Working at Heights

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Permits / JHA

• Is the Permit and JHA signed and current

  Yes

  No

  N/A

• JHA number on Permit

  Yes

  No

  N/A

• Is the JHA / Permit relevant to task

  Yes

  No

  N/A

• Is a rescue plan attached to the JHA

  Yes

  No

  N/A

Good To Go

• Do employees have a Good to Go

  Yes

  No

  N/A

• Is the Good to Go relevant to the task

  Yes

  No

  N/A

Safety Systems

• Fall Arrest / Restraint test and tagged

  Yes

  No

  N/A

• Is harness used in a safe manner and fitted correctly

  Yes

  No

  N/A

• Are rated anchor points used

  Yes

  No

  N/A

• Is there sufficient Barricading / Drop Zone / Signs n place

  Yes

  No

  N/A

• Are tool lanyards and drop sheets being used correctly

  Yes

  No

  N/A

EWP Operations

• Is the EWP Logbook filled out

  Yes

  No

  N/A

• Is the EWP Checklist filled out

  Yes

  No

  N/A

• Is the Spotter / Operator licensed and VOC'd

  Yes

  No

  N/A

• Is there good communication between the Operator and Spotter

  Yes

  No

  N/A

• Is the Operator using the EWP safely

  Yes

  No

  N/A

Scaffolds / Ladders

• Is the Scafftag in place and current ( 14 Days )

  Yes

  No

  N/A

• Is Ladder 3meters away from the edge

  Yes

  No

  N/A

• Is the Safety Step 2 Meters from the edge

  Yes

  No

  N/A

• Is there safe Access / Egress

  Yes

  No

  N/A

General

• Safe Access / Egress to work site

  Yes

  No

  N/A

• Safe storage of Plant and Equipment

  Yes

  No

  N/A

• Is there access to emergency equipment (First Aid Kits / Fire Extinguisher)

  Yes

  No

  N/A

• Slip, Trip and Fall hazards controlled

  Yes

  No

  N/A

• Are loose items secure

  Yes

  No

  N/A

• Are manual handling controls in place

  Yes

  No

  N/A

• Is correct PPE used and in good condition

  Yes

  No

  N/A

Comments and Sign Off

• Comments

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