Take 5 Inspection Template [Free Download]

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Take 5 Inspection Template

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Take 5 Inspection

General Information

Company Name

Date

Specific Location

Task

Before Starting Work

Have you received induction training?

Do you know the company’s health & safety rules?

Are you familiar with how to report hazards & incidents?

Are there emergency facilities and an evacuation procedure/route for the site?

Do you have the correct procedures and equipment to do the work safely?

Have any manual handling risks been identified and accessed?

Are hazardous/dangerous substances used and stored according to their safety data sheets?

Have you asked the person in charge about all relevant hazards?

If you answer “no” to any of those above, you may need to follow up with the person in charge before you start work to help ensure your safety.

Identify and Assess the Hazards

Hazard type

Take or attach photo evidence of hazard identified

Description

At the End of Work

Have you left the worksite in an appropriate condition free from hazards and risks (clean-up, tools put way, housekeeping)?

Comments

Signature

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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.