Information
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Document No.
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Job Title
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Client:
- Other
- Abernethy Contractors
- Asplundh
- Asset Managers Ltd
- Asset Monitoring Ltd
- Auckland Racing
- Auckland Sandblasting Ltd
- Auckland Waikato Cranes
- Aurecon
- Bishman Electrical Contractors
- Canadian Pacific Ltd
- Cassidy Construction
- Civic Events
- Civil Con
- Coastline
- Concrete-it ltd
- ConTech
- Counties Sandblasting
- CSR NZ Ltd
- DP Construction
- Drill Force
- Electrix Ltd
- Euro Plumbing
- Filltech
- Filtration Technology Ltd
- Fletchers - Christchurch
- Fulton Hogan Ltd
- Geotechnics
- Gubb Builders
- HEB Construction Ltd
- Hill Design Engineering Ltd
- HydroTech Drainage
- ITC
- Leightons
- Lend Lease
- MACHINERY MOVERS
- Mainline Construction Ltd
- McConnell Dowell Constructors Ltd CHC
- McMillan and Lockwood BOP Ltd
- MWH Global
- NGA Newmarket
- NZ STRONG
- Opus
- Parallaxx Limited
- Peter Campbell Matakana
- Peter Hill
- Peter Lehman
- Pipeline & Civil
- Prestige Events Ltd
- R M Paris.Co
- Scarbro Construction
- Selen Kurmar
- Sherry - Private
- Skin Tight Ltd
- Steel Roofing Ltd
- Temporary Traffic Control Ltd
- The Fletcher Construction Company Ltd
- Tree Fellas
- Troy Wheeler Civil Ltd
- Watercare
- Your Local Plumber
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Enter Client Name Here
-
Time of Job Start Form being completed
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Prepared by
- Labour Hire
- Other
- Angaino Monty Timoti Tauti (54477)
- Arama Rubena (51163)
- Arthur Tapiki (56863)
- Ashley Young (64645)
- Banaba Kavana (46031)
- Billy Araipu (23519)
- Bobby-Joe Kelly (63370)
- Brian Mita (66556)
- Caleb Arama (78593)
- David Mai (70472)
- David Williams (67543)
- Dean Rua (68041)
- Dwayne Tapiki (34509)
- Dylan Ravarua (75221)
- Eriata Peri (66425)
- Gareth Waller
- George Mann (68613)
- George Tate (11557)
- Glen Ruma (50378)
- Jacob Teura (66424)
- Jamal Pendergast (76041)
- Jamie Lee Jerry (59895)
- Jason Tapsell
- Jessie Tekeu (69374)
- Jim Polima (66561)
- John Cook (52402)
- John Kelly (65830)
- John Keu (70088)
- John Williams (46040)
- Joshua Amohanga
- Joshua Harding (34508)
- Junior Katu (69372)
- Justyn Murray
- Kaitapu Timoti (54478)
- Kereama Littin
- Kelvin Tangiiti (36672)
- Lance Seiuli (64419)
- Loma Tengere (46039)
- Mana Sutherland
- Marlon
- Metuatini Henry
- Muri Williams (44710)
- Nelson Ravia (56403)
- Nicholas Green
- Nicholas Repoama (42394)
- Nick Aloua
- Nooroa Strickland (67534)
- Palepano Tukia (61677)
- Peki Dunn (76035)
- Piri Kake (56401)
- Quincy Williams
- Refiti Manase (66248)
- Rhys Reuben (66423)
- Richard McChutchie (70087)
- Riordan Waipouri
- Shaq Ono (69373)
- Shawn Tomlin (72216)
- Taputoa Kiikoro
- Te Mina Vila (44708)
- Te Okiwa McLean
- Te Rangihau Toi (72217)
- Teinakore Ngatoko (42391)
- Teruarau Tangiiti (15979)
- Thomas Jerry
- Tom Liana (78578)
- Villimoni Vunimasi (40324)
- William Pou
- Willy Green (45869)
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Enter Name Here
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Location of Job
Daily Job Record
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Description of Job
- Contraflow
- Full Closure
- Lane Closure
- Mobile
- Semi Static
- Shoulder Closed
- Stop/Go
- Other
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Other
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TMP Number
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Job Number
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STMS
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Add Employees
- Labour Hire
- Other
- Angaino Monty Timoti Tauti (54477)
- Arama Rubena (51163)
- Arthur Tapiki (56863)
- Ashley Young (64645)
- Banaba Kavana (46031)
- Billy Araipu (23519)
- Bobby-Joe Kelly (63370)
- Brian Mita (66556)
- Caleb Arama (78593)
- David Mai (70472)
- David Williams (67543)
- Dean Rua (68041)
- Dwayne Tapiki (34509)
- Dylan Ravarua (75221)
- Eriata Peri (66425)
- Gareth Waller
- George Mann (68613)
- George Tate (11557)
- Glen Ruma (50378)
- Jacob Teura (66424)
- Jamal Pendergast (76041)
- Jamie Lee Jerry (59895)
- Jason Tapsell
- Jessie Tekeu (69374)
- Jim Polima (66561)
- John Cook (52402)
- John Kelly (65830)
- John Keu (70088)
- John Williams (46040)
- Joshua Amohanga
- Joshua Harding (34508)
- Junior Katu (69372)
- Justyn Murray
- Kaitapu Timoti (54478)
- Kereama Littin
- Kelvin Tangiiti (36672)
- Lance Seiuli (64419)
- Loma Tengere (46039)
- Mana Sutherland
- Marlon
- Metuatini Henry
- Muri Williams (44710)
- Nelson Ravia (56403)
- Nicholas Green
- Nicholas Repoama (42394)
- Nick Aloua
- Nooroa Strickland (67534)
- Palepano Tukia (61677)
- Peki Dunn (76035)
- Piri Kake (56401)
- Quincy Williams
- Refiti Manase (66248)
- Rhys Reuben (66423)
- Richard McChutchie (70087)
- Riordan Waipouri
- Shaq Ono (69373)
- Shawn Tomlin (72216)
- Taputoa Kiikoro
- Te Mina Vila (44708)
- Te Okiwa McLean
- Te Rangihau Toi (72217)
- Teinakore Ngatoko (42391)
- Teruarau Tangiiti (15979)
- Thomas Jerry
- Tom Liana (78578)
- Villimoni Vunimasi (40324)
- William Pou
- Willy Green (45869)
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Labour Hire
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Other
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Start Time
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Finish Times
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Did you have a 30 min break?
Driver
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- Labour Hire
- Other
- Angaino Monty Timoti Tauti (54477)
- Arama Rubena (51163)
- Arthur Tapiki (56863)
- Ashley Young (64645)
- Banaba Kavana (46031)
- Billy Araipu (23519)
- Bobby-Joe Kelly (63370)
- Brian Mita (66556)
- Caleb Arama (78593)
- David Mai (70472)
- David Williams (67543)
- Dean Rua (68041)
- Dwayne Tapiki (34509)
- Dylan Ravarua (75221)
- Eriata Peri (66425)
- Gareth Waller
- George Mann (68613)
- George Tate (11557)
- Glen Ruma (50378)
- Jacob Teura (66424)
- Jamal Pendergast (76041)
- Jamie Lee Jerry (59895)
- Jason Tapsell
- Jessie Tekeu (69374)
- Jim Polima (66561)
- John Cook (52402)
- John Kelly (65830)
- John Keu (70088)
- John Williams (46040)
- Joshua Amohanga
- Joshua Harding (34508)
- Junior Katu (69372)
- Justyn Murray
- Kaitapu Timoti (54478)
- Kereama Littin
- Kelvin Tangiiti (36672)
- Lance Seiuli (64419)
- Loma Tengere (46039)
- Mana Sutherland
- Marlon
- Metuatini Henry
- Muri Williams (44710)
- Nelson Ravia (56403)
- Nicholas Green
- Nicholas Repoama (42394)
- Nick Aloua
- Nooroa Strickland (67534)
- Palepano Tukia (61677)
- Peki Dunn (76035)
- Piri Kake (56401)
- Quincy Williams
- Refiti Manase (66248)
- Rhys Reuben (66423)
- Richard McChutchie (70087)
- Riordan Waipouri
- Shaq Ono (69373)
- Shawn Tomlin (72216)
- Taputoa Kiikoro
- Te Mina Vila (44708)
- Te Okiwa McLean
- Te Rangihau Toi (72217)
- Teinakore Ngatoko (42391)
- Teruarau Tangiiti (15979)
- Thomas Jerry
- Tom Liana (78578)
- Villimoni Vunimasi (40324)
- William Pou
- Willy Green (45869)
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Times same as STMS
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Start Time
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Finish Time
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30 Minute Break
TC
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- Labour Hire
- Other
- Angaino Monty Timoti Tauti (54477)
- Arama Rubena (51163)
- Arthur Tapiki (56863)
- Ashley Young (64645)
- Banaba Kavana (46031)
- Billy Araipu (23519)
- Bobby-Joe Kelly (63370)
- Brian Mita (66556)
- Caleb Arama (78593)
- David Mai (70472)
- David Williams (67543)
- Dean Rua (68041)
- Dwayne Tapiki (34509)
- Dylan Ravarua (75221)
- Eriata Peri (66425)
- Gareth Waller
- George Mann (68613)
- George Tate (11557)
- Glen Ruma (50378)
- Jacob Teura (66424)
- Jamal Pendergast (76041)
- Jamie Lee Jerry (59895)
- Jason Tapsell
- Jessie Tekeu (69374)
- Jim Polima (66561)
- John Cook (52402)
- John Kelly (65830)
- John Keu (70088)
- John Williams (46040)
- Joshua Amohanga
- Joshua Harding (34508)
- Junior Katu (69372)
- Justyn Murray
- Kaitapu Timoti (54478)
- Kereama Littin
- Kelvin Tangiiti (36672)
- Lance Seiuli (64419)
- Loma Tengere (46039)
- Mana Sutherland
- Marlon
- Metuatini Henry
- Muri Williams (44710)
- Nelson Ravia (56403)
- Nicholas Green
- Nicholas Repoama (42394)
- Nick Aloua
- Nooroa Strickland (67534)
- Palepano Tukia (61677)
- Peki Dunn (76035)
- Piri Kake (56401)
- Quincy Williams
- Refiti Manase (66248)
- Rhys Reuben (66423)
- Richard McChutchie (70087)
- Riordan Waipouri
- Shaq Ono (69373)
- Shawn Tomlin (72216)
- Taputoa Kiikoro
- Te Mina Vila (44708)
- Te Okiwa McLean
- Te Rangihau Toi (72217)
- Teinakore Ngatoko (42391)
- Teruarau Tangiiti (15979)
- Thomas Jerry
- Tom Liana (78578)
- Villimoni Vunimasi (40324)
- William Pou
- Willy Green (45869)
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Times same as STMS?
-
Start Time
-
Finish Time
-
30 Minute Break
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Job Comments
Additional Comments
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Signed:
-
Add media
Daily Closure
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Type of Closure:
- 24 Hours/Long Term
- Static Closure
- Semi Static Closure
- Mobile Closure
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Shift Time
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TSL Already Installed?
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TSL Installed:
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TSL Removed:
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Weather Conditions:
- Fine
- Sun Strike
- Overcast
- Drizzly
- Rain
- Heavy Rain
- Wind
- Heavy Wind
- Snow
- Cold
- Hot
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Work Operations:
Closure Equipment Checks (Check PPE, Safety Jackets, Cones, Signs...)
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Check Number
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Comments/Conditions: (Note any missing signs, signs or cones down, etc...)
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Add media
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Signed:
Accidents/Incidents:
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Accidents/Incidents:
Accident/Incident
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Date/Time of Incident
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Accident/Incident Description:
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Signed
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Event Report Filed Out?
Job Start
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1. LOOK - Do the Job START
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2. TELL - My mate if he is being UNSAFE
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3. TALK - About the Hazard Controls and Behaviours
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Onsite Client Representative
Risk Rating Chart
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1. What can harm me?
2. What can harm others?
3. What can harm the environment? -
Common Hazards
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Lots of contractor movements
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Good toolbox (site entry procedures), designated site access, other work vehicles well away.
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Poor Road Surface
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Side friction, speed restriction, additional advanced warning (new seal?)
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Mobility Scooters
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Good road surface, additional pedestrian lane width, use of driveways
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Large Vehicles
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Additional lane width, turning circles, tapers at good length
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Weather
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Additional signage, condition of signage, additional cones, extra sandbags, cable tie signage to poles, additional safety zones
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Cyclists (cycle lane diversion/allowence)
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Additional lane width, visibility,shoulders available
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Excess Speed
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Narrow lanes, speed restriction, side friction kerb line of cones, additional safety zones
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Pedestrians (footpath closed)
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Placed where good visibility is achievable, out of worksite, TC on site, inside speed restriction
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Pedestrians (footpath detour)
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1.2m wide, cone barrier arms/safety fencing to contain, no trip hazards on route
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Traffic/Vehicles
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Positive Traffic Management, good delineation, side friction, RGs
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Visibility
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Good signage visibility, centreline of cones, side friction, extra safety zone area
Site Specific Hazard
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Hazard Description
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Likelihood of Harm
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Potential Consequences
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Risk Rating Before Controls
Hazard Controls (How can we reduce personal and environmental harm here?)
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Behaviour/Action to eliminate, isolate or minimise:
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Person or Team Responsible
- Labour Hire
- Other
- Angaino Monty Timoti Tauti (54477)
- Arama Rubena (51163)
- Arthur Tapiki (56863)
- Ashley Young (64645)
- Banaba Kavana (46031)
- Billy Araipu (23519)
- Bobby-Joe Kelly (63370)
- Brian Mita (66556)
- Caleb Arama (78593)
- David Mai (70472)
- David Williams (67543)
- Dean Rua (68041)
- Dwayne Tapiki (34509)
- Dylan Ravarua (75221)
- Eriata Peri (66425)
- Gareth Waller
- George Mann (68613)
- George Tate (11557)
- Glen Ruma (50378)
- Jacob Teura (66424)
- Jamal Pendergast (76041)
- Jamie Lee Jerry (59895)
- Jason Tapsell
- Jessie Tekeu (69374)
- Jim Polima (66561)
- John Cook (52402)
- John Kelly (65830)
- John Keu (70088)
- John Williams (46040)
- Joshua Amohanga
- Joshua Harding (34508)
- Junior Katu (69372)
- Justyn Murray
- Kaitapu Timoti (54478)
- Kereama Littin
- Kelvin Tangiiti (36672)
- Lance Seiuli (64419)
- Loma Tengere (46039)
- Mana Sutherland
- Marlon
- Metuatini Henry
- Muri Williams (44710)
- Nelson Ravia (56403)
- Nicholas Green
- Nicholas Repoama (42394)
- Nick Aloua
- Nooroa Strickland (67534)
- Palepano Tukia (61677)
- Peki Dunn (76035)
- Piri Kake (56401)
- Quincy Williams
- Refiti Manase (66248)
- Rhys Reuben (66423)
- Richard McChutchie (70087)
- Riordan Waipouri
- Shaq Ono (69373)
- Shawn Tomlin (72216)
- Taputoa Kiikoro
- Te Mina Vila (44708)
- Te Okiwa McLean
- Te Rangihau Toi (72217)
- Teinakore Ngatoko (42391)
- Teruarau Tangiiti (15979)
- Thomas Jerry
- Tom Liana (78578)
- Villimoni Vunimasi (40324)
- William Pou
- Willy Green (45869)
-
Labour Hire
-
Other
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Completed By: (initials)
-
Date
Signed by All Workers or Visitors to site:
-
Signed
TMP Modification
- TMP Mod
-
Add media
