Title Page
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FIELD OBSERVATION CHECKLIST - Document No.
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EMPLOYEE NAME :
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OBSERVER/MANAGER:
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SITE WORK / LOCATION
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DATE
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ACTIVITIES PERFORMED DURING OBSERVATION:
FIELD OBSERVATION CHECKLIST:
PRE-WORK PLANNING:
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Arrival notification to HSN / customer sign-in, etc.
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Employee is aware of customer contacts and procedure for reporting hazards outside of HLA control, incidents, injuries etc.?
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Employee has completed pre-start risk assessment, Take5, Fast_Tool assessment etc.?
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Employee is familiar with customer emergency and/or safety procedures, including permitto work systems?
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No obvious slip, trip, fall hazards in the workplace?
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Chemical, radiological, biological, communicable diseases and similar hazards avoided, minimised or controlled?
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Additional comments :
PERSONAL PROTECTIVE EQUIPMENT (PPE)
PPE available, adequate and used for task performed?
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Foot protection - safety toed, slip resistant etc.?
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Eye and face protection - safety glasses, goggles, face shield, welding helmet?
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Head protection - hard hat, bump cap etc.?
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Hand protection - leather gloves, electrical insulating gloves, chemical resistant gloves, cut resistant etc?
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Respiratory protection - half face/cartridge mask, dust mask, full face etc.?
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Body protection - welding, electrical work, cut resistance clothing, cold suit, etc.?
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Hearing protection - ear plugs, muffs etc.?
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Fall protection - harness, lanyard, anchoring equipment etc.
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Additional comments :
GENERAL OBSERVATIONS :
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Housekeeping - work area well maintained in a neat and orderly condition. Emergency egress paths are kept clear?
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Tools properly selected for the job, in good condition and guarded where necessary. Power tools tested and tagged.
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Extension cords in good condition and not causing trip hazards?
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Correct lift and carry techniques demonstrated. Employee avoids awkward postures wherever practicable?
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Ladders in good condition, Platform ladders selected before A-Frame step ladders. Fibre glass construction and correct type for the load and work performed? Safe work practices in used for ladder set-up/deployment and security?
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Employee has Safety Data Sheets (SDS) for chemicals used. Chemicals handled, stored, used and disposed of properly. Chemical containers clearly labelled?
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Does the work in progress comply with procedures as outlined in SWMS/JSEA?
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Additional comments:
SPECIAL RISKS AND CONSTRUCTION:
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Work at heights - safe access to work area established, pre-use inspection of plant and equipment, completed (pre-use inspection of boom lifts, harness systems etc.). Safe work practices used, including; getting tools and equipment to and from the elevated work area. Emergency plans in place for hoist and scissor lift use, rescue of injured person etc.?
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Penetrations in floors/walls are covered / barricaded, perimeter protection in place, void protection scaffold planks within span limit and secured. Materials stored clear of leading edges?
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Scaffolding handover certificate available, guardrails in place (top, mid and toe-board), planking in good condition, persons below protected from falling objects. Area secured out of hours?
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Mobile plant / equipment - workers are licensed to operate high risk plant.
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Survey of electrical hazards conducted prior to starting work, safe electrical work practices used. Employee is qualified to conduct electrical work?
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Lockout, tag out devices available and used for exposures to hazardous sources of energy or unguarded / moving or rotating parts. Supervisor verifies that worker has deenergised equipment under service?
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Line breaking activities are managed in accordance with company policy, included permits, system isolations, valve and system lockout/tagouts in place, pressures equalized and vented before opening, signage, etc.?
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Confined space entry - appropriate ventilation, permits, testing used. Workers trained?
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Hot work (welding, cutting, brazing) - safe practices in place, permits used, fire extinguisher readily available, equipment in good condition,specialised welding/cutting PPE available and used?
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Work near trenches/excavations - protected, safe work procedures followed, public and other workers protected.
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Lifting/hoisting equipment, chains, slings in good condition and inspected prior to use, load rating (SWL) known and appropriate for the works. Safe work practices followed.
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Work near cranes - persons kept from under suspended loads and crane swing/work area, crane operator/rigger/dogman certified/licensed.
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Ceiling spaces - pre-work hazard review performed, building asbestos register reviewed, adequate illumination in place, safe work practices for access followed.
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Additional comments:
ENVIRONMENTAL
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Adequate environmental controls used to prevent pollution of ground water, soils, or the air by uncontrolled release of hazardous substances.
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Refrigerant handling equipment is in good condition and not allowing refrigerant to leak to atmosphere, e.g. gauge manifolds m gas cylinders, reclaim units etc.
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Waste oils are contained in appropriate containers for recycling.
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Cardboard and paper packaging are recycled.
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Fluorescent tubes, batteries and other hazardous wastes generated by the works are recycled appropriately.
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Additional comments:
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Observer and employee signatures:
