Information
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Process:
* Observe behaviour
* Safety Stop Activity - introduce yourself and explain process
* Ask person to explain tasks and risks
* Commend positive behaviour
* Discuss at risk behaviour
* Get commitment to work safely
* Thank the person
* Action findings and provide feedback -
Outcome:
* Positive behaviours reinforced
* At risk behaviours discussed and addressed
* Record field leadership data on this form
* Raise actions in 1SAP if required
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New Take Time Talk - Observation
Field Leadership Record -
Date of TTT
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Time of TTT
- 0000-0300
- 0300-0600
- 0600-0900
- 0900-1200
- 1200-1500
- 1500-1800
- 1800-2100
- 2100-0000
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Site of TTT
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Site Specific Details
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Task / Activity Detail
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Area Visited
- Open Cut Mining Area
- Coal Processing Area
- Maintenance Workshop Area
- Rail Area
- Projects Location
- Exploration Location
- Support Services
- Shutdown
- Other
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Does this TTT relate to one of the BMA Material Risks?
- No
- Aviation Incident
- Bus Incident
- Catastrophic Infrastructure Failure
- Coal Seam Gas
- Confined Space Incident
- Diesel Particulate Matter Expsoure
- Explosives Detonation
- Fall from Height
- Fall of Ground (open cut)
- Inrush
- Lifting & Cranage
- Noise Exposure
- Overtopping
- Rotating & Moving Equipment
- Vehicle Accident
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How long did the TTT take?
- less than 10 minutes
- 10 - 19 minutes
- 20 - 29 minutes
- 30 - 39 minutes
- 40 - 49 minutes
- 50 - 59 minutes
- greater than 60 minutes
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Team Members
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Facilitator #1
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Facilitator #2
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Facilitator #3
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Facilitator #4
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Safe Behaviours Observed
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Were any Safe Behaviours observed?
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Comments
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Add media
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Safe Behaviours Observed
- Standards or Procedures
- Body Mechanics
- Tools & Equipment
- PPE
- People-Related Factors
- Housekeeping
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At Risk Behaviours Observed
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Were any At Risk Behaviours / Conditions observed?
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Category A - Reactions of people
- A1 Adjusting PPE
- A2 Rearranging job
- A3 Stopping job
- A4 Attaching to
- A5 Changing lockouts
- A6 Unfit for Work
- N/A
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Potential consequence
- Level 5 - Multiple fatality
- Level 4 - Single fatality
- Level 2 or 3 - Serious injury
- Level 1 - Minor injury
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Category B - Positions of people
- B1 Striking against
- B2 Struck by
- B3 Caught between
- B4 Temperature extremes
- B5 Inhaling
- B6 Absorbing
- B7 Swallowing
- B8 Posture, Lifting, Twisting
- B9 Over-extension
- B10 Falling
- N/A
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Potential consequence
- Level 5 - Multiple fatality
- Level 4 - Single fatality
- Level 2 or 3 - Serious injury
- Level 1 - Minor injury
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Category C - PPE
- C1 Eyes & Face
- C2 Ears
- C3 Head
- C4 Hands & Arms
- C5 Feet & Legs
- C6 Respiratory
- C7 Trunk
- C8 Other
- N/A
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Potential consequence
- Level 5 - Multiple fatality
- Level 4 - Single fatality
- Level 2 or 3 - Serious injury
- Level 1 - Minor injury
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Category D - Tools & Equipment
- D1 Not right for the job
- D2 Used incorrectly
- D3 Unsafe condition
- N/A
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Potential consequence
- Level 5 - Multiple fatality
- Level 4 - Single fatality
- Level 2 or 3 - Serious injury
- Level 1 - Minor injury
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Category E - Procedures
- E1 Procedures inadequate for the job
- E2 Procedure not known or understood
- E3 Procedure not followed
- N/A
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Potential consequence
- Level 5 - Multiple fatality
- Level 4 - Single fatality
- Level 2 or 3 - Serious injury
- Level 1 - Minor injury
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Category F - Work Area
- F1 Poor housekeeping
- F2 Inadequate storage
- F3 Unclean
- F4 Not barricaded
- N/A
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Potential consequence
- Level 5 - Multiple fatality
- Level 4 - Single fatality
- Level 2 or 3 - Serious injury
- Level 1 - Minor injury
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Was immediate action taken to manage the At Risk Behaviour?
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Has a work order been raised for any outstanding actions?
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Task Risk Assessment Completed?
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General Comments
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Add media
Sign off
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Signature of facilitators