ATC - Site Pre Start Documents

• Site conducted

• Site ID

• Supervisor

  Sign

• Risk Assessor

  Sign

• Conducted on

  Date

• Prepared by

• Location
  Address

HAZARD IDENTIFICATION & RISK ASSESSMENT

Hazards to Safety

• Power cables (electricity)

  High

  Medium

  Low

  N/A

• Hand tools

  High

  Medium

  Low

  N/A

• Excavation collapse

  High

  Medium

  Low

  N/A

• Open excavations

  High

  Medium

  Low

  N/A

• Sharp edged objects/articles

  High

  Medium

  Low

  N/A

• Loose rocks/materials

  High

  Medium

  Low

  N/A

• Snakes/Spiders/Bees

  High

  Medium

  Low

  N/A

• Bad weather (lightning/hail)

  High

  Medium

  Low

  N/A

• Hazardous chemicals/substances

  High

  Medium

  Low

  N/A

• Ladders

  High

  Medium

  Low

  N/A

• Work at heights

  High

  Medium

  Low

  N/A

• Local community

  High

  Medium

  Low

  N/A

• Falling objects/loads

  High

  Medium

  Low

  N/A

• Moving machinery or trucks

  High

  Medium

  Low

  N/A

• Defective machinery/equipment

  High

  Medium

  Low

  N/A

• Lithium-ion batteries

  High

  Medium

  Low

  N/A

• Thorns/branches

  High

  Medium

  Low

  N/A

• Security (risk to be attacked)

  High

  Medium

  Low

  N/A

• Welding/grinding/cutting

  High

  Medium

  Low

  N/A

• Vibrating machinery

  High

  Medium

  Low

  N/A

Hazards to Health

• Manual handling/lifting objects

  High

  Medium

  Low

  N/A

• Electromagnetic fields (RF)

  High

  Medium

  Low

  N/A

• Dust inhallation

  High

  Medium

  Low

  N/A

• Heat exposure/Sunburn

  High

  Medium

  Low

  N/A

• Muscle strains/pains

  High

  Medium

  Low

  N/A

• High noise level

  High

  Medium

  Low

  N/A

• Diesel/petrol/gas fumes

  High

  Medium

  Low

  N/A

• Working in awkward posture

  High

  Medium

  Low

  N/A

• Exposure to extreme cold

  High

  Medium

  Low

  N/A

• Dehydration (no access to water)

  High

  Medium

  Low

  N/A

CONTROLS TO REDUCE THE RISK

• Please describe how you will control the applicable Riks

PPE CONTROLS

• Safety boots

  Yes

  No

  N/A

• Overalls

  Yes

  No

  N/A

• Hi-visibility clothing

  Yes

  No

  N/A

• Ear protection

  Yes

  No

  N/A

• Face Shield

  Yes

  No

  N/A

• Fall Arrest Kit

  Yes

  No

  N/A

• Gumboots

  Yes

  No

  N/A

• Hard hat

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• Dust masks

  Yes

  No

  N/A

• Safety glasses

  Yes

  No

  N/A

• Rescue Kit (WAH)

  Yes

  No

  N/A

POTENTIAL EMERGENCIES FOR THIS SITE

• Assault/attack/mugging

  Yes

  No

  N/A

• Electrocution/electrical burn

  Yes

  No

  N/A

• Fire

  Yes

  No

  N/A

• Fall from height

  Yes

  No

  N/A

• Back injury

  Yes

  No

  N/A

• Bone fracture

  Yes

  No

  N/A

• Entrapment under collapsed soil

  Yes

  No

  N/A

• Lightning or hail storm

  Yes

  No

  N/A

• Out of control equipment

  Yes

  No

  N/A

• Sunburn/heatstroke

  Yes

  No

  N/A

• Injury requiring first aid

  Yes

  No

  N/A

• LiB explosion

  Yes

  No

  N/A

• Falling load

  Yes

  No

  N/A

• Massive bleeding from cut

  Yes

  No

  N/A

• Poisonous sting or bite

  Yes

  No

  N/A

• Struck by moving equipment

  Yes

  No

  N/A

• Large chemical spill (>125L)

  Yes

  No

  N/A

• Flooding

  Yes

  No

  N/A

SITE SECURITY

• Site Classification:

  High

  Medium

  Low

• Security required:

  Yes

  No

  N/A

• Security on site:

  Yes

  No

  N/A

• Any observations:

EMERGENCY TEAM ON SITE

• First Aider:

  Yes

  No

  N/A

• Name and Surname

• Contact Number

• Fire Fighter:

  Yes

  No

  N/A

• Name and Surname

• Contact Number

• Rescuer for Heights:

  Yes

  No

  N/A

• Name and Surname

• Contact Number

• Supervisor:

  Yes

  No

  N/A

• Name and Surname

• Contact Number

• Driver 1:

  Yes

  No

  N/A

• Name and Surname

• Contact Number

• Driver 2:

  Yes

  No

  N/A

• Name and Surname

• Contact Number

EMERGENCY PREPAREDNESS

• DCP Fire Extinguisher:

  Yes

  No

  N/A

• First Aid Kit:

  Yes

  No

  N/A

• Sun Protection:

  Yes

  No

  N/A

• Lith-Ex Fire Extinguisher:

  Yes

  No

  N/A

• Spill Kit:

  Yes

  No

  N/A

• Drinking Water:

  Yes

  No

  N/A

• Assembly Point:

EMERGENCY NUMBERS

• National Emergency Nr 112

• Netcare 082 911

• Fire Brigade 10177

• Poison Info Center (Snake bites etc) 0861 555 777

• Closest Clinic/Hospital and Telephone Number :

INDUCTION TOPICS

• Company rules on site

  Yes

  No

  N/A

• Where to put personal items

  Yes

  No

  N/A

• Where to put tools and equipment

  Yes

  No

  N/A

• Work times and meal breaks

  Yes

  No

  N/A

• Reporting incidents to Supervisor

  Yes

  No

  N/A

• Toilets and drinking water

  Yes

  No

  N/A

• Wearing PPE on site

  Yes

  No

  N/A

• If unsure about anything, ASK

  Yes

  No

  N/A

• Make sure you sign RA and ER plan

  Yes

  No

  N/A

• GENERAL COMMENTS

COMMUNICATION TO TEAM MEMBER ON SITE

• Add signature

  Sign