Asphalt F.X Toolbox meeting - 26/06/13

• Project Work Order Number

• Reinstatement Address
  Address

• Conducted on

  Date

• Prepared by

• Job/task number / purchase order number

• Customer

  Select Fulton Hogan Southeast Water Lendlease Frasers Bitumill Other

  • Fulton Hogan
  • Southeast Water
  • Lendlease
  • Frasers
  • Bitumill
  • Other

• Emergency Assembly Location

• Crew truck

  Float

  nominated area

• First Aid Officers Present

  Select Peter Henderson Joji Verea Terry Hoendorf Paul Shultz

  • Peter Henderson
  • Joji Verea
  • Terry Hoendorf
  • Paul Shultz

• JSEA/SWMS available on site

  Yes

  No

• Water available

• Site Safety Risk Assessment

• Overhead power lines / obstructions

  Select spotter Yellow cones Maintain safe distance from power lines Cover or barricade

  • spotter
  • Yellow cones
  • Maintain safe distance from power lines
  • Cover or barricade

• Open pits / ditches / culverts

  Select spotter Yellow cones Maintain safe distance from power lines Cover or barricade

  • spotter
  • Yellow cones
  • Maintain safe distance from power lines
  • Cover or barricade

• Uneven ground (profiled edges, back of kerb and channel)

  Select spotter Yellow cones Maintain safe distance from power lines Cover or barricade

  • spotter
  • Yellow cones
  • Maintain safe distance from power lines
  • Cover or barricade

• Steep grades (more than 1-10)

  Select chock parked vehicles maintai safe distance from pant and people use experienced personnel for site conditions Brief and closely supervise trainees to gain experience

  • chock parked vehicles
  • maintai safe distance from pant and people
  • use experienced personnel for site conditions
  • Brief and closely supervise trainees to gain experience

• Traffic

  Select ensure traffic is set up in accordance with TMP Nominate traffic separation distances Traffic speed >60kph min 3m clearance required Traffic speed <60kph min 1.2 Clearance required <1.2 metre clearance distance traffic must be dropped to 40kph and traffic stopped by traffic controller with stop/slow sign so traffic is controlled through work zone

  • ensure traffic is set up in accordance with TMP
  • Nominate traffic separation distances
  • Traffic speed >60kph min 3m clearance required
  • Traffic speed <60kph min 1.2 Clearance required
  • <1.2 metre clearance distance traffic must be dropped to 40kph and traffic stopped by traffic controller with stop/slow sign so traffic is controlled through work zone

• Pedestrians public / ground personnel

  Select ensure traffic is set up in accordance with TMP Nominate traffic separation distances Traffic speed >60kph min 3m clearance required Traffic speed <60kph min 1.2 Clearance required <1.2 metre clearance distance traffic must be dropped to 40kph and traffic stopped by traffic controller with stop/slow sign so traffic is controlled through work zone

  • ensure traffic is set up in accordance with TMP
  • Nominate traffic separation distances
  • Traffic speed >60kph min 3m clearance required
  • Traffic speed <60kph min 1.2 Clearance required
  • <1.2 metre clearance distance traffic must be dropped to 40kph and traffic stopped by traffic controller with stop/slow sign so traffic is controlled through work zone

• Schools

  Yes

  No

  N/A

• Control measure

• Fall hazard &/or working at >2m

  Yes

  No

  N/A

• Control measure

• Weather conditions (heat / rain etc)

  Select greater than 35 deg Rain Showers Less than 12 deg

  • greater than 35 deg
  • Rain
  • Showers
  • Less than 12 deg

• Control measure

• Other contractors/activities onsite

  Yes

  No

  N/A

• Control measure

• Are other controls needed to manage environmental issues? -flora & fauna -dust -noise -contaminated run off

  Select leave native fora and fauna habitats unaffected by ongoing works clean up and remove all oil, fuel and other chemical spills maintain on site spill kits block drainage points

  • leave native fora and fauna habitats unaffected by ongoing works
  • clean up and remove all oil, fuel and other chemical spills
  • maintain on site spill kits
  • block drainage points

• Control measure

• Have all employees and subcontractors been inducted to the principal contractors site induction

  Yes

  No

• Have subcontractors been inducted into site specific prestart

  Yes

  No

• Are all machine/plant operators licensed and competent ? If not trainees must have completed the initial machine induction & will be supervised for machine/plant operating

  Yes

  No

• Have plant daily pe-start sheets been completed for all mobile plant including subcontractors

  Yes

  No

• Is traffic management (TPM) available and traffic control set up in accordance with TMP?

  Yes

  No

• Are all personnel provided with appropriate PPE for task undertaken?

  Yes

  No

• Site induction record - all personnel (including subcontractors personnel)

• Name

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

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• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

Reinstatement 1

• Type

  Asphalt patch

  Concrete

• Length (m)

• Width (m)

• Depth mm

• Preconstruction Photo 1

  Media

Reinstatement 2

• Type

  Asphalt patch

  Concrete

• Length (m)

• Width (m)

• Depth mm

• Preconstruction Photo

  Media

Reinstatement 3

• Type

  Asphalt patch

  Concrete

• Length (m)

• Width (m)

• Depth mm

• Preconstruction Photo

  Media

Other

• Comments (extra reinstatement patches, odd ball sizes, coloured concrete, etc)

• Traffic Required?

  Yes

  No

• Signed

  Sign