GRM Area Inspection Form

• GRM Area Inspection Form

General Details

• Person conducting inspection

• Department

• Area being inspected
  Address

• Date and time of inspection

  Date

• Work Order number

• Please consider all areas of on-site activities at a place where such activities are carried on, continuously or from time to time, on land adjoining, adjacent to, or contiguous with, the boundaries of land the subject of mining tenures of the mine.

Active Area Inspection Details

• Location

• Findings

• Actions

• Sub-notification or hazard raised?

  Yes

  No

  N/A

• Take photo

  Media

Active Area Inspection Details

• Location

• Findings

• Actions

• Sub-notification or hazard raised?

  Yes

  No

  N/A

• Take photo

  Media

Active Area Inspection Details

• Location

• Findings

• Actions

• Sub-notification or hazard raised?

  Yes

  No

  N/A

• Take photo

  Media

Active Area Inspection Details

• Location

• Findings

• Actions

• Sub-notification or hazard raised?

  Yes

  No

  N/A

• Take photo

  Media

Idle Area Inspection Details

• Location

• Findings

• Actions

• Sub-notification or hazard raised?

  Yes

  No

  N/A

• Take photo

  Media

Idle Area Inspection Details

• Location

• Findings

• Actions

• Sub-notification or hazard raised?

  Yes

  No

  N/A

• Take photo

  Media

Idle Area Inspection Details

• Location

• Findings

• Actions

• Sub-notification or hazard raised?

  Yes

  No

  N/A

• Take photo

  Media

Risk Assessments and Permits

• For working being completed in the area, was a risk assessment conducted for the task observed?

  Select Informal (BMA Safe) Formal (JSA) None

  • Informal (BMA Safe)
  • Formal (JSA)
  • None

• For the work being completed in the area, was the appropriate permit observed?

  Select Working at Heights Permit Hazardous Work Permit Confined Space Permit Hot Work Permit Permit to Penetrate / Dig Permit to Disturb High Voltage Access Permit Permit to Travel under Powerlines at Non-Designated Areas None

  • Working at Heights Permit
  • Hazardous Work Permit
  • Confined Space Permit
  • Hot Work Permit
  • Permit to Penetrate / Dig
  • Permit to Disturb
  • High Voltage Access Permit
  • Permit to Travel under Powerlines at Non-Designated Areas
  • None

• Take photo of any risk assessments / permits

  Media

Checklist

• Please consider the prompt list below as a guide when conducting the Area Inspection

• 1. General

• 1.1 Edge protection / bunding

  Safe

  At Risk

  N/A

• 1.2 Seatbelt use verified in vehicles and mobile equipment

  Safe

  At Risk

  N/A

• 1.3 Hazards - clearly marked, appropriately managed

  Safe

  At Risk

  N/A

• 1.4 Overhead power lines identified

  Yes

  No

  N/A

• 1.5 Personal protective equipment - adequate for task

  Safe

  At Risk

  N/A

• 1.6 Pre-start inspections - completed and defects rectified

  Yes

  No

  N/A

• 1.7 Positive communication

  Safe

  At Risk

  N/A

• 1.8 Roads - condition, intersections, LV/HV separation, watering practices

  Safe

  At Risk

  N/A

• 1.9 Risk assessment - suitable quality, appropriate for task

  Yes

  No

  N/A

• 1.10 Ground condition

  Safe

  At Risk

  N/A

• 1.11 Signage - appropriate, in place, visible

  Safe

  At Risk

  N/A

• 1.12 Vehicle parking

  Safe

  At Risk

  N/A

• 1.13 Visibility - lighting, dust, obstructions

  Safe

  At Risk

  N/A

• 1.15 Tie-down - Temporary buildings, sea containers, other loose equipment/items (including trolleys) are tied down and secured in preparation for severe weather

  Safe

  At Risk

  N/A

• 1.14 Waste management - correct bins, accumulated waste, spill kits

  Safe

  At Risk

  N/A

• Additional comments

• Take photo

  Media

• Offices, Workshops and Facilities

• 2.1 Amenities - equipped, clean, tidy

  Safe

  At Risk

  N/A

• 2.2 Emergency evacuation plan - displayed and current

  Safe

  At Risk

  N/A

• 2.3 Fire extinguishers / blankets - in place, test/tag, serviceable

  Safe

  At Risk

  N/A

• 2.4 First aid kit - accessible, stocked

  Safe

  At Risk

  N/A

• 2.5 Housekeeping - clean, tidy, storage, slip/trip hazards

  Safe

  At Risk

  N/A

• 2.6 Lighting - in place, adequate for task

  Safe

  At Risk

  N/A

• 2.7 Office equipment - fit for purpose, electrical test/tag, serviceable

  Safe

  At Risk

  N/A

• 2.8 Manual handling / ergonomics / workstation set-up

  Safe

  At Risk

  N/A

• 2.9 Noticeboards - tidy, up to date information displayed

  Yes

  No

  N/A

• 2.10 Walkways / Access route - slip/trip hazards

  Safe

  At Risk

  N/A

• Additional comments

• Take photo

  Media

• 3. Maintenance Activities

• 3.1 Access - clearly marked, safe

  Safe

  At Risk

  N/A

• 3.2 Cranes / hoists / winches - safe condition

  Safe

  At Risk

  N/A

• 3.3 Defective equipment - tagged, quarantined

  Safe

  At Risk

  N/A

• 3.4 Dust, fumes, gas vapours

  Safe

  At Risk

  N/A

• 3.5 Equipment - fit for purpose, test/tag, no prohibited items

  Safe

  At Risk

  N/A

• 3.6 Fencing and barricades - in place, suitable

  Safe

  At Risk

  N/A

• 3.7 Hand tools - serviceable

  Safe

  At Risk

  N/A

• 3.8 HazChem - storage, SDS, PPE

  Safe

  At Risk

  N/A

• 3.9 Ladders - safe condition

  Safe

  At Risk

  N/A

• 3.10 Scaffolds - inspected, suitable condition

  Safe

  At Risk

  N/A

• 3.11 Stairways - clear, adequate

  Safe

  At Risk

  N/A

• 3.12 Welding practices - safe, PPE, barricading

  Safe

  At Risk

  N/A

• 3.13 Work platforms - safe, secure

  Safe

  At Risk

  N/A

• Additional comments

• Take photo

  Media

• 4. Other

• Additional comments

• Take photo

  Media

• Select date

  Date

• Add signature

  Sign