1 Plant Hazard Checklist (complete before undertaking Risk Assessment)

• PLANT HAZARD CHECKLIST

• Plant Name

• Plant Number:

• Conducted on

  Date

Part A - PLANT SUMMARY

• Date Checklist Completed

  Date

• Plant Description / Name of Plant

• Plant No.

• Please take photo of plant

  Media

• Department

• Location (where plant is usually stored or located)?

• DETAILS OF PERSON UNDERTAKING CHECKLIST

• Name

• Position

• Signature

  Sign

• Date

  Date

• DETAILS OF PERSON UNDERTAKING CHECKLIST

• Name

• Position

• Signature

  Sign

• Date

  Date

• What is the equipment used for?

• Any known Incident History? (List details if know)

• WHS Representative (HSR)

  Sign

• Select date

  Date

Part B - HAZARD CHECKLIST

• Use the following prompts to identify the hazards associated with the plant. If the prompt is applicable or relevant tick "YES" and continue, a separate risk assessment on the "Plant Risk Assessment Form" will then need to be completed addressing each hazard ticked "YES". If the prompt is not applicable to the plant tick "NO" If it does not apply to the plant at all, tick "N/A".

• Code A - ENTANGLEMENT

• A1 - Can anyone's hair, clothing, gloves, jewellery, cleaning materials becoming entangled in moving or spinning parts?

  Yes

  No

  N/A

• A2 - Other or additional information (specify)

  Yes

  No

  N/A

• Code B - CRUSHING

• B1 - Due to material falling off the plant?

  YES

  NO

  Not Applicable

• B2 - Due to uncontrolled or unexpected movement of the plant?

  YES

  NO

  Not Applicable

• B3 - Due to lack of capacity of the plant to be slowed, stopped or immobilised?

  YES

  NO

  Not Applicable

• B4 - Due to the plant tipping or rolling over?

  YES

  NO

  Not Applicable

• B5 - Due to parts of the plant collapsing?

  YES

  NO

  Not Applicable

• B6 - Due to coming into contact with moving parts during testing, inspection, operation, maintenance, cleaning or repair?

  YES

  NO

  Not Applicable

• B7 - Due to being thrown off or under the plant?

  YES

  NO

  Not Applicable

• B8 - Other or additional information (specify)

  Yes

  No

  N/A

• Code B - CUTTING, STABBING & PUNCTURING

• C1 - Due to coming into contact with sharp or flying objects?

  YES

  NO

  Not Applicable

• C2 - Due to coming into contact with moving parts of plant during testing, inspection, maintenance, cleaning or repair of the plant?

  YES

  NO

  Not Applicable

• C3 - Due to the plant or work pieces disintegrating?

  YES

  NO

  Not Applicable

• C4 - Due to work pieces or plant pieces being ejected?

  YES

  NO

  Not Applicable

• C5 - Due to the mobility of the plant?

  YES

  NO

  Not Applicable

• C6 - Due to the uncontrolled or unexpected start up or movement of the plant?

  YES

  NO

  Not Applicable

• C7 - Other or additional information (specify)

  Yes

  No

  N/A

• Code D - SHEARING

• D1 - Due to body parts being sheared between two parts of the plant or parts of the plant and a work piece or structure?

  YES

  NO

  Not Applicable

• D2 - Other or additional information (specify)

  Yes

  No

  N/A

• Code E - FRICTION BURN

• E1 - Due to contact with friction heated moving parts/surfaces of plant or materials?

  YES

  NO

  Not Applicable

• E2 - Other or additional information (specify)

  Yes

  No

  N/A

• Code F - STRIKING BY MOVING OBJECTS

• F1 - Due to uncontrolled or unexpected movement of the plant or materials?

  YES

  NO

  Not Applicable

• F2 - Due to the plant, parts or work pieces disintegrating?

  YES

  NO

  Not Applicable

• F3 - Due to work pieces being ejected?

  YES

  NO

  Not Applicable

• F4 - Due to mobility or movement of the plant or plant parts?

  YES

  NO

  Not Applicable

• F5 - Other or additional information (specify)

  Yes

  No

  N/A

• Code G - HIGH PRESSURE FLUID INJURY

• G1 - Due to coming into contact with fluids under high pressure due to plant or hose failure or misuse of the plant?

  YES

  NO

  Not Applicable

• G2 - Other or additional information (specify)

  Yes

  No

  N/A

• Code H - SUFFOCATION

• H1 - Due to lack of oxygen or atmospheric contamination?

  YES

  NO

  Not Applicable

• H2 - Other or additional information (specify)

  Yes

  No

  N/A

• Code I - HIGH TEMPERATURE INJURY

• I1 - Due to coming into contact with objects at high temperatures?

  YES

  NO

  Not Applicable

• I2 - Due to fire?

  YES

  NO

  Not Applicable

• I3 - Other or additional information (specify)

  Yes

  No

  N/A

• Code J - THERMAL DISCOMFORT

• J1 - Due to exposure to high or low temperatures?

  YES

  NO

  Not Applicable

• J2 - Other or additional information (specify)

  Yes

  No

  N/A

• Code K - ELECTRICAL SHOCK OR ELECTRICAL BURN

• K1 - Due to the plant contacting live electrical conductors?

  YES

  NO

  Not Applicable

• K2 - Due to the plant working in close proximity to electrical conductors?

  YES

  NO

  Not Applicable

• K3 - Due to overload of electrical circuits?

  YES

  NO

  Not Applicable

• K4 - Due to damage or worn electrical cables, leads or switches?

  YES

  NO

  Not Applicable

• K5 - Due to water near electrical equipment?

  YES

  NO

  Not Applicable

• K6 - Due to inadequate isolation of electrical power supply?

  YES

  NO

  Not Applicable

• K7 - Due to residual electrical energy?

  YES

  NO

  Not Applicable

• K8 - Other or additional information (specify)

  Yes

  No

  N/A

• Code L - EXPLOSION

• L1 - Due to explosion of flammable or explosive gases, vapours, liquids, dust or other substances triggered by operation of the plant or material?

  YES

  NO

  Not Applicable

• L2 - Due to high pressure build up?

  YES

  NO

  Not Applicable

• L3 - Other or additional information (specify)

  Yes

  No

  N/A

• Code M - SLIPPING, TRIPPING OR FALLING

• M1 - Due to uneven or slippery surfaces?

  YES

  NO

  Not Applicable

• M2 - Due to poor housekeeping, e.g. equipment, etc. not stored properly?

  YES

  NO

  Not Applicable

• M3 - Due to obstacles being placed in the vicinity of the plant?

  YES

  NO

  Not Applicable

• M4 - Other or additional information (specify)

  Yes

  No

  N/A

• Code N - FALLING FROM HEIGHT

• N1 - Due to lack of a proper work platform?

  YES

  NO

  Not Applicable

• N2 - Due to lack of proper stairs or ladder?

  YES

  NO

  Not Applicable

• N3 - Due to lack of guardrails or suitable edge protection?

  YES

  NO

  Not Applicable

• N4 - Due to unprotected holes, penetrations or gaps?

  YES

  NO

  Not Applicable

• N5 - Due to poor floor or walking surfaces, not slip resistant?

  YES

  NO

  Not Applicable

• N6 - Due to steep or sloping walking surfaces?

  YES

  NO

  Not Applicable

• N7 - Due to collapse of the supporting structure?

  YES

  NO

  Not Applicable

• N8 - Other or additional information (specify)

  Yes

  No

  N/A

• Code O - ERGONOMICS OR PLANT ENVIRONMENT INJURY

• O1 - Due to poorly designed seating?

  YES

  NO

  Not Applicable

• O2 - Due to repetitive body movements?

  YES

  NO

  Not Applicable

• O3 - Due to constrained body posture or the need for excessive effort?

  YES

  NO

  Not Applicable

• O4 - Due to design deficiency causing mental or psychological stress?

  YES

  NO

  Not Applicable

• O5 - Due to inadequate or poorly placed lighting?

  YES

  NO

  Not Applicable

• O6 - Due to Lack of consideration given to human error or human behaviour?

  YES

  NO

  Not Applicable

• O7 - Due to mismatch of the plant with human traits and natural limitations?

  YES

  NO

  Not Applicable

• O8 - Other or additional information (specify)

  Yes

  No

  N/A

• Code P - OTHER HAZARDS - INJURIES OR ILL HEALTH

• P1 - Due to chemicals?

  YES

  NO

  Not Applicable

• P2 - Due to dust?

  YES

  NO

  Not Applicable

• P3 - Due to radiation?

  YES

  NO

  Not Applicable

• P4 - Due to toxic gases?

  YES

  NO

  Not Applicable

• P5 - Due to noise?

  YES

  NO

  Not Applicable

• P6 - Due to fumes?

  YES

  NO

  Not Applicable

• P7 - Due to vibration?

  YES

  NO

  Not Applicable

• P8 - Other or additional information (specify)

  Yes

  No

  N/A