CWW Field Works Job Safety Analysis

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Lone Worker

• Office notified and aware of return time

  Yes

  No

  N/A

• Mobile phone available

  Yes

  No

  N/A

• Other

Personal Protective Equipment

• Hearing protection used

  Yes

  No

  N/A

• Safety boots used

  Yes

  No

  N/A

• Safety eye wear used

  Yes

  No

  N/A

• Hard hats worn

  Yes

  No

  N/A

• Safety vest worn and zipped up

  Yes

  No

  N/A

• Gloves used

  Yes

  No

  N/A

• Other

Manual Handling

• Team lifting undertaken where applicable

  Yes

  No

  N/A

• Lifting equipment used

  Yes

  No

  N/A

• Manual Handling Training completed

  Yes

  No

  N/A

• Lightweight equipment used

  Yes

  No

  N/A

• Other

Dangerous Goods/Hazardous Substances

• MSDS available and understood

  Yes

  No

  N/A

• SWMS relating to use prepared and understood

  Yes

  No

  N/A

• Safety eye wear worn

  Yes

  No

  N/A

• Half mask respirator worn

  Yes

  No

  N/A

• Gloves worn

  Yes

  No

  N/A

• Other

Environmental/Weather

• Sunhat worn

  Yes

  No

  N/A

• Sunscreen

  Yes

  No

  N/A

• Sunglasses worn

  Yes

  No

  N/A

• Shelter from weather

  Yes

  No

  N/A

• Wet weather gear

  Yes

  No

  N/A

• Gumboots worn

  Yes

  No

  N/A

• Long sleeves worn

  Yes

  No

  N/A

• Other

Snakes/Spiders/Insects

• Awareness of snakes/spiders/insects (refer to IRD-16, Guidelines for outdoor safety)

  Yes

  No

  N/A

• Gloves worn

  Yes

  No

  N/A

• Spider/insect repellent

  Yes

  No

  N/A

• Other

Traffic

• Vehicle hazard lights

  Yes

  No

  N/A

• Witches hats

  Yes

  No

  N/A

• Safety vest worn

  Yes

  No

  N/A

• Parked in designated location/parking spot

  Yes

  No

  N/A

• Other

Public

• Pedestrian warning signs

  Yes

  No

  N/A

• Site taped off

  Yes

  No

  N/A

• Other

Slips, Trips and Falls

• Access to area via safest route, avoiding wet, muddy areas taken

  Yes

  No

  N/A

• Area kept clean and tidy

  Yes

  No

  N/A

• Other

Confined Space Associated

• Permit

  Yes

  No

  N/A

• Permit number

• Gas detector calibration expiry date

• Call in process to OCC

  Yes

  No

  N/A

• Other

Plant & Equipment

• Awareness of plant in vicinity

  Yes

  No

  N/A

• Tools & Equipment checked

  Yes

  No

  N/A

• Hard hats worn in vicinity of plant

  Yes

  No

  N/A

• Other

Other Works in Vicinity

• Awareness of other works in vicinity which may have an impact

  Yes

  No

  N/A

• Contact made with others to ensure they are aware of you

  Yes

  No

  N/A

• Other

Electrical Cabinets

• Understanding of what can and cannot be handled within

  Yes

  No

  N/A

• Call in process to OCC advising that access is required

  Yes

  No

  N/A

• Other

Fall from Heights

• Barricades in position

  Yes

  No

  N/A

• Fall arrest harness used

  Yes

  No

  N/A

• Lad Safe system used

  Yes

  No

  N/A

• Lad Safe/harness system certified/current

  Yes

  No

  N/A

• Second person required

  Yes

  No

  N/A

• Gas detector used - opening wet well/MH

  Yes

  No

  N/A

• Fall protection device located in manhole

  Yes

  No

  N/A

• Other

Sign off

• Are there other hazards?

  Yes

  No

  N/A

• If yes, what are they?

• Is the job safe to proceed (if no, notify supervisor immediately)

  Yes

  No

  N/A

• Are all risks and controls communicated to attending personnel?

  Yes

  No

  N/A

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• Notes