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FORMATE

Site-Specific Safety Plan (SSSP)

Free template for NZ construction sites. Built to WorkSafe NZ guidance. Fill in by hand on-site, or use it as a baseline when building your own. Tired of re-writing this every job? Try Formate free for 30 days — same plan, ready in 60 seconds.

1. Project & Site Details

Project name
Site address
Start / end dates
Scope of work

2. PCBU 1 (Principal / Main Contractor / Client)

Business name
Contact person
Phone
Email

3. PCBU 2 (Contractor — Your Company)

Business name
Contact person
Phone
Email

4. Site Personnel

NameRoleInductions / TicketsInitial

5. Hazard & Risk Register

HazardRisk (L/M/H)ControlsPerson responsible
Working at heightEdge protection, harnesses, exclusion zones
Slips, trips, fallsKeep walkways clear, signage, daily housekeeping
Manual handlingMechanical aids, team lifts, technique training
Power tools / equipmentDaily checks, RCDs, PPE, trained operators only
Vehicle & plant movementsSpotter, exclusion zone, hi-vis, reversing beepers
Hazardous substancesSDS on site, PPE, ventilation, spill kit
Electrical (live services)Locate & tag, LOTO, qualified personnel only
Noise & dustHearing protection, dust suppression, RPE

6. Task Steps & Controls

Task stepHazardsControls

7. Emergency Procedures

Assembly point
First aider on site
Nearest hospital / A&E
Fire / evacuation plan
Notifiable incident reporting

8. PPE Required

Tick all that apply on this site:

☐ Hard hat    ☐ Hi-vis vest    ☐ Safety boots    ☐ Eye protection    ☐ Hearing protection    ☐ Gloves    ☐ Respirator / dust mask    ☐ Harness    ☐ Sunscreen    ☐ Other: __________

9. Sign-Off — Declaration

By signing below, both parties confirm they have read and understood this SSSP and agree to follow the controls listed.

PCBU 1 — Name & Signature
Date
PCBU 2 — Name & Signature
Date

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