Information

  • Client / Site

  • Document No.

  • Project Number/Job

  • Conducted on

  • Prepared by

  • Location of First Aid Kit and Fire Extinguisher

  • Name of First Aider

  • Location
  • Site Emergency Assembly Area

  • Personnel

  • Are safe systems of work in place for the following:

  • Any work on Asbestos materials? If yes, enter your authority number

  • Enter ACM Authorisation Number:

  • Ground Breaking / Civils works? If so - lists SWMS that apply below.

  • SWMS - CON-HSE-SWMS-0112 - Site Establishment
    SWMS - CON-HSE-SWMS-0113 - Use of Tools and Equipment
    SWMS - CON-HSE-SWMS-0116 - Excavation and Trenching
    SWMS - CON-HSE-SWMS-0119 - Use of Plant and Equipment

  • Dial Before You Dig Obtained? Check GeoOp. If no, explain why.

  • Enter Number

  • Plant on site? Are all Plant Operators licenced and accredited? MUST have tickets ONSITE!

  • Operator Name

  • SWMS - CON-HSE-SWMS-0119 - Use of Plant and Equipment

  • All workers hold current: Construction Awareness Card (white/blue card), ISGM Induction, Asbestos awareness certificate, NBN Safety and Awareness Training?). Workers MUST have tickets ONSITE!

Site Conditions

  • Are safe systems of work in place for the following:

  • Ground surfaces - is there a risk of trips and falls?

  • Dangerous animals and plants. Are there potentially dangerous animals or plants?

  • Snake catchers Brisbane http://www.snakecatchers.com.au/

  • Electrical hazards. Are there electrical hazards or ignition sources?

  • Hazardous substances or dangerous goods. Use of hazardous substances or dangerous goods? If so - refer to MSDS for safe handling and what to do in the event of an emergency.

  • Biological hazards - eg syringes, contaminated water?

  • Use sharps kit for syringe removal. Call supervisor for contaminated water.

  • Confined spaces. Will you be working in confined spaces?

  • A confined space permit and qualified person is required.

  • Fumes from pits/manholes/ducts. Are you working on or near a service station? Is there a danger of fumes near pit/manhole/ducts?

  • Excessive noise. Will you be making excessive noise? Have you informed the neighbours?

Climate Conditions

  • Are there safe systems of work in place for the following:

  • Lighting. Is there sufficient light for all tasks?

  • Weather. Are climate conditions suitable for performing tasks?

Environmental Hazards

  • Are there safe systems of work in place for the following:

  • Contaminated soil/water?

  • Pesticides/Insecticides used?

  • Stormwater or sediment controls? Dewatering?

  • Air quality? Dust emissions? Noise or vibrations?

  • Disturbance to flora/fauna? Potential for spreading of weeds/pests?

  • Will you be disposing of waste from site? If so, where/how?

  • Enter Disposal Site

Traffic Management

  • Traffic/Pedestrian management needed? Refer to Traffic Management Plan.

  • Enter Company Used

Plant

  • Are there safe systems of work in place for the following:

  • Plant/Equipment used? Have the pre-start checks been completed?

  • Complete Harmonise Pre-Site plant check
    SWMS - CON-HSE-SWMS-0119 - Use of Plant and Equipment

  • Gas detection.

  • Overhead electrical hazards?

Manual Handling

  • Possibility of awkward postures, pushing or pulling?

  • Will you be lifting, lowering or will there be sudden body movements?

  • Will you be subjected to sustained vibrations?

  • SWMS - CON-HSE-SWMS-0113 - Use of Tools and Equipment

Working at Heights

  • Is there ladder use?

  • Check ladder Condition as per CON-HSE-FRM-107 for cracks, breaks rust and corrosion before use!

  • Are there unprotected ledges on site resulting in fall hazards?

Working with Tools

  • Are power tools being used for drilling/cutting?

  • SWMS - CON-HSE-SWMS-0113 - Use of Tools and Equipment

Other safety concerns/hazards.

  • List any other Safety Concerns /Hazards

Sign-on

  • Sign on

  • Worker
  • Worker

Visitors

  • All visitors attending work site are to be inducted into this JSEA and sign as an acknowledgement that they have read and understand the document.

  • Visitors
  • Name

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.