Safety, Health and Environment Management System

    Forms: Safe Start Form

    Function of form: This form is to be completed each day
    Site Address
    Supervisor on Site
    Date


    Ensure that each day is signed. The list of areas below are to be checked on each daily shift. If all is safe and where appropriate is in place work can then proceed. If the work is unsafe then work cannot start until it is safe to do so.

    Areas to discuss with personnel Not applicable

    All safe & in place

    Not safe

    Comment
    Scaffolding if used is visually safe to use Not applicableAll safe & in placeNot Safe
    Harnesses are visually inspected before use and safe to use Not applicableAll safe & in placeNot Safe
    All personnel are wearing PPE - safety shoes, high vis, gloves, ear and eye protection (where appropriate), hard hat, mask Not applicableAll safe & in placeNot Safe
    All job site specific hazards discussed with operatives Not applicableAll safe & in placeNot Safe
    Ladders are safe to use - visual inspection done before use Not applicableAll safe & in placeNot Safe
    Personnel have not reported being sick or unwell Not applicableAll safe & in placeNot Safe
    Welfare facilities available - toilets, water Not applicableAll safe & in placeNot Safe
    Tools are safe to use Not applicableAll safe & in placeNot Safe
    Mobile phones not to be used whilst working. To be used only on breaks and in an emergency Not applicableAll safe & in placeNot Safe
    Dust mask & eye protection used when working in dusty environments Not applicableAll safe & in placeNot Safe
    Good housekeeping measures discussed Not applicableAll safe & in placeNot Safe
    No eating, drinking or smoking allowed discussed Not applicableAll safe & in placeNot Safe
    Due care and attention discussed Not applicableAll safe & in placeNot Safe
    Only retractable blades to be used Not applicableAll safe & in placeNot Safe
    Dust sheets used where required Not applicableAll safe & in placeNot Safe
    Tools tethered when working at height Not applicableAll safe & in placeNot Safe
    Only trained operators to use MEWPS & other plant Not applicableAll safe & in placeNot Safe
    Personnel aware to report near miss & incidents immediately Not applicableAll safe & in placeNot Safe
    First Aid & Eye wash access discussed Not applicableAll safe & in placeNot Safe
    Toolbox talk completed weekly Not applicableAll safe & in placeNot Safe
    All portable equipment PAT tested Not applicableAll safe & in placeNot Safe
    Environmental issues such as waste removal discussed Not applicableAll safe & in placeNot Safe
    Site fire evacuation discussed Not applicableAll safe & in placeNot Safe
    Permit issued by site where required Not applicableAll safe & in placeNot Safe
    No asbestos in area of work Not applicableAll safe & in placeNot Safe
    Any other specific site requirements discussed Not applicableAll safe & in placeNot Safe




    Signature