Farm quad bike assessment

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

DETAILS:

• FARM VISIT:

  Announced

  Unannounced

• IDENTIFICATION

  Warrant shown

  Business card given

  Warrant shown & Business card given

• DETECTED FAILURE:

  YES

  NO

• TYPE OF FARM OPERATION:

  Select Dairy farm Sheep farm Sheep and Beef Dry stock Deer farm lifestyle block orchard other

  • Dairy farm
  • Sheep farm
  • Sheep and Beef
  • Dry stock
  • Deer farm
  • lifestyle block
  • orchard
  • other

• FONTERRA NUMBER:

• DETAILS of person spoken to: NAME, DOB, ADDRESS

• DUTY HOLDER DETAILS

GENERAL:

• Quads - Type, Size, Age, How many?

  Yes

  No

  N/A

• Who owns them?

  Yes

  No

  N/A

• Manufacturers instructions - Where?

  Yes

  No

  N/A

• Description of farm terrain

  Select FLAT LAND GENTLE ROLLING ROLLING STEEP ROLLING STEEP RUGGED EXTREME

  • FLAT LAND
  • GENTLE ROLLING
  • ROLLING
  • STEEP ROLLING
  • STEEP
  • RUGGED
  • EXTREME

• Safe areas within the property been identified

  Yes

  No

  N/A

• How is the correct vehicle selected for the tasks?

  Yes

  No

  N/A

• Other farm vehicles available

  Yes

  No

  N/A

• Regular vehicle maintainence

  Yes

  No

  N/A

HELMETS:

• Awareness of requirement for helmets to be available and worn.

  Yes

  No

  N/A

• Evidence that quad bike users wear helmet<br>

  Yes

  No

  N/A

• What type of helmets? - are they compliant?

  Yes

  No

  N/A

• Ratio of helmets to quad bikes and riders

  Select No helmets available No helmets provided 1:1 Each rider issued own helmet shared helmets helmet stays with bike less helmets than bikes

  • No helmets available
  • No helmets provided
  • 1:1
  • Each rider issued own helmet
  • shared helmets
  • helmet stays with bike
  • less helmets than bikes

• Method for maintaining helmets and handling different sizes

  Yes

  No

  N/A

AGE

• Awareness of the age restrictions on operating a quad bike over 90cc

  Yes

  No

  N/A

• How many under 16s working on the farm

  Select N/A 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21+

  • N/A
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • 21+

• Where under 16 workers ride quad bikes, how is the hazard controlled?

  Yes

  No

  N/A

TOWING OF IMPLEMENTS:

• What is towed - consistency with vehicle limits?

  Yes

  No

  N/A

LOADING OF QUAD BIKE:

• What loads are carried - consistency with vehicle limits?

  Yes

  No

  N/A

PASSENGERS:

• Are passengers carried?

  Select Yes No Sometimes Refused to answer Observed carrying passenger Admitted to carrying passengers

  • Yes
  • No
  • Sometimes
  • Refused to answer
  • Observed carrying passenger
  • Admitted to carrying passengers

• What controls are in place?

  Yes

  No

  N/A

RIDER COMPETENCY:

• Awareness of obligation re training

  Yes

  No

  N/A

• What formal training provided (and to who)

  Yes

  No

  N/A

• Methods for on-farm rider assessment

  Yes

  No

  N/A

• How is rider behavior monitored?

  Yes

  No

  N/A

OTHER ISSUES (Discussed or found on visit)

• Observed mechanical deficiencies, lack of safeguards for staff working remotely, etc

  Yes

  No

  N/A

• Good stories?

  Yes

  No

  N/A

INFORMATION GIVEN TO PERSON:

• INFORMATION GIVEN TO PERSON:

  Fact sheet

  Guidelines

  other

COMPLIANCE ACTION TAKEN:

• COMPLIANCE ACTION TAKEN:

  Improvement notice

  Written Warning

  Negotiated Agreement

  Prohibition Notice

  Infringement notice