FIxed Plant

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Risk Assessment Completed

  YES

  NO

• TAKE 5

• Do I Fully Understand This Task?

  Yes

  No

  N/A

• Controls

• Am I Fit To Carry Out The Task?

  Yes

  No

  N/A

• Controls

• Do I Have The Correct Tools for the Task?

  Yes

  No

  N/A

• Controls

• Is there a procedure or JSEA for the Task and have you read and Understood it?

  Yes

  No

  N/A

• Controls

• Am I trained and competent to carry out the task?

  Yes

  No

  N/A

• Controls

• Do I have the correct PPE for the Task?

  Yes

  No

  N/A

• Controls

• Is my work area safe?

  Yes

  No

  N/A

• Controls

• Can I get caught in or between anything?

  YES

  NO

• Controls

• Can My work affect anybody else's safety eg Interaction ?

  YES

  NO

• Controls

• Have I identified and Isolated any dangerous energy sources?

  Yes

  No

  N/A

• Controls

• Is there exposure to excessive Heat/Dust/Noise/Vibration?

  YES

  NO

• Controls

• Can anything fall on me?

  YES

  NO

• Controls

• Is a Permit required?

  YES

  NO

• Controls

• Can my actions harm the environment?

  YES

  NO

• Controls

• Other

  Yes

  No

  N/A

• Controls

• List

• Are All Hazards Assessed and Controls in place

  YES

  NO

• DO NOT PROCEED CONTACT YOUR SUPERVISOR

• Sign

Person

• Add signature

  Sign

Day 1

• Completing Day 1 Checklist

  Off

  On

• All Bolts throughout structure Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Structure checked for Cracks/Breaks/Weakness

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• wear Packages Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Rollers and Trough Sets Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Belt Condition Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Walkways and Mesh Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Screen Mesh Condition including Holder Plates Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Head Drum Lagging Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Head and Tail Drum Bearing Condition Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Belt Alignment Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Audit Complete

  YES

  NO

• Check Partially Completed By

  Sign

• To be Completed by

  Date

• Check Completed By

  Sign

• Workshop Supervisor

  Sign

• SSE/Delegate

  Sign

Day 2

• Completing Day 2 Checklist

  Off

  On

• All Bolts throughout structure Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Structure checked for Cracks/Breaks/Weakness

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• wear Packages Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Rollers and Trough Sets Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Belt Condition Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Walkways and Mesh Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Screen Mesh Condition including Holder Plates Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Head Drum Lagging Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Head and Tail Drum Bearing Condition Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Belt Alignment Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Audit Complete

  YES

  NO

• Check Partially Completed By

  Sign

• To be Completed by

  Date

• Check Completed By

  Sign

• Workshop Supervisor

  Sign

• SSE/Delegate

  Sign

Day 3

• Completing Day 3 Checklist

  Off

  On

• All Bolts throughout structure Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Structure checked for Cracks/Breaks/Weakness

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• wear Packages Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Rollers and Trough Sets Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Belt Condition Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Walkways and Mesh Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Screen Mesh Condition including Holder Plates Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Head Drum Lagging Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Head and Tail Drum Bearing Condition Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Belt Alignment Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Audit Complete

  YES

  NO

• Check Partially Completed By

  Sign

• To be Completed by

  Date

• Check Completed By

  Sign

• Workshop Supervisor

  Sign

• SSE/Delegate

  Sign

Day 4

• Completing Day 4 Checklist

  Off

  On

• All Bolts throughout structure Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Structure checked for Cracks/Breaks/Weakness

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• wear Packages Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Rollers and Trough Sets Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Belt Condition Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Walkways and Mesh Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Screen Mesh Condition including Holder Plates Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Head Drum Lagging Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Head and Tail Drum Bearing Condition Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Belt Alignment Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Audit Complete

  YES

  NO

• Check Partially Completed By

  Sign

• To be Completed by

  Date

• Check Completed By

  Sign

• Workshop Supervisor

  Sign

• SSE/Delegate

  Sign

Day 5

• Completing Day 5 Checklist

  Off

  On

• All Bolts throughout structure Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Structure checked for Cracks/Breaks/Weakness

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• wear Packages Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Rollers and Trough Sets Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Belt Condition Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Walkways and Mesh Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Screen Mesh Condition including Holder Plates Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Head Drum Lagging Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Head and Tail Drum Bearing Condition Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Belt Alignment Checked

  Yes

  No

  N/A

• Any Issues Found

  YES

  NO

• Photographs

  Media

• Issue Found

• Immediate Corrective Actions Required

  YES

  NO

• Immediate Corrective Actions

• Person Responsible

  Sign

• Audit Complete

  YES

  NO

• Check Partially Completed By

  Sign

• To be Completed by

  Date

• Check Completed By

  Sign

• Workshop Supervisor

  Sign

• SSE/Delegate

  Sign