Job No:

Job Site:

Date:

Engineer:

Accompanying Engineers:

1. Site Safety Induction Completed?

If No, please provide more details:

2. Workspace inspected?

If No, please provide more details:

3. Planned work complies with approved General Risk Assessment? *

If No, please provide more details:

4. Planned work complies with approved Method Statement? *

If No, please provide more details:

5. All relevant tools and equipment available on site? *

If No, please provide more details:

6. All relevant PPE available on site? *

If No, please provide more details: