Allwater Job Safety Observations

• Work Order No.

• Job Safety Observation

• Site / Depot

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel - Observation Team

People

• Is PPE being used as required?

  Yes

  No

  N/A

• Type details of incorrect PPE

• Compliance with JSA or other procedures confirmed

  Yes

  No

  N/A

• Type details of JSA or procedure failure here

• Is appropriate behaviour shown

  Yes

  No

  N/A

• Type details of inappropriate behaviour here

• Are Personnel adequately trained for task

  Yes

  No

  N/A

• Type details of training concerns here

Tools/Plant/Facilities

• Are tools appropraite for task

  Yes

  No

  N/A

• Type details of inappropriate tools here

• Have tools/plant been inspected before use

  Yes

  No

  N/A

• Type details of failed inspections here

• Is all gear maintained and serviceable? eg. slings, cables etc.

  Yes

  No

  N/A

• Type details of of all equipment that is not being sufficiently maintained

• Are all Electrical tools or plant being used in good condition and safe to use? eg. tested, tagged

  Yes

  No

  N/A

• Type details of all electrical issues here

Environment

• Is access and egress safe

  Yes

  No

  N/A

• Type details of access/egress issues here

• Good Housekeeping? eg. are tools packed away, is site tidy and free of tripping hazards

  Yes

  No

  N/A

• Type details of bad housekeeping here

• Are all noise, dust, odour, or discharge concerns being addressed in a safe manner?

  Yes

  No

  N/A

• Type details of any noise, dust, odour, discharge issues here

• Is the environment being protected during the works? eg. fuels and chemicals stowed correctly, vegetation being considered

  Yes

  No

  N/A

• Type details of environment concerns here

• Is the waste being managed correctly? eg. spoil, bitumen

  Yes

  No

  N/A

• Type details of bad waste management here

Systems

• Is Job Analysis Complete and appropriate for task

  Yes

  No

  N/A

• Type details of no JSA or inappropriate JSA here

• Are all procedures being followed

  Yes

  No

  N/A

• Type details of failed procedures here

• For any works that requires an isolation, water or sewer, is the isolation effective?

  Yes

  No

  N/A

• Type details of failed or poor isolation here

Discussion

• Discuss the JSO with all personnel and note outcomes of discussion

Follow Up Actions

• After completing the JSO and having discussions with all personnel on-site, are you free of any follow up actions?

  Yes

  No

  N/A

• Type all actions required here. Include who will be responsible for those actions and when the follow up should be completed.