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
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Time of Job Start Form being completed
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Prepared by
- Labour Hire
- Other
- Albert Heke
- Apa Vila
- Daniel Bishop
- David Bridgewater
- Eroni Baleilevuka
- Jasmin Alvarado
- John Maro
- Jordan MacDonald
- Josh Heke
- Kahu Sutherland
- Kelly Rebate
- Matai Vila
- Phillip Cooper
- Soul Suliasi Toa
- William Wilson
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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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Add Employees
Employees who worked on this job
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Add Employees
- Labour Hire
- Other
- Albert Heke
- Apa Vila
- Daniel Bishop
- David Bridgewater
- Eroni Baleilevuka
- Jasmin Alvarado
- John Maro
- Jordan MacDonald
- Josh Heke
- Kahu Sutherland
- Kelly Rebate
- Matai Vila
- Phillip Cooper
- Soul Suliasi Toa
- William Wilson
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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?
Add Truck
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Driver
- Labour Hire
- Other
- Albert Heke
- Apa Vila
- Daniel Bishop
- David Bridgewater
- Eroni Baleilevuka
- Jasmin Alvarado
- John Maro
- Jordan MacDonald
- Josh Heke
- Kahu Sutherland
- Kelly Rebate
- Matai Vila
- Phillip Cooper
- Soul Suliasi Toa
- William Wilson
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Labour Hire
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Other
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Job Comments
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Additional Comments
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Signed:
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
- Traffic/Vehicles
- Pedestrians (footpath closed)
- Pedestrians (footpath detour)
- Excess Speed
- Visibility
- Cyclists (cycle lane diversion/allowance)
- Cyclists (with live traffic)
- Large Vehicles
- Weather
- Mobility Scooters
- Poor Road Surface
- 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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Side friction, speed restriction, additional advanced warning (new seal?)
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Good road surface, additional pedestrian lane width, use of driveways
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Additional lane width, turning circles, tapers at good length
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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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Additional lane width, visibility,shoulders available
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Narrow lanes, speed restriction, side friction kerb line of cones, additional safety zones
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Placed where good visibility is achievable, out of worksite, TC on site, inside speed restriction
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1.2m wide, cone barrier arms/safety fencing to contain, no trip hazards on route
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Positive Traffic Management, good delineation, side friction, RGs
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Good signage visibility, centreline of cones, side friction, extra safety zone area
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Mitigation:
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
- Albert Heke
- Apa Vila
- Daniel Bishop
- David Bridgewater
- Eroni Baleilevuka
- Jasmin Alvarado
- John Maro
- Jordan MacDonald
- Josh Heke
- Kahu Sutherland
- Kelly Rebate
- Matai Vila
- Phillip Cooper
- Soul Suliasi Toa
- William Wilson
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Labour Hire
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Other
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Completed By: (initials)
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Date
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Emergency Evacuation Point
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Nearest emergency medical facilities
Signed by All Workers or Visitors to site:
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Signed
TMP Modifications
- TMP Modifications
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TMP Modifications
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Comment
TTM Count
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Cones
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Cone Bars
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L2 Stand and Base
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L2 Sign
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L2 Supplementary Sign
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L1 Stand and Base
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L1 Sign
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L1 Supplementary Sign
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Water filled barrier
