Title Page
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Select date
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1.Job ID
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1. Job Description
- Scope
- Tech
- Civil
- Aerial
- Blowing
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1. Job location
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2. Job ID
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2. Job Description
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2. Job location
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3. Job ID
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3. Job Description
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3. Job location
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4. Job ID
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4. Job Description
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4. Job location
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5. Job ID
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5. Job Description
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5. Job location
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6. Job ID
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6. Job Description
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6. Job location
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7. Job ID
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7. Job Description
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7. Job location
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8. Job ID
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8. Job Description
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8. Job location
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Emergency Plan (detail)
- First Aid kit
- DRSABCD
- MSDS
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Documents Location - Documents onsite i.e. JA/ SWMS, SDS, Permits and other HSE related documents on site
- Van
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Kit location
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Are all personnel inducted appropriately for site and activity i.e. BRS, Client Inductions?<br><br>
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Has all staff signed off on/onto SWMS/JSA and appropriate signage/ isolation/barricading controls been implemented to work area?
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Traffic management plan required
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Traffic management diagram no.
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List Plant and Equipment
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Close Approach Consent required
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Confirm working outside of MAD
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Safety observer required
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Place a tick if the hazards are identified in the Job Analysis or SWMS
- Electrical
- Chemical
- Tools
- Gasses
- First Aid
- Vehicles
- Heights
- Depth
- Weight
- Lighting
- Pressure
- Access
- Vibration
- Noise
- Trenches
- Weather
- Bacteria
- Dust
- Slip/ Trip
- Remote Site
- Hot/ Cold objects
- Rotating Equipment
- Moving Equipment
- Underground Services
- Confined space
- Dehydration
- Radiation(Sun)
- Manual handling
- Exposed holes
- Overhead
- Sharps/ needles
- Pedestrians
- Amenities
- Working alone
- Hit by moving objects
- Caught in/ between
- Strain/ repetitive
- Dropped objects
- Strike against
- Inhalation
- Burns
- Exposure to gas/ heat
- Exposure to dust/ chemicals
- Pollution to the environment
- Soil erosion/contamination
- Runoff to drainage systems
- Simultaneous operations
- Security
- Damage to equipment
- Air/ fumes and odours
- Public liability
- Waste management
- Other hazards
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JA
- Handling Fibre Optic Cables JA - TMF-9402-SA-0037
- Suspended Loads at Worksites JA - TMF-9000-SA-0215
- Blown Fibre Installation and Testing JA - TMF-9402-SA-0039
- Working in the Vicinity of Asbestos JA - TMF-9402-SA-0028
- UFB Aerial Provisioning JA - TMF-9402-SA-0032
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What PPE is likely to be used? Tick if applicable
- Respiratory Protective Device
- Harness/ Lifeline
- Eye Protection: Glasses / Goggles/ Visor
- Hand Protection/ Gloves
- Safety Boots/ Gum Boots
- Overalls/ Disposable Overalls
- Barricading and signage
- Lock Out Tag Out Kit
- Hearing Protection
- Safety helmet
- Communications equipment
- Torch/ Lighting
- Fire Fighting equipment
- Mechanical ventilation device
- Sun hat
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Other PPE not listed above
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List site specific hazards and conduct Risk Assessment - 1.Job Reference
- All
- Selected
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Hazard
- Pole audit
- Vehicle Operation
- Weather
- Animals
- Parking on Council berm
- Telco ETP
- Outdoor pools in vicinity
- Time restrictions
- Boots
- Wet weather PPE
- Stress and fatigue
- Using stairs
- Errors in judgment leading accidents, injuries
- Cellphone usage
- Parking
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Initial Risk
- 1
- 2
- 3
- 4
- 5
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Control
- Drive responsibly
- Drive to the conditions
- PPE appropriate to the task
- Have owner tie up dogs, or terminate visit and place job on hold
- Slow down
- Increase following distances
- Where possible stop safely to the side of the road before answering calls or texts. Or use hands free kit
- Visual inspection, Hammer and probe test if applicable
- Use designated parking spaces
- Park with consideration, do jot obstruct other vehicles or pedestrians
- Use cones, signs, lights at night
- Seek assistance from owner or fellow employee
- Use correct lifting techniques
- Mechanical aid
- Take breaks
- Follow correct procedures and practices at all times
- Job start
- Hold on to rail
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Residual risk
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Job ref
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Hazard
- Pole audit
- Vehicle Operation
- Weather
- Animals
- Parking on Council berm
- Telco ETP
- Outdoor pools in vicinity
- Time restrictions
- Boots
- Wet weather PPE
- Stress and fatigue
- Using stairs
- Errors in judgment leading accidents, injuries
- Cellphone usage
- Parking
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Initial risk
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Control
- Drive responsibly
- Drive to the conditions
- PPE appropriate to the task
- Have owner tie up dogs, or terminate visit and place job on hold
- Slow down
- Increase following distances
- Where possible stop safely to the side of the road before answering calls or texts. Or use hands free kit
- Visual inspection, Hammer and probe test if applicable
- Use designated parking spaces
- Park with consideration, do jot obstruct other vehicles or pedestrians
- Use cones, signs, lights at night
- Seek assistance from owner or fellow employee
- Use correct lifting techniques
- Mechanical aid
- Take breaks
- Follow correct procedures and practices at all times
- Job start
- Hold on to rail
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Residual risk
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I have read and understood the Job Analysis/ Safe Work Method Statement and agree to perform the work according to the requirements of this Job Start Form and associated SDS, procedures, legislative requirements. Supervisor:
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