Fieldfix S.O. Daily Report (Build) v 2.3

• Document No.

• Audit Title

• Tap to enter information

  Select Wodonga Launceston Hobart Ballarat Bendigo Melbourne

  • Wodonga
  • Launceston
  • Hobart
  • Ballarat
  • Bendigo
  • Melbourne

• Conducted on

  Date

• Conducted by

  Select Mark Ludbrook Anthony Aloe Craig Newcombe Patrick Cooper Tania Wilson Non ACES Contractor

  • Mark Ludbrook
  • Anthony Aloe
  • Craig Newcombe
  • Patrick Cooper
  • Tania Wilson
  • Non ACES Contractor
• Location
  Address

Hazard Identification.

Hazard

• Approx time of observation.

  Date

• Area description.

  Select Delivery area Outside of loading bay Inside of loading bay Main Hall Entrance Area Toilets Production Office FOH Office

  • Delivery area
  • Outside of loading bay
  • Inside of loading bay
  • Main Hall
  • Entrance Area
  • Toilets
  • Production Office
  • FOH Office

• Location.

• Has the location been secured?

  Yes

  No

  N/A

• What is the Hazard?

  Select Untidy Work space Obsticles in pathway Vehicular collision Falling Objects Electrical Cables Ladders Unauthorised Access Falling from height. u Unauthorised Entry Mechanical Failure Unstable platform Sawdust Toxic Substances Toxic Substances Hot Works Hot Works Public EWP Congestion Other

  • Untidy Work space
  • Obsticles in pathway
  • Vehicular collision
  • Falling Objects
  • Electrical Cables
  • Ladders
  • Unauthorised Access
  • Falling from height.
  • u Unauthorised Entry
  • Mechanical Failure
  • Unstable platform
  • Sawdust
  • Toxic Substances Toxic Substances
  • Hot Works Hot Works
  • Public
  • EWP
  • Congestion
  • Other

• What is the risk?

  Select Trip causing injury Cuts/Abrasions Falling from heights Electricoution Risk of Serious Injury Risk of Death

  • Trip causing injury
  • Cuts/Abrasions
  • Falling from heights
  • Electricoution
  • Risk of Serious Injury
  • Risk of Death

• Suggested solution.

  Follow up not required

  Follow up required.

• Notify Imagination Management when suitable to do so.

• Person(s) informed.

• Is issue resolved?

  Hazard Removed

  Hazard Remains

• Extra drawings or notes.

  Drawing

• Extra Photo's

  Media

• Notes.

Incidents.

• Check box if there has been an incident to report today.

• Enter details.

Incident

• General Area of incident

  Select Delivery area Outside of loading bay Inside of loading bay Main Hall Entrance Area Toilets Production Office FOH Office

  • Delivery area
  • Outside of loading bay
  • Inside of loading bay
  • Main Hall
  • Entrance Area
  • Toilets
  • Production Office
  • FOH Office

• Location.

• Type of Incident?

  Select Cuts/bruising/abrasions Strain Injury Broken Limbs Electricoution Poisioning Death Property Damage Public Risk Fire Terrorist threat/attack Structural Failure Other

  • Cuts/bruising/abrasions
  • Strain Injury
  • Broken Limbs
  • Electricoution
  • Poisioning
  • Death
  • Property Damage
  • Public Risk
  • Fire
  • Terrorist threat/attack
  • Structural Failure
  • Other

• Names of those involved.

• Who has been notified?

• Is further action required?

  No

  Yes

Observations.

• Note down any general observations from todays work.

• With 1 being low and 10 being high, how is the morale of the crew

• With 1 being low and 10 being high, how fatigued are the crew members.

• If concerned, name of crew member(s)<br>

  Not Concerned

  Concerned

Sign Off.

• Signature of Safety Officer

  Sign