WEEKLY HSE INSPECTION REPORT Date:

Project & Location Page:

Issued to Inspection By

Time of Inspection Weather Condition

Current Activity

Item Covered ( if inspected)

1. SAFETY MANAGEMENT 12. POWER TOOLS / HAND TOOLS
2. HEALTH & WELFARE 13. HOUSEKEEPING
3. FIRST AID 14. SCAFFOLDING
4. FIRE PRECAUTIONS 15. ACCESS & EGRESS
5. PPE / SAFETY EQUIPMENT 16. EXCAVATION / EARTHWORKS
6. ELECTRICITY 17. DEMOLITION
7. PLANT / EQUIPMENT 18. GUARDING / FENCING
8. LIFTING APPLIANCE / GEAR 19. DANGEROUS GOODS
9. LOADSHIFTING MACHINERY 20. GASES / FLAMMABLE LIQUIDS
10. WORKING AT HEIGHT 21. SAFETY PROCEDURE
11. TRAINING 22. MEETING
OTHER PHOTOGRAPHS TAKEN - ATTACHMENT
Findings Action Completed

* delete as necessary
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