Title Page
-
Site name
-
Conducted on
-
Prepared by
-
Location
-
FWM Name and Company
Work Undertaken
-
Brashing
-
Hours worked
-
Standard felling up to 380mm
-
Hours worked
-
Large tree felling (over 380mm)
-
Hours worked
-
Single windblow
-
Hours worked
-
Multiple windblow
-
Hours worked
-
Hardwood windblow
-
Hours worked
-
Steep ground felling
-
Hours worked
-
Large crown hardwood felling and breakdown
-
Hours worked
-
Winch assisted felling
-
Hours worked
-
Felling to harvester
-
Hours worked
-
Examples of work undertaken
-
Description of work
-
Has there been any unsafe acts, near misses or accidents?
-
Name of person reporting the near miss
-
Date of reporting
-
Date of the event
-
Location
-
Who did it involve?
-
Who else was there?
-
Describe what happened
-
What caused this to happen?
- Third party access
- Environmental
- Equipment
- Human error
-
What caused this to happen?
-
What can be done to stop this happening again?
-
What is the target date for this to happen?
-
Signature
-
Report this near miss to the FWM and Contractor
Pre use checks
-
Equipment used
- Chainsaw
- Hammer, wedges, breaking bar
- Felling jack/hydraulic wedge
- Tractor winch
- Digger winch
- Ladders
- Other (record in notes)
-
Has a chainsaw pre use been carried out?
-
Make and model
-
Is the chain catcher front and rear in place?
-
Is the chain break fully functional?
-
Is the bar, chain and body work in good condition?
-
Is the safety information sticker in place?
-
Are anti vibration dampers fully functioning?
-
Starter cord and return spring fully functional?
-
Throttle- lock, control and stop switch fully functional?
-
Detail of any repairs or maintenance undertaken?
-
Helmet condition
-
Ensure helmet receives detailed inspection every 6 months
-
Ensure helmet receives detailed inspection every 6 months
-
Is the defect safety critical?
-
Remove from use
-
Chainsaw boots condition
-
Is the defect safety critical?
-
Remove from use
-
Chainsaw trousers condition
-
Is the defect safety critical?
-
Remove from use
Sign off
-
Operator sign off
-
Site safety co ordinator sign off