sitesafety - Amrick

PROJECT DETAILS
Please provide details of the project below.
Company Name*
Project / Site Address*
Type of Project*
Stage*
Role on Site*
Estimated Handover Date*
DD slash MM slash YYYY
Site Supervisor Full Name*
Site Supervisor's Phone*
WORKERS & INCIDENTS ON SITE
Incidents on site*
Have there been any incidents or near miss occurrences on site?
Incident report*
Incident details Action taken

Please list the details of the incident(s) on site
How many total workers on site?*
Type of workers CURRENTLY on site*
- Supervisors
- OH&S Representatives
- Tradesmen
- Labourers
You can select more than one
Type of workers YOU NEED on site
- Supervisors
- OH&S Representatives
- Tradesmen
- Labourers
Please select any workers you may be short staffed (or expect to be short staffed) on site.

HAZARDS ON SITE
Please indicate if any hazards have beed identified. You can report more than one.
Common Hazards On Site*
- Chemicals & Substances
- Electrical
- Loud Noise
- Manual Handling
- Overhead Hazards
- Trip Hazards
- Plant & Equipment
- Vehicles
- OTHER HAZARDS
Please tick any identified hazards on site and provide details below.
HAZARD DETAILS AND METHODS OF CONTROL
Chemicals & Substances*
Hazard Details Method of Control
Electrical*
Hazard Details Method of Control
Loud Noise*
Hazard Details Method of Control
Manual Handling*
Hazard Details Method of Control
Overhead Hazards*
Hazard Details Method of Control
Trip Hazards*
Hazard Details Method of Control
Plant & Equipment*
Hazard Details Method of Control
Vehicles*
Hazard Details Method of Control
Other Hazards*
Hazard Details Method of Control

You can list more than one. Click the (+) button to add hazard details and their methods of control.

HEALTH AND SAFETY SYSTEMS
Please indicate whether or not the following systems are in place. If not, please provide details.
Are OH&S policies displayed on site?*
Is there an incident report book on site?*
Are there induction records on site?*
Is there a rehabilitation policy on site?*
Are emergency procedures clearly displayed?*
Are there training records on site?*
Is there an OH&S manual onsite?*
Is there an equipment record on site?*
Is an MSDS available?*
Is there an OH&S representative appointed?*
Please provide details of why this/these systems are not in place*
OTHER ITEMS
Please provide any additional comments
Your name*
First Last
Your Email*
Signature*
Date
DD slash MM slash YYYY

Site Safety Questions

Incident details	Action taken

Hazard Details	Method of Control