SAFETY REPRESENTATIVE MONTHLY CHECKLIST

NAME OF SAFETY REPRESENTATIVE:____________________________________________ SITE ADDRESS:

Do not tick? Write "O.K."If faulty, mark with "X". INSPECTION

MAR

AUG
MAY

NOV
OCT

DEC
APR

SEP
FEB

JUN
JAN

JUL
Ser no. ITEMS TO BE INSPECTED

1 PUBLIC SAFETY
1.1 Signage"No unauthorised entry, Visitors to report to site office, construction work, etc "
1.2 Nets, canopies, screens, etc to protect passing public?

2 PERSONAL PROTECTIVE EQUIPMENT

2.1 Signage placed depicting required PPE to be worn on site and specific areas?
2.2 Are all persons (Visitors/subcontractors included) wearing PPE?
2.3 Are all persons and operators involved in hazardous tasks wearing the required PPE?

3 HOUSEKEEPING
3.1 Is the site clean and tidy?
3.2 Bricks, offcuts, dagha, rubble, spillage being controlled. Is it removed regularly?
3.3 Storage facilities provide, packing stacking sort-by-sort, identified areas?
3.4 Are sub-contractors required to comply with housekeeping standards?

4 SCAFFOLDING/FORMWORK/SUPPORTWORK
4.1 Does scaffolding comply with minimum standards?
4.2 Are toeboards, hook-on-boards, hand railings being used?
4.3 Signage "scaffolding safe for use, scaffolding unsafe for use" displayed.
4.4 Access to scaffolds and formwork being provided.

5 LADDERS
5.1 Are ladders being used on site the correct type?(No make shift ladders?)
5.2 Ladders numbered, hung up in specific allocated area?
5.3 Ladders extend above platform/landing, chocked/secured at the base?
5.4 Fixed ladders have cages?
5.5 No painted wooeden ladders, general condition acceptable, rungs secure etc?

6 ELECTRICITY
6.1 Extension leads, DB boards numbered.
6.2 DB board warning signs posted, locked, circuits marked?
6.3 DB placement accessible, safe, no wet conditions, cables protected?
6.4 Electric cables feeding from DB boards being protected from vehicle/site traffic damage?
6.5 Electric power tools working through earth leakage unit? DB fitted with earth leakage?

7 FIRE PROTECTION
7.1 Sufficient fire equipment available? Equipment serviced?
7.2 Equipment strategically placed, accessible, signage depicting placement?
7.3 Hazardous areas protected with sufficient, correct Fire Equipment?

8 EXCAVATIONS
8.1 Inspected, barricaded, warnings posted, shored, braced and access provided?
8.2 Lighted after dark to prevent persons falling in?

9 TOOLS
9.1 Handtools correct type, serviced, maintained. NO MAKE SHIFT TOOLS?
9.2 5% of tools inspected weekly?
9.3 Explosive power tools inspected,stored and cleaned, appointed trained operator?

10 LIFTING EQUIPMENT, MOBILE CRANES, TOWER CRANES

10.1 Operated by trained, authorised operator?
10.2 Slinging done correctly, rigger trained, signalling and communication procedure in place?
10.3 MML displayed, warnings posted, equipment checked, registers available and updated?

11 BUILDERS HOIST
11.1 Warning signs displayed, operator trained and appointed?"
11.2 Landings and access barricading in place, moving parts guarded, Weekly inspection?

12 TRANSPORT AND MATERIALS HANDLING EQUIPMENT/PLANT AND MACHINERY

12.1 Daily checklists being completed, trained licenced operators?
12.2 No passengers on plant, no over speeding, no unauthorised operators/
12.3 All moving parts, nip points guarded/ unauthorised access in place?

13 HEALTH AND HYGIENE

13.1 Sufficient toilets? (1 / 30 persons) Toilet paper, changing facility, Water and soap?
13.2 Showers, eating facilities, drinking water?
13.3 Clean, hygienic, drainage suitable?
13.4 First Aid facilities, appointed first aider, signage depicting location of FA box?
13.5 Hazardous chemicals Identified, Hazchem procedures on file?

14 EDGE PROTECTION / BARRICADING

14.1 Are all edges to decks being prepared and already poured being protected.
14.2 Constructed of sound material, high enough, can prevent person falling through.
14.3 Demarcated, clearly visible. Lighting after dark.

SAFETY REPRESENTATIVE INITIAL

CONSULTANT/AUDITOR INITIAL

PRINCIPLE 16(2) INITIAL / Chairman of safety committee

NB!! ALL DEVIATIONS TO BE RECORDED ON THE REVERSE SIDE.

Copyright: Chris Haefele

SAFETY REPRESENTATIVES DEVIATIONS

SERIOUS DEVIATIONS NOTED AND ACTION PLAN TO RECTIFY ACTION BY TARGET DATE DONE

MONTH DEVIATION
YES NO

JANUARY

FEBRUARY

MARCH

APRIL

MAY

JUNE

JULY

AUGUST

SEPTEMBER

OCTOBER

NOVEMBER

DECEMBER