Information

  • Job No.

  • Title

  • Conducted on

  • Prepared by

  • Asset Serial Number

  • Asset Hour Meter Reading

STOP AND THINK

BEFORE YOU START WORK

  • Are you fit and suitably competent to carry out all required tasks?

  • Have you signed in and been inducted on Site?

  • Do you fully understand the task at hand and the steps to take?

  • Do you have a work permit and work instructions/procedure?

  • Do you have the correct PPE and tools for every task?

  • Do you have safe and suitable access to the work area?

  • Have all power tools and lifting gear been tested and inspected?

  • Does the site SWMS adequately cover all site hazards and risks identified, If "NO" proceed to JOB HAZARD ANALYSIS.

  • Has the site SWMS been reviewed by all personnel working on the job

JOB HAZARD ANALYSIS "SPOT THE HAZARD"

  • Is the equipment electrically "Live" and could I be electrocuted?

  • Insert Controls to reduce or eliminate hazard

  • Have the controls reduced or eliminated the hazard to work safely

  • DO NOT PROCEED

  • Could I fall from height?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Could I slip, trip, or fall on anything? (Housekeeping, floor condition)?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Could I be burnt or scolded? (Water, oil, metal, flames or hot)

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Could I be caught in, on or in between anything in the way?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Are there any biological hazards? (Cooling towers etc).

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Could something fall and hit me or anyone else?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Is there any stored energy hazards (charged capacitors, hydraulic / air pressure, charged springs)?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Does the task involve hazardous chemicals or materials?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Is the air ok to breathe? (Gas, fumes, dust)

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Is there any moving vehicles or equipment close to where I am working?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Could I be exposed to noise, vibration, thermal stress, radiation?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Am I handling loads using mechanical handling methods?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Am I stretching or twisting and could I strain or over exert myself?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Am I working in a confined or restricted space?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Are my colleagues or other persons fit and safe for work?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Does the weather conditions create any hazards?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Are the lighting levels adequate for the task?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Are all loads secure using correct methods?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Are there any other hazards left uncontrolled?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Are there any other persons working in the area who present a risk?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Should I communicate my movements to any other personnel?

  • Insert controls to reduce or eliminate hazards

  • Have the controls reduced or eliminated the hazards to work safely

  • DO NOT PROCEED

  • Are all hazards suitably controlled, are risks as low as reasonably practicable and everyone safe? Can I control all hazards with this JSA

  • A full SWMS/JSA must be carried out before commencing any work

1.0 Machine

(A) IN GOOD ORDER, (B) SERVICEABLE, MONITOR CONDITION, (C) ATTENTION, REPAIRS REQUIRED, (D) SAFETY ITEM, (NA) NOT APPLICABLE

1.1 GENERAL ASSEMBLY

  • Visual Inspection General Finish

  • Check Name Plates Details

  • Check Operating Instructions Details

  • Check Telephone Operation, Mounting & Condition

  • Check UPS Operation

  • Visual & Operational Inspection Of Panels, Gates, Latches & Guarding

  • Check Equipment Keys Availability And Operation

  • Visual Inspection Of SWL Signs For Compliance

  • Check Electrical Drawings Provided

  • Check Machine Greater Than 10 Years Old

  • Visual Inspection Of Cradle Cleanliness

  • Visual Inspection Of Garage Doors, Shutters, Lighting and Clear Access

1.2 HOIST (DRUM TYPE)

  • Visual Inspection Of General Condition Of Hoist

  • Visual Inspection For Corrosion

  • Visual Inspection Of Electrical Connections

  • Visual Inspection Of Electrical Limit Switch Entries Sealed (Where Practicable)

  • Visual & Function Inspection Of BMU Operation

  • Visual & Function Inspection Of Hoist Raise / Lower

  • Visual & Function Inspection Of Operation From Cradle

  • Visual & Function Inspection Of Hand Wind Operation

  • Visual & Function Inspection Of Hand Wind Limit Switch

  • Inspect Bolts For Tightness

  • Visual & Audible Inspection Of Motor / Gearbox

  • Inspect Oil Level (Gearbox And Gear Motor, Top Up)

  • Inspect Hoist General Lubrication (Top Up As Required)

  • Visual Inspection & Function Test Of Hoist Primary Brake

  • Visual Inspection & Function Test Of Hoist Secondary Brake

  • Visual & Function Inspection Of Over / Under Speed

  • Visual & Audible Inspection Of Pinion

  • Visual Inspection Of Slew Unit

  • Visual Inspection Of Wire Rope Condition

  • Visual Inspection Of Wire Rope Termination

  • Visual Inspection Of Slack Rope Sensor

  • Visual Inspection Of Wire Rope Lubrication (Lubricate As Required)

  • Visual Inspection Of Bearings (Where Practicable)

  • Visual Inspection Of Slip Rings, Contacts and Clean If Neccessary

  • Visual Inspection Of Rope Drum

  • Visual Inspection Drum Empty Limit

  • Visual Inspection Rope Layering Limit

  • Visual Inspection Of Drum Drive Gear & Pinion

  • Visual & Function Inspection Of Anti - Bunching limit

  • Visual Inspection of PLC Rotary Pulse Generators

  • Visual & Function Inspection of PLC Proximity Switches

1.3 INTERNAL DIVERTERS

  • Visual Inspect For Structural Damage (Where Practicable)

  • Visual Inspect For Corrosion

  • Visual & Function Inspection Of Operation

  • Inspect General Finish

  • Visual & Audible Inspection Of Sheaves

  • Visual & Operational Inspection Of Wire Rope Keepers

  • Visual & Audible Inspection Of Bearings (Where Practicable)

  • Visual Inspection Of Thrust Washers

  • Visual Inspection Of Pivot Pins

  • Visual Inspection Of Sheave Connection To Machine

  • Visual Inspection Of Bushes (Where Practicable)

1.4 MACHINE FRAME

  • Visual Inspection Of General Finish

  • Inspect For Structural Damage (Where Practicable)

  • Visual Inspection Of Welds

  • Visual Inspection For Corrosion

  • Visual Inspection Of Water Seals (Where Practicable)

  • Visual & Function Inspection Of Self Reeling Power Cable Drum And Cable

  • Visual & Function Inspection Of Proximity & Limit Switches On Self Reeling Drum

  • Visual Inspection For Cracks

  • Visual Inspection Of Main Control Cubicle Securely Locked

  • Visual Inspection Of Main Control Cubicle Labelling

  • Visual Inspection Of Main Control Cubicle Waterproofing

  • Visual Inspection Of Contactors

  • Visual Inspection Of Auxiliary Controls

  • Visual & Function Test Of Auxiliary Emergency Stop Switch

  • Visual Inspection Of Electrical Wiring

  • Visual Inspection Of Electrical Connections

  • Visual Inspection Of Indicator Lights

  • Visual Inspection Of Limit Switch Entries Sealed (Where Practicable)Electrical Connections

  • Visual Inspection Of PLC Indicator Lights

  • Visual & Function Inspection Of Isolation Switch

  • Visual & Function Inspection Of RCD's

  • Visual Inspection Of Slip Rings

  • Visual & Function Inspection Of Doors

  • Visual & Audible Inspection Of Motor Gearbox

  • Visual Inspection Of Oil Levels / Lubrication (Top Up and Apply As required)

  • Inspect Bolts Tightness

  • Visual Inspection Of Brushes (Where Practicable)

1.5 SUB FRAME

  • Visual Inspection Of General Finish

  • Visual Inspection For Structural Damage (Where Practicable)

  • Visual Inspection Of Welds

  • Visual Inspection For Corrosion

  • Visual Inspection Of Bushes (Where Practicable)

  • Visual Inspection Of Pivots Arms

  • Visual Inspection For Cracks

  • Inspect Bolts For Tightness

  • Visual & Audible Inspection Of Slew Drive

  • Visual & Audible Inspection Of Slew Positioning & Limits

  • Lubricate Slew Ring

  • Visual Inspection Of For Water Retention / ingress (Where Practicable)

1.6 DRIVE WHEELS

  • Visual Inspection For Structural Damage (Where Practicable)

  • Visual Inspection For Corrosion

  • Visual Inspection Of Thrust Washer

  • Visual & Function Inspection Of Operation

  • Visual & Function Inspection Of Cam Followers

  • Lubricate Cam Followers As Required

  • Visual Inspection of Anti - Tipping Guides

  • Lubricate Gearbox As Required

  • Visual Inspection Of Electrical Cables Condition

  • Visual Inspection Of Limit Switch Entries Sealed (Where Practicable)

  • Visual & Audible Inspection Of Bearings (Where Practicable)

  • Visual Inspection Of Bushes (Where Practicable)

  • Visual & Audible Inspection Of Pivot Pins

  • Visual & Audible Inspection Of Motor / Gearbox

  • Visual Inspection Of Torsion Arm

1.7 CROSSBAR ASSEMBLY

  • Visual Inspection Of General Finish

  • Visual Inspection For Corrosion

  • Visual Inspection For Structural Damage (Where Practicable)

  • Visual & Function Inspection Of Operation

  • Visual & Function Inspection Of Linear Actuator

  • Visual & Audible Inspection Of Bearings Where Practicable

  • Visual Inspection Of Pivot Pin

  • Visual Inspection Of Bushes (Where Practicable)

  • Visual & Function Inspection Of Full up limit switch

  • Visual Inspection For Cracks

  • Visual & Function Inspection Of Cross Bar Slew Limit

  • Visual & Function Inspection Of Full Up Over Travel Limit

  • Visual Inspection Of Limit Switch Entries Sealed (Where Practicable)

  • Visual Inspection Of Electrical Wiring & Controls

1.8 JIB ASSEMBLY

  • Visual Inspection Of General Finish

  • Visual Inspection For Structural Damage (Where Practicable)

  • Visual Inspection For Corrosion

  • Visual Inspection Of Welds

  • Visual Inspection Of Pins For Wear

  • Visual & Audible Inspection Of Power Pack

  • Visual Inspection Of Hydraulic Hoses

  • Visual & Function Inspection Of Valves

  • Visual Inspection For Cracks

  • Visual & Audible Inspection Of Motor / Gearbox / Tank

  • Visual & Audible Inspection Of Operation

  • Visual Inspection Of Luffing Assembly

  • Visual Inspection Of Luffing Pivot Pins & Bushes (Where Practicable)

  • Visual Inspection Of Structural Connections to the Luffing Assembly

  • Visual Inspection Of Electrical Wiring & Controls

  • Visual & Function Inspection Of Hydraulics (Cylinders, Hoses, Fittings, For Leaks)

1.9 SLEW ASSEMBLY

  • Visual Inspection Of General Finish

  • Visual Inspection For Oils Leaks

  • Visual Inspection Of Oil Levels (Top Up as Required)

  • Visual Inspection Of Brake Air Gap

  • Visual & Function Test Of Brake Operation

  • Visual Inspection For Corrosion

  • Visual Inspection Of Pinion

  • Inspect Bolts For Tightness (Where Practicable)

  • Visual & Audible Inspection For Correct Operation

  • Visual Inspection for Ingress Of Water In Motor (Where Practicable)

  • Visual Inspection Of Limit Switch Entries Sealed (Where Practicable)

  • Visual Inspection For Cracks

  • Visual Inspection Of Electrical Controls & Wiring

  • Visual Inspection Of General Lubrication (Top Up And Apply As Required)

  • Visual & Audible Inspection Of Slew Ring - Slew Assembly

  • Lubricate Slew Ring - Slew Assembly

  • Visual & Audible Inspection Of Pinion Alignment & Back Lash (Where Practicable)

1.10 COUNTERWEIGHT

  • Visual Inspection Of General Finish

  • Visual Inspection For Corrosion

  • Visual Inspection Of Pins & Bolts Condition. Check Secure

  • Visual Inspection Of Cover In Position & Secure

1.11 STABILITY

  • Visual Inspection Of Tie Down Anchors & Interlocks

  • Visual Inspection Of Tie Down Anchors Condition

  • Visual Inspection For Corrosion

  • Visual Inspection All Drive Wheel Are In Full Contact With The Track / Surface

  • Visual & Audible Inspection For Correct Operation

1.12 HYDRAULIC

  • Visual & Audible Inspection Of Hydraulic Motor

  • Visual Inspection Of Hoses

  • Visual Inspection Of Fittings

  • Visual Inspection Of Ram & Holding Valve

  • Visual Inspection Of Seals For Leaks (Where Practicable)

  • Inspect Oil Levels (Top Up as Required)

  • Visual Inspection Of Solenoid Plugs / Electrical

  • Visual Inspection Of Reservoir Conditions

  • Visual Inspection Of Filters (Where Practicable)

  • Visual Inspection Of Hose & Pipe Clamps

  • Lubricate Hand Pump & Clinder

  • Visual And Function Inspection of Hand Pump Operation

  • Visual Inspection of Pressure Switches

  • Visual Inspection of Pressure Gauges

  • Visual & Function Inspection Of Cylinder Condition

2.0 CRADLE

(A) IN GOOD ORDER, (B) SERVICEABLE, MONITOR CONDITION, (C) ATTENTION, REPAIRS REQUIRED, (D) SAFETY ITEM, (NA) NOT APPLICABLE

2.1 CRADLE ASSEMBLY

  • Visual Inspection Of General Finish

  • Visual Inspection For Corrosion

  • Visual Inspection For Water Retention (Where Practicable)

  • Visual Inspection Of Welds

  • Visual Inspect All Covers Are Secure

  • Visual and Audible Inspection Of Pivot, Brushes & Bearings (Where Practicable)

  • Visual Inspection Of Cradle Overload

  • Visual & Function Inspection Of Stop Button - Cradle

  • Visual Inspection Of Cradle Rope / Termination & Bulldog Clamps

  • Visual & Function Inspection Of Equaliser Assembly & Slack Rope

  • Visual Inspection Of Electrical Connections

  • Visual Inspection Of Indicator Lights

  • Visual& Function Inspection Of PLC Proximity Switches

  • Visual & Function Inspection Of PLC Rope Equaliser Limits

  • Visual & Function Inspection Of Slack Rope Sensor

  • Visual & Function Inspection Of Trip Bar / Under Load

  • Visual Inspection Of Lanyard Trip Bars

  • Visual Inspection Of SWL Signage

  • Visual Inspection Of Operating Instructions

  • Visual Inspection Of Communication Contact Number

  • Visual Inspection Of Cradle Frame, Floor & Sides for damage. Ensuring Any Openings or Holes Are Compliance to Minimum Enclosure Opening Sizes.

  • Visual Inspection Of Limit Switch Entries Sealed (Where Practicable)

  • Visual & Function Inspection Of Cross Bar Assembly

  • Visual Inspect, Cradle Control Panel Condition, Functions, Wiring, Waterproofing

  • Visual Inspection Of Cradle Protective Finish

  • Visual & Function Inspection Of Hand Winders

  • Inspect That The Phone Unit Is Operating & Fasten Correctly

  • Visual Inspect Harness Anchor points

  • Visual Inspection Of Springs

  • Visual Inspection Of Cradle Bumper Rollers

2.2 CRADLE RESTRAINTS

  • Visual Inspection Of Wire Rope/Belts

  • Visual Inspection Of Lanyard Connections

  • Visual Inspection Of Sensor Buckle

  • Visual Inspection Socket /Plug / Mullion Guide

  • Visual & Function Inspection Of System

  • Inspect For Corrosion

  • Visual Inspection Of Electrical Cables

3.0 TRACK ASSEMBLY

(A) IN GOOD ORDER, (B) SERVICEABLE, MONITOR CONDITION, (C) ATTENTION, REPAIRS REQUIRED, (D) SAFETY ITEM, (NA) NOT APPLICABLE

3.1 TRACK ASSEMBLY

  • Visual Inspection Of General Finish

  • Visual Inspection for Structural Damage (Where Practicable)

  • Visual Inspection For Water Ingress/ Retention (Where Practicable)

  • Visual Inspection For Corrosion

  • Visual Inspection Of Welds

  • Visual Inspection Of Support Structure (Where Practicable)

  • Visual Inspection Of Gap Between Sections

  • Visual Inspection Of Anchor Bolts (Where Practicable)

  • Visual Inspection Of Running Track For Wear (Where Practicable)

  • Visual Inspection Of Lightening Strip & Grounding

4.0 FIELD TEST RESULTS

MAIN HOIST DATA

  • Cradle Safe Working Load (SWL) (kg)

  • Wire Rope Weight (kg)

  • Material Hoist Safe working Load (SWL) (kg) If Applicable

  • Cradle Test load (kg) = Cradle SWL + Wire Rope Mass + Material Hoist SWL If Applicable

DYNAMIC LOAD TEST: (Cradle Test Load = Cradle SWL + Wire Rope Mass + Material Hoist SWL If Applicable)

  • Test Result

HOIST BRAKE TEST: (Cradle Test Load = Cradle SWL + Wire Rope Mass)

  • Test Result

HOIST BRAKE TEST SECONDARY / EMEGENCY BRAKE: (Cradle Test Load = Cradle Test Load = Cradle SWL + Wire Rope Mass)

  • Test Result

HOIST OVER-SPEED TEST: (Cradle Test Load = Cradle SWL + Wire Rope Mass)

  • Test Result

OVERLOAD LIMITING DEVICE TEST: (Cradle SWL + 20 kg)

  • Test Result

CHECK TORQUE TENSION OF A PERCENTAGE OF SLEW RING BOLTS

  • Inspection Result

INSPECT CONDITION ON ROOF TOP GPO'S

  • Inspection Result

5.0 SUMMARY

IDENTIFIED SAFETY, CODE & REPAIR ITEMS

5.1 SAFETY ITEMS

  • Outstanding Safety Items To Be Completed Before The BMU Is "SAFE FOR USE"

  • Safety Items
  • Description

5.2 CODE COMPLIANT ITEMS

  • Outstanding Code Compliant Items

  • Code Compliant Item
  • Description

5.3 REPAIR ITEMS

  • Recommended Preventative Repair Item

  • Repair Items
  • Description

6.0 GENERAL COMMENTS

GENERAL COMMENTS

    General Comments
  • Description

7.0 AUTHORISATION

TECHNICIAN / ENGINEER

  • Service Inspector / Technician / Engineer Signature: All Work Completed in Compliance With The Relevant Australian Standards

  • Service Inspector / Technician / Engineer Signature
  • Signature

CUSTOMER

    Customer Signature
  • Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.