Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

  • Description of tasks being conducted:

  • Are works being done safely and in accordance with relevant SWMS and SOP's?

  • Is Exclusion zone maintained to a good standard?

  • Is the area free from trip hazards?

  • Is lighting in the area adequate?

  • Is there good access and egress maintained through the area?

  • Is the area free from any other hazard that requires attention?

Working at Heights

  • Is there any working at heights taking place? (please type "yes" or "no")

  • Is there any live edge?

  • Is the live edge being controlled?

  • Is there a drop zone in place? (Falling Objects)

Mobile Plant

  • Is there any mobile plant operating in the area? (please type "yes" or "no")

  • Does the operator have a licence for that type of plant?

  • Is the plant logbook updated and filled out?

  • Positive feedback on controls implemented / Further Comments:

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.