Information
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Document No.
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Bushland Reserve Name
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Bushland Contractor
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Team Leader
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Number of Crew
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Conducted on
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Prepared by
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Others Present
1. OHS
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1.1 Has a site specific JSA been written?
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Photo of JSA
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1.2 Does it have detailed emergency location information (not just mel ref)?
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1.3 Is it displayed in a location (e.g. dashboard) where all crew can see emergency location details?
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1.4 Are all tasks being undertaken listed on the JSA?
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1.5 Are the specified risk control measures for each task acceptable?
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1.6 Are the specified risk control measures being applied by the crew?
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1.7 Does the JSA address pathogen and weed propagule management?
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1.8 Are works occurring near pedestrian paths or roadsides?
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1.9a Are appropriate risk control measures outlined in the JSA?
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1.9b Are these being applied on ground?
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1.9 Have the crew been inducted into the site?
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1.10 Enter further comments or actions on section 1 here
2. WORKS PROGRESS
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2.1 What is the activity ID code (refer to the worksplan) for the works being undertaken?
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2.2 Are the works undertaken at a hectare or hourly rate?
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2.3 Has the team leader been given adequate written instructions regarding the days works?
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2.4 Do the instructions reflect the activity as outlined in the worksplan?
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2.5 Are the works being carried out as per the instructions?
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2.6 Are the works occurring in the correct location?
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2.7 Do the works observe appropriate protection of rare and threatened species?
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2.8 Do the works observe appropriate protection of fauna habitat?
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2.9 Further comments or actions on section 2
3. CHEMICAL USE
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3.1 Are chemicals in use?
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Chemical use record
Chemical
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Chemical name
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Application method
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Rate
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Is this rate as per the label?
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Target species
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Is there a current (< 5 yrs old) label and MSDS available for this chemical on site?
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Comments on chemical use
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Is spraying being carried out?
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Is appropriate signage in place to warn the public (as per the contract)?
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Are fruiting Blackberries being sprayed?
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Does the crew have signs to put in place to warn the public (as per contract)?
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3.2 Further comments or actions on section 3
4. GENERAL
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4.1 Do vehicles display Shire magnets?
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4.2 Has there been any public interest or contact?
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4.3 Further comments or actions on section 4