Information
-
Audit Title
-
Document No.
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
-
TASK :
-
SUPERVISOR:
-
INITIALS:
STEP 1: INITIAL ASSESSMENT
-
Is mobile plant required to undertake the task?
-
Does the task involve the use of hazardous substances?
-
Is the task part of a 'permit to work' activity?
-
Is the task part of a 'permit to work' activity?
-
When undertaking the task could there be potential exposure to energy sources (e.g. heat, power, air, hydraulics etc)?
-
Does the task involve excavation or trenching?
-
Will the task be conducted at height?
-
Will the task interact with other plant/equipment, public or traffic?
-
Will you be working near/in waterways, protected vegetation, sensitive residences or heritage sites?
-
If you answer "YES" to any of the questions above, you need to see your Supervisor to ensure a JHA is developed prior to commencing.
-
If "NO", proceed to Step 2 - Hazard/Issue Check
STEP 2: HAZARD/ISSUE CHECK
-
I have completed Step 1 to determine if a JHA is needed and if so, I have signed onto it.
-
I have being brief on the task by site supervisor or attended a Pre-start.
-
Appropriate Permits and Approvals are in place and I understand their conditions.
-
I am trained and competent to undertake this task.
-
The work area is clean, tidy, has adequate lighting, waste bins and spill kits for the task.
-
There is safe access and egress to work at height are in place.
-
Appropriate controls to work at height are in place.
-
I know what assistance I may need to lift materials.
-
The weather conditions will not impact on the environment or quality of works of my task.
-
Equipment for the task is tested/tagged & safe for use.
-
The controls in place are appropriate to protect others around me, the environment, and the work itself.
-
I feel that it is safe to conduct this task.
-
If the answer is 'NO' to any of the above questions, then fixed the hazard and/or inform your Supervisor immediately.
-
If you have answered 'YES' to all of the questions, then proceed to Step 3 - Final Assessment.
STEP 3: FINAL ASSESSMENT (Controlling My Hazard/Issues)
-
Hazard/Issues (What else can go wrong?).
-
Controls (What can I do to stop this from happening?)
-
Hazard/Issues (What else can go wrong?)
-
Controls (What can I do to stop this from happening?)
-
Hazard/Issues (What else can go wrong?)
-
Controls (What can I do to stop this from happening?)
-
Hazard/Issues (What else can go wrong?)
-
Controls (What can I do to stop this from happening?)
-
Hazard/Issues (What else can go wrong?)
-
Controls (What can I do to stop this from happening?)
