Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Job location

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  • Description

  • Completed By

  • Generic safe work method Statment/s (SWMS) for this job is?

  • A) General chicklist

  • Are all workers present for this induction and hazard assessment and control discussion

  • Are there enough works to completed the job safely?

  • Are all workers appropriately qualified or supervised as required?

  • Have all services been located? e.g. Electricity, water, phone and gas etc.

  • Are control measures for hazardous substances implemented?

  • Have you endured radio/ telephone communication are suitable?

  • Have all workers been briefed and roles/ responsibility clearly identified?

  • Can manual handing task be minimised?

  • Have trip hazard, ground depressions or obstacles been identified?

  • Are all works aware of the accident emergency and evacuation procedures?

  • Make all workers that are unaware of the procedures aware.

  • Are all workers aware of the statutory requirements/ site specific requirement for this job?

  • Explain to all workers unaware of the statutory requirements specific to the site.

  • Is access to confined space necessary?

  • Please complete the confined space entry permit.

  • Have working at heights issues been identified?

  • List controls measures

  • Please write down any additional hazard and control measures implemented below

  • B) Work-site Traffic Management (if not applicable go to section C)

  • If a control plan has been developed has it been fully implemented? (TRAFFIC PLAN NO.)

  • Has access for emergence vehicles been considered?

  • Is a vehicle access plan required

  • Is a work-site speed restriction required?

  • Are all additional warning signs in place. e.g. slippery when wet, gravel on road, etc?

  • Please write down any additional hazard and control measures implemented below

  • ELECTRICAL HAZARD IDENTIFICATION/ CONTROL (if not applicable go to section E)

  • Have HV and / or LV mains / apparatus Identified?

  • If HV/LV mains/ apparatus are live are the Safe Work Procedures Being followed?

  • Have all electrical hazard been identified?

  • Are appropriate clearances being maintained?

  • Are sufficient barriers in place to secure the work area

  • Have lock out and tag out procedures been implemented where applicable?

  • place lock out and tag out procedures implemented

  • D) WORK METHOD STATEMENT (If not applicable go to E)
    Must complete for short task when no SWMS exits.

  • Work Steps

  • Hazards & Risk Identification Control

  • Control Measures

  • Work Steps

  • Hazards & Risk Identification

  • Control Measures

  • Work Steps

  • Hazards & Risk Identification

  • Control Measures

  • Work Step

  • Hazards & Risk Identification

  • Control Meassures

  • E) ALL STAFF ON THE WORK-SITE HAVE PARTICIPATED IN AND ACKNOWLEDGE THIS INDUCTION

  • NAME

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  • NAME

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  • NAME

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  • NAME

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  • NAME

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  • NAME

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  • AUDITOR

  • COMMENTS

  • Checked/Filled by Supervisor

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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.