Title Page
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GRM Area Inspection Form
General Details
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Person conducting inspection
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Department
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Area being inspected
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Date and time of inspection
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Work Order number
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Please consider all areas of on-site activities at a place where such activities are carried on, continuously or from time to time, on land adjoining, adjacent to, or contiguous with, the boundaries of land the subject of mining tenures of the mine.
Active Area Inspection Details
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Location
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Findings
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Actions
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Sub-notification or hazard raised?
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Take photo
Active Area Inspection Details
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Location
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Findings
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Actions
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Sub-notification or hazard raised?
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Take photo
Active Area Inspection Details
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Location
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Findings
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Actions
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Sub-notification or hazard raised?
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Take photo
Active Area Inspection Details
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Location
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Findings
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Actions
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Sub-notification or hazard raised?
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Take photo
Idle Area Inspection Details
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Location
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Findings
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Actions
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Sub-notification or hazard raised?
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Take photo
Idle Area Inspection Details
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Location
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Findings
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Actions
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Sub-notification or hazard raised?
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Take photo
Idle Area Inspection Details
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Location
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Findings
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Actions
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Sub-notification or hazard raised?
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Take photo
Risk Assessments and Permits
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For working being completed in the area, was a risk assessment conducted for the task observed?
- Informal (BMA Safe)
- Formal (JSA)
- None
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For the work being completed in the area, was the appropriate permit observed?
- Working at Heights Permit
- Hazardous Work Permit
- Confined Space Permit
- Hot Work Permit
- Permit to Penetrate / Dig
- Permit to Disturb
- High Voltage Access Permit
- Permit to Travel under Powerlines at Non-Designated Areas
- None
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Take photo of any risk assessments / permits
Checklist
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Please consider the prompt list below as a guide when conducting the Area Inspection
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1. General
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1.1 Edge protection / bunding
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1.2 Seatbelt use verified in vehicles and mobile equipment
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1.3 Hazards - clearly marked, appropriately managed
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1.4 Overhead power lines identified
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1.5 Personal protective equipment - adequate for task
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1.6 Pre-start inspections - completed and defects rectified
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1.7 Positive communication
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1.8 Roads - condition, intersections, LV/HV separation, watering practices
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1.9 Risk assessment - suitable quality, appropriate for task
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1.10 Ground condition
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1.11 Signage - appropriate, in place, visible
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1.12 Vehicle parking
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1.13 Visibility - lighting, dust, obstructions
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1.14 Waste management - correct bins, accumulated waste, spill kits
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Additional comments
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Take photo
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Offices, Workshops and Facilities
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2.1 Amenities - equipped, clean, tidy
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2.2 Emergency evacuation plan - displayed and current
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2.3 Fire extinguishers / blankets - in place, test/tag, serviceable
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2.4 First aid kit - accessible, stocked
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2.5 Housekeeping - clean, tidy, storage, slip/trip hazards
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2.6 Lighting - in place, adequate for task
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2.7 Office equipment - fit for purpose, electrical test/tag, serviceable
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2.8 Manual handling / ergonomics / workstation set-up
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2.9 Noticeboards - tidy, up to date information displayed
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2.10 Walkways / Access route - slip/trip hazards
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Additional comments
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Take photo
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3. Maintenance Activities
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3.1 Access - clearly marked, safe
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3.2 Cranes / hoists / winches - safe condition
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3.3 Defective equipment - tagged, quarantined
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3.4 Dust, fumes, gas vapours
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3.5 Equipment - fit for purpose, test/tag, no prohibited items
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3.6 Fencing and barricades - in place, suitable
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3.7 Hand tools - serviceable
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3.8 HazChem - storage, SDS, PPE
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3.9 Ladders - safe condition
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3.10 Scaffolds - inspected, suitable condition
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3.11 Stairways - clear, adequate
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3.12 Welding practices - safe, PPE, barricading
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3.13 Work platforms - safe, secure
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Additional comments
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Take photo
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4. Other
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Additional comments
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Take photo
Sign off page
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Select date
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Add signature