Daily Job Record

Description of Job

Other

TMP Number

Job Number

STMS

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Labour Hire

Other

Start Time
Finish Times
Total Hours

Did you have a 30 min break?

Truck Number
Driver

Times same as STMS

Start Time
Finish Time
Total Hours

30 Minute Break

Truck Number
TC

Times same as STMS?

Start Time
Finish Time
Total Hours

30 Minute Break

Job Comments

Additional Comments

Signed:
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Daily Closure

Type of Closure:

Shift Time

TSL Already Installed?

TSL Installed:
TSL Removed:
Weather Conditions:

Work Operations:

Closure Equipment Checks
(Check PPE, Safety Jackets, Cones, Signs...)
Check Number

Comments/Conditions: (Note any missing signs, signs or cones down, etc...)

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Signed:
Accidents/Incidents:

Accidents/Incidents:

Accident/Incident
Date/Time of Incident

Accident/Incident Description:

Signed

Event Report Filed Out?

Job Start

1. LOOK - Do the Job START

2. TELL - My mate if he is being UNSAFE

3. TALK - About the Hazard Controls and Behaviours

Onsite Client Representative

Risk Rating Chart

1. What can harm me?
2. What can harm others?
3. What can harm the environment?

Common Hazards

Lots of contractor movements

Good toolbox (site entry procedures), designated site access, other work vehicles well away.

Poor Road Surface

Side friction, speed restriction, additional advanced warning (new seal?)

Mobility Scooters

Good road surface, additional pedestrian lane width, use of driveways

Large Vehicles

Additional lane width, turning circles, tapers at good length

Weather

Additional signage, condition of signage, additional cones, extra sandbags, cable tie signage to poles, additional safety zones

Cyclists (cycle lane diversion/allowence)

Additional lane width, visibility,shoulders available

Excess Speed

Narrow lanes, speed restriction, side friction kerb line of cones, additional safety zones

Pedestrians (footpath closed)

Placed where good visibility is achievable, out of worksite, TC on site, inside speed restriction

Pedestrians (footpath detour)

1.2m wide, cone barrier arms/safety fencing to contain, no trip hazards on route

Traffic/Vehicles

Positive Traffic Management, good delineation, side friction, RGs

Visibility

Good signage visibility, centreline of cones, side friction, extra safety zone area

Site Specific Hazard

Hazard Description

Likelihood of Harm

Potential Consequences

Risk Rating Before Controls

Hazard Controls (How can we reduce personal and environmental harm here?)

Behaviour/Action to eliminate, isolate or minimise:

Person or Team Responsible

Labour Hire

Other

Completed By: (initials)
Date
Signed by All Workers or Visitors to site:
Signed

TMP Modification

TMP Mod
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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.