Asphalt F.X Toolbox meeting - Crew

• Project Work Order Number

• Reinstatement Address
  Address

• Conducted on

  Date

• Prepared by

• Select date

  Date
• Address
  Address

• Job/task number / purchase order number

• Customer

  Select Other

  • Other

• Prestart record completed by

• Emergency Assembly Location

• First Aid Officers Present

  Yes

  No

  N/A

• JSEA/SWMS available on site

  Yes

  No

  N/A

• Water available

• Site Safety Risk Assessment

• Overhead power lines / obstructions

  Yes

  No

  N/A

• Control measure

• Open pits / ditches / culverts

  Yes

  No

  N/A

• Control measure

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

  Yes

  No

  N/A

• Control measure

• Steep grades (more than 1-10)

  Yes

  No

  N/A

• Control measure

• Traffic

  Yes

  No

  N/A

• Control measure

• Pedestrians public / ground personnel

  Yes

  No

  N/A

• Control measure

• Schools

  Yes

  No

  N/A

• Control measure

• Fall hazard &/or working at >2m

  Yes

  No

  N/A

• Control measure

• Weather conditions (heat / rain etc)

  Yes

  No

  N/A

• Control measure

• Other contractors/activities onsite

  Yes

  No

  N/A

• Control measure

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

  Yes

  No

  N/A

• Control measure

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

  Yes

  No

  N/A

• Have subcontractors been inducted into site specific prestart

  Yes

  No

  N/A

• 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

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

• Name

• Add signature

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Reinstatement 1

• Type

  Theiss asphalt

• Length (m)

• Width (m)

• Depth mm

• Preconstruction Photo 1

  Media

Reinstatement 2

• Type

  Theiss asphalt

• Length (m)

• Width (m)

• Depth mm

• Preconstruction Photo

  Media

Reinstatement 3

• Type

  Theiss asphalt

• Length (m)

• Width (m)

• Depth mm

• Preconstruction Photo

  Media

Other

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

• Traffic Required?

  Yes

  No

  N/A

• Signed

  Sign