CCV Working at Heights

• Work Order Number

• Job Description

• Location

• Conducted on

  Date

• Conducted by

• CMW's involved in the working at heights task

Fit for Purpose Equipment - PPE All Working at Heights Equipment will comply with Australian Standards

• All CMW's performing working at heights PPE inspections have been trained to the required competency - RIIWHS204D Working at Heights<br>Confirm LMS records to verify all participants are certified

  Yes

  No

  N/A

• Validate the PPE is made to an Australian Standard (stamped). Relevant standard AS1891 Industrial Fall Arrest Systems & Devices <br>

  Yes

  No

  N/A
Gather evidence

• Check JSEA's and W@H Permit controls are in place and relevant to maintain risk at an acceptable level.

  Safe

  At Risk

  N/A

• Take a photo of evidence

  Media

• Add comments:

• Check LMS records for current authorisations

  Yes

  No

  N/A

• Take a photo of evidence

  Media

• Add comments:

• Inspect W@H equipment has Australian Standard marking (BMC & Contractors)

  Yes

  No

  N/A

• Take a photo of evidence (Aust Standard Tag)

  Media

• Add comments:

• Inspect W@H equipment has current in date test identifier (Coloured cable tie ) <br>Check current colour with tool store.

  Yes

  No

  N/A

• Take a photo of evidence

  Media

• Add comments:

• Confirm pre-inspection was completed and understood. <br>Response should include stitch integrity; ingress of dirt; damaged hook; operation of safety latch

  Safe

  At Risk

  N/A

• Add comments:

Working at Heights - Equipment (e.g. Sissor lifts, EWP, lift boxes) are inspected as fit for purpose and display a safe working load limit

• Verify equipment inspections have been completed <br>

  Yes

  No

  N/A

• Take a photo of evidence - Prestart book competed

  Media

• Add comments:

• If a lift box is in use, verify a lift plan has been completed.

  Yes

  No

  N/A

• Take a photo of evidence

  Media

• Add comments:

• Verify equipment has a safe load limit displayed <br>Includes - EWP, sissor lift, lift box, mobile work platforms.

  Yes

  No

  N/A

• Take a photo of evidence

  Media

• Add comments:

Exclusion zones identified and demarcated taking into account the potential of working at heights plant and equipment from being struck by other plant or equipment used on site

• Confirm scaffold build plan (if required) or JSEA demonstrates equipment interactions have been high lighted and exclusion zones have been identified as controls.

  Yes

  No

  N/A

• Take a photo of evidence (scaff. Tag)

  Media

• Add comments:

• Verify identified exclusion zones have been implemented and are effective to maintain risk at an acceptable level.

  Yes

  No

  N/A

• Take a photo of evidence - exclusion zone

  Media

• Add comments:

• Verify identified exclusion zones have been implemented and are effective in line with BMC barricading standard (tape/signage/lighting etc.)

  Yes

  No

  N/A

• Take a photo of evidence

  Media

• Add comments:

• Type in name and sign.

  Sign

• Email audit and attach to Notification of Work Order