Information
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Site and Date
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Prepared by
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Risk Assessment Completed
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TAKE 5
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Do I Fully Understand This Task?
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Controls
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Am I Fit To Carry Out The Task?
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Controls
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Do I Have The Correct Tools for the Task?
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Controls
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Is there a procedure or JSEA for the Task and have you read and Understood it?
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Controls
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Am I trained and competent to carry out the task?
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Controls
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Do I have the correct PPE for the Task?
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Controls
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Is my work area safe?
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Controls
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Can I get caught in or between anything?
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Controls
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Can My work affect anybody else's safety eg Interaction ?
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Controls
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Have I identified and Isolated any dangerous energy sources?
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Controls
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Is there exposure to excessive Heat/Dust/Noise/Vibration?
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Controls
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Can anything fall on me?
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Controls
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Is a Permit required?
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Controls
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Can my actions harm the environment?
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Controls
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Other
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Controls
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List
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Are All Hazards Assessed and Controls in place
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DO NOT PROCEED CONTACT YOUR SUPERVISOR
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Sign
Person
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Add signature
OVERHEAD BINS
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Gates Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Solenoids Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Rams and Clevises Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Airlines Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
GROUND BINS
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Vibrators Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Gates and Adjusters Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Rams and Clevises Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Airlines Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Solenoids Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
AGG BINS
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Vibrators Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Gates and Adjusters Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Rams and Clevises Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Airlines Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Hanging Bolts Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
CEMENT BIN
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Vibrators Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Discharge Valves Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Rams and Clevises Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Aeration Equipment Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
BATCH CONVEYOR
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Scrapers Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Gearbox Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Bearings Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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V-Belts Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Pulleys Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Conveyor Belt Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Skirting Rubbers Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Rollers Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Gob Hopper Sock Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
COMPRESSOR
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Filters Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Oilers Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Airlines Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
WATER TANKS
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Socks Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Build up Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Discharge Valves Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
SILOS
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Overfill Valves Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Vibrators Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Pressure Relief Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Discharge Valves Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Solenoids Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Air Slides Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Aeration Equipment Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Cam locks and Caps Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Socks Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
GENERAL
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All Guarding Checked
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Any Issues Found
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Photographs
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Issue Found
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Immediate Corrective Actions Required
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Immediate Corrective Actions
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Person Responsible
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Time inspected
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Is the General Area Clean
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Reason
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Add media
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Generator Hours
Generator
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Hours
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Comments
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Any Further Issues
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Suggestions
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Add media
Down Time
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Start of down time
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Down Time
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Reason
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Total Down Time
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Total Cubic Metres
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TASKS REQUIRED
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Check Complete