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Complete before commencing work each day: brief all workers on scope, hazards and procedures
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Permits, Rules & Procedures
Mark Y (Yes), N (No) or N/A for each item. Add notes where required.
| # | Item | Y | N | N/A | Notes |
|---|---|---|---|---|---|
| Permits Required | |||||
| 1 | Hot work permit | ||||
| 2 | Confined space permit | ||||
| 3 | Working at heights permit | ||||
| 4 | Excavation / penetration permit | ||||
| 5 | Isolation / lock-out / tag-out permit | ||||
| 6 | Other permit (specify in notes) | ||||
| Site Rules & Access | |||||
| 7 | Site induction completed for all workers | ||||
| 8 | Speed limits, exclusion zones and traffic management discussed | ||||
| 9 | Sign-in/out procedures confirmed | ||||
| Emergency Procedures | |||||
| 10 | Muster point location communicated | ||||
| 11 | First aider identified and known to all workers | ||||
| 12 | Nearest hospital / medical facility identified | ||||
| 13 | Emergency contact numbers displayed / available | ||||
| Environmental, PPE & Plant | |||||
| 14 | Environmental controls discussed (dust, noise, spills, waste) | ||||
| 15 | Minimum PPE requirements confirmed for all workers | ||||
| 16 | Plant and equipment on-site identified and operators confirmed | ||||
Site supervisor: ________________ Safety officer: ________________
Client rep: ________________ Emergency: ________________
Attendee Sign-on All persons on-site must print name, company, trade and sign below
| # | Name (print) | Company | Trade | Signature |
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