Title Page
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Site conducted
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Conducted on
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Prepared by
- Adam Pinn
- Josh Perry
- Paul Wilkinson
- Greg Burgess
- Dave Wilkinson
- Stephen White
- Kynan O'Brien
- Luke Howard
- Rob McMaster
- Gary Eisenhauer
- Kim Broughton
- Neil Ebbels
- Mitch Ramsay
- Mick Molloy
- Steven Mendoza
- Jordan Johnstone
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Use this record to fill in the cleaning tasks that have been completed for this job. Complete this inspection once all cleaning tasks have been completed, take notes and media of any areas that require attention or pose safety hazards. Follow all relevant JSEA'S and Work instructions when completing tasks and wear the required PPE.
Pre-Start Checklist
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A mandown alarm must be used at all times while you are blowing down the bulkhead catwalks. This alarm is located in the control room near the soft intake desk.
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Lock out tag out procedure understood and implemented correctly by all involved?
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If answer is no, explain why.
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Relevant work instruction and JSEA understood and will be followed by all involved?
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If answer is no, explain why.
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All workers completing the task are using correct PPE?
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If answer is no, explain why.
Bulkhead 1 & Grain intake 1
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Bulkhead 1 catwalk has been blown down? (Complete this as required on the cleaning schedule)
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If answer is no, explain why.
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Date Completed?
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Grain intake 1 has been cleaned (Complete this as required on the cleaning schedule)
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If answer is no, explain why.
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Date Completed?
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The surrounding area of bulkhead 1 has been cleaned (Complete this monthly)
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If answer is no, explain why.
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Date Completed?
Bulkhead 2 & Grain intake 2
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The catwalk has been blown down for bulkhead 2 (Complete this as required on the cleaning schedule)
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If answer is no, explain why.
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Date Completed?
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Grain intake 2 has been cleaned (Complete this as required on the cleaning schedule)
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If answer is no, explain why.
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Date Completed?
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The surrounding area of bulkhead 2 has been cleaned (Complete this monthly)
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If answer is no, explain why.
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Date Completed?
Bulkhead 3 & Grain Intake 3
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The catwalk has been blown down for bulkhead 3 (Complete this monthly)
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If answer is no, explain why.
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Date Completed?
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Grain intake 3 has been cleaned (Complete this as required on the cleaning schedule)
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If answer is no, explain why.
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Date Completed?
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The surrounding area of bulkhead 3 has been cleaned (Complete this monthly)
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If answer is no, explain why.
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Date Completed?
Name & Signature
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Type your name and sign
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Type your name and sign
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Type your name and sign
