002A RMS Surveillance Checklist H2A Use, Installation, Inspection and/or repair of Plant and Equipment.

• Inspection Title: H2A USE, INSTALLATION, INSPECTION AND/OR REPAIR OF PLANT AND EQUIPMENT .

• Project Name: Tabulam New Bridge.

• Location: BRUXNER HIGHWAY TABULAM

• Contractor

• Prepared by

• Conducted on

  Date

• References:
  WHS Regs. Chapter 5, Part 5.1, 5.2, 5.3 – s186-s288
  G22 – In complete and Annexure G22/J – Truck & Plant Requirements
  There are numerous Codes of Practice that relate to Plant & Equipment – WorkSafe NSW has the documents available on their website:
  http://www.safework.nsw.gov.au/law-and-policy/legislation-and-codes/codes-of-practice
  Additionally there are numerous Australian Standards that should be reviewed for information and specification requirements for specialised plant and equipment. Discuss with WHS Partner.
  
  

• N.A. Not Applicable N.C. Not Checked

1 Have foreseeable hazards from the operation of plant/equipment been assessed, including the following:

• <br> Contact or entanglement with the machinery or materials?<br>

  Yes

  No

  N.A.

  N.C.

• Being trapped between the machine and any material or fixed structures?

  Yes

  No

  N.A.

  N.C.

•  Being struck by ejected material from the machinery?

  Yes

  No

  N.A.

  N.C.

•  Noise and vibration from the machinery?

  Yes

  No

  N.A.

  N.C.

•  Release of potential energy?

  Yes

  No

  N.A.

  N.C.

• 2<br>Have the design limitations of the machine been assessed, with regard to the intended use of the machine?

  Yes

  No

  N.A.

  N.C.

• 3<br>Has any history of unsafe incidents or adverse health effects involving the plant/equipment been investigated and control responses applied?

  Yes

  No

  N.A.

  N.C.

• 4<br>Have the consequences of reasonably foreseeable misuse or malfunction been assessed?

  Yes

  No

  N.A.

  N.C.

• 5<br>Has a schedule of inspection, maintenance, repair and cleaning been developed for all plant/equipment?<br>

  Yes

  No

  N.A.

  N.C.

• 6<br>Are records kept of inspection

  Yes

  No

  N/A

• 7<br>Were risk assessments carried out on any modification to plant/equipment and the results of the risk assessment taken into account in the final modification?

  Yes

  No

  N.A.

  N.C.

8 Have all operators of plant/equipment:

• <br> Received the appropriate training,<br>

  Yes

  No

  N.A.

  N.C.

•  Hold certificates of operation where required,

  Yes

  No

  N.A.

  N.C.

•  Demonstrated their competence to operate the plant/equipment to the satisfaction of the contractor?

  Yes

  No

  N/A

• 9<br>Are records kept to show that all operators have received appropriate training and instruction?

  Yes

  No

  N.A.

  N.C.

• Is the activity compliant.

  Yes

  No

  N/A

• Surveillance Officer

  Sign

• NCPN or memo number.

  Yes

  No

  N/A

• Follow up action

  Yes

  No

  N/A

• Product Non Conformance

  Yes

  No

  N/A

• System Non Conformance

  Yes

  No

  N/A

• Contractor generated NCR

  Yes

  No

  N/A

• Contractor generated a CAR

  Yes

  No

  N/A

Matters arising

• NCPN no

• Contractors NCR no

• CAR no

• Closed out.

• RMS representative's name

  Sign