any outriggers?

  • Any comments further to support ?

Crane and other Mobile Plant

  • Crane/Plant SW<S acceptable for works being carried out?

  • Maintenance record for vehicle valid?

  • Is the operator fit for duty ?

  • Barricades / Cone/Temp fencing in place with signage to prevent public access ?

  • Lift Plan has been implemented and followed ?

Traffic and pedestrian Management

  • Vehicles separate from public ?

  • Delivery and laydown area defined as required ?

  • Traffic and Pedestrian Management in place where required and plan on site ?

Personnel Amenities

  • Toilet facilities identified locally

  • Water available on site

  • Rest area/rib available and identified ?

First Aid and Emergencies

  • First aid kits readily available and access able and stoked?

  • Fire Extinguishers available at work location?

  • Emergency response plan in place with local medical center details

  • Assembly area defined ?

  • Emergency contact details displayed and available

Personal Protective Equipment (PPE)

  • Appropriate clothes being worn ie Long and Long

  • Hard hats worn on site

  • Adequate safety footwear for the task in hand

  • Respirators available on site if required

  • Safety Glasses worn as required

  • Hearing protection available as required

  • Sun Protection available if required

  • Appropriate Gloves work for handling material and electrical works conducted?

Manual handling

  • Safe work practices adopted ?

  • Correct posture used for the task ?

  • Correct tools and lifting devises adopted for the task?

Tools and Equipement

  • All personnel on site feel they have been allocated adequate recourses for the work to be done safely

  • Tool lanyards fitted /available for overhead works?

  • Tools tested and tagged

Electrical

  • Power supply adequate?

  • Tools and equipment tagged, tested and current

  • RCD 's in use

  • Leads on stands etc. protected from damage and ft for purpose

Hot Works / Protection

  • Area clear of flammables / combustibles ?

  • Fire extinguishers available on work area and appropriate for use

  • Screens applied and used as required ?

  • Hot works permit applied and approved

Wastes Management

  • House keeping acceptable ( eg free of litter/clearance of rubbish/hazards) ?

  • Appropriate waste disposal in place

  • Is regular removal of waste carried out in a timely manner

Confined and Restricted Spaces

  • Entry permit used where required

  • Confined space signage in place ?

  • Stand by Person at entrance ?

  • Air monitor in place

  • Respirators available if appropriate

  • Rescue procedure in place and equipment available

  • Communications and method agreed and in use during task

Asbestos

Opportunity for Improvement

  • Corrective Actions

  • Inspection carried out by

  • Signature of person involved

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.