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Technician Name

Date

Area / Task

Q1. PROCEDURE

Is there an SOP or work instruction for this task? Am I familiar with it?

Q2. TRAINING

Am I trained to perform this task? Do I fully understand the task?

Q3. PRESTART

Have I done a pre-start check? Is my PPE/equipment in a good and safe condition? Are there any obvious hazards? Is everything in place to perform the task safely and efficiently?

Q4. CONTROL

Are all required safety and environmental hazard controls in place? (e.g. Machine guards, equipment controls) Air pollution control (via fume cupboard or similar) Noise control Spill control for chemicals, etc. Are ALL hazards identified and controlled?

Q5. AUTHORISATION

Are all the required work permits in place? (e.g. isolation, hot work, confined spaces) Working at heights, H/V access etc

If NO, review or perform a JSEA. If further action is required — consult your supervisor. Don't start until you can Start Safe!

Job Site Photo (Required)

📷

Tap to take or upload a photo of the job site

* At least one photo required

Signature

Technician Name

Date

Drive Duration

Journey Purpose

From

Q1. EMPLOYEE

Do I feel fit to drive? If I am taking medication, have I checked if this affects my driving? Do I have my license? Do I have all my PPE and other job requirements?

Q2. VEHICLE

Do I have all the paperwork? Do I have the requirements if carrying radiation, dangerous goods etc? Is the car in good conditions and is all required safety equipment in place (jack, spare tyre etc)? Are all items being transported secure? Including items such as laptops and bags within the car?

Q3. VEHICLE PRE-START

Tyres are in good condition and properly inflated? All lights and indicators are working? Oil, coolant, and windscreen washer fluid levels are adequate? Windscreen wipers are in good condition? All mirrors are clean and properly adjusted? No visible damage or defects on the vehicle? Brakes are functioning properly? Horn is working?

Q4. JOURNEY PLANNING (for longer journeys)

Do I have a map? Have I got any provisions required (Water, phone, food, petrol)? Have I checked traffic, road and weather conditions? Have I prepared a journey management plan for longer trips or remote travel (F-0000-SA-062.1)? Is my supervisor aware of my expected departure and arrival times? Is someone at the arrival point aware of my expected arrival time?

If NO, do not commence your journey. Further action is required — Consult your supervisor. Don't start until you can Start Safe!

Odometer / Vehicle Photo (Required)

🚗

Tap to take a photo of the odometer

* At least one photo required

Signature