The Plumbing Company – Pre-Start Safety Checklist

Site Name *

Site Address

Date *

Supervisor *

STAFF & CONTRACTORS

Contractors are on The Plumbing Company approved contractor list? *

Staff are fully trained for the work activities required at site? *

Supervior has had a pre start meeting to discuss how the work activities are to be carried out in a safe manner? *

PRE-START DOCUMENTS & INSPECTIONS TO BE COMPLETED

Completed Safety Management Plan *

Completed Job Safety Analysis *

Working Plans/ Drawings received, understood and communicated *

First Aid supplies adequate *

Electrical equipment tagged and tested *

Safety data sheets available *

Site Inspection completed *

Fire extinguishers charged *

Proof of worker competency *

Working at height job safety analysis completed *

Hazards and Controls

Hazard 1

Controls for Hazard 1

Hazard 2

Controls for Hazard 2

Hazard 3

Controls for Hazard 3

Hazard 4

Controls for Hazard 4

BRIEF TASK DESCRIPTION

Task 1

Task 2

Task 3

Task 4

Task 5

DECLARATION:

I declare that to the best of my knowledge, the information I have supplied is true and correct and where “Yes” has been stated, the applicable documentation has been completed and communicated to all concerned and filed as per The Plumbing Company’s requirements

SUPERVISOR SIGNATURE *

Clear

Pre-Start Safety Checklist copied to:

(this is an optional field - when Submit is clicked, the completed checklist is emailed to The Plumbing Company (Otago)

Email

Add Remove