Hazard Report - MARKSCON

Hazard / Incident Report - MARKSCON

• Document No.

• Report Made on?

  Date

• Site Name / Location:

  Select 1-3 Moffat St, Brighton 956 Doncaster Rd, Doncaster

  • 1-3 Moffat St, Brighton
  • 956 Doncaster Rd, Doncaster

• Conducted by:

• Date and Time of Occurrence ?

  Date

WHO'S INVOLVED

• Name of Employee / Contractor

• Time of Incident / HAZARD occured

  Date

• Supervisor / Site Manager

• Working Area

LISTING OF HAZARDS TYPES

• Environmental Hazards

  Select Spill Potential Weather Condition MSDS's / Eyewash Ventilation / Inhalation Heat / Cold Stress Other Workers in Area Cuts / Sharp Edges Inadequate Lighting Housekeeping / Hygiene Poor Access / Egress UV Exposure / Chemical Burns Barricades / Guardrails

  • Spill Potential
  • Weather Condition
  • MSDS's / Eyewash
  • Ventilation / Inhalation
  • Heat / Cold Stress
  • Other Workers in Area
  • Cuts / Sharp Edges
  • Inadequate Lighting
  • Housekeeping / Hygiene
  • Poor Access / Egress
  • UV Exposure / Chemical Burns
  • Barricades / Guardrails

• Ergonomic Hazards

  Select Working in Tight Areas Working Above Your Head Repetitive Moition Pinch Point / Workstation Overexertion / Awkward Back / Knee Stress / Pulling In Line of Fire Confined Space / Water Lifting / Carrying / Pushing Rigid Postures / Vibration Overloading Spine / Joints Ladders / Platforms

  • Working in Tight Areas
  • Working Above Your Head
  • Repetitive Moition
  • Pinch Point / Workstation
  • Overexertion / Awkward
  • Back / Knee Stress / Pulling
  • In Line of Fire
  • Confined Space / Water
  • Lifting / Carrying / Pushing
  • Rigid Postures / Vibration
  • Overloading Spine / Joints
  • Ladders / Platforms

• Personal Limitations Hazards

  Select Instructions Clearly Understood Trained to Use Tool and Perform Task Distraction in the Work Area Working Alone (communications) Lift Heavy/Awkward Position External Noise Levels / Hearing Physical Limitations / Positioning Visibility / Accessibility Respirator Fit Test Reversing Vehicles /Traffic Safety Compliance / Signage Area Secure / Whipchecks

  • Instructions Clearly Understood
  • Trained to Use Tool and Perform Task
  • Distraction in the Work Area
  • Working Alone (communications)
  • Lift Heavy/Awkward Position
  • External Noise Levels / Hearing
  • Physical Limitations / Positioning
  • Visibility / Accessibility
  • Respirator Fit Test
  • Reversing Vehicles /Traffic
  • Safety Compliance / Signage
  • Area Secure / Whipchecks

• Activity Hazards

  Select Grinding / Welding Burn / Heat / Spark Sources Compressed Gases Energized Equipment / Cords / Tools Operator Seat Belts Equipment Guards / Parts Lockout / Black / Block / Blind Airborne Particles / Smoking Critical Lift / Move / Placement Slip / Trip Potential Scaffolds / Toe Boards Proper Rigging / Tag Lines Working at Heights Personal Protective Equipment Confined Space

  • Grinding / Welding
  • Burn / Heat / Spark Sources
  • Compressed Gases
  • Energized Equipment / Cords / Tools
  • Operator Seat Belts
  • Equipment Guards / Parts
  • Lockout / Black / Block / Blind
  • Airborne Particles / Smoking
  • Critical Lift / Move / Placement
  • Slip / Trip Potential
  • Scaffolds / Toe Boards
  • Proper Rigging / Tag Lines
  • Working at Heights
  • Personal Protective Equipment
  • Confined Space

• OTHER, NOT LISTED, HAZARD. PLEASE DEFINE:

Describe the HAZARD / INCIDENT - detail WHAT happened - include area and task, equipment, tools and people involved

• Incidents relate to any person—whether an employee, contractor or member of the public.
  Incidents are:
  - ‘serious injury or illness’
  - dangerous incident arising out of work carried out by a business, undertaking or a workplace.
  - death of a person
  
  A hazard is anything in the workplace that has the potential to harm people.
  Hazards can include objects in the workplace, such as machinery or dangerous chemicals.
  Other hazards relate to the way work is done. For instance, hazards on a production line could include manual handling, excessive noise and fatigue caused by the pace of work.
  
  

• Hazard OR Incident?

  HAZARD

  INCIDENT

• Description:

• ADD PHOTOS

  Media

• Area of site Hazard or Incident took place

• ADD PHOTOS

  Media

• Tools / Equipment invloved

• ADD PHOTOS

  Media

Possible Solutions / how to PREVENT recurrence - Do you have any suggestions for fixing the problem or preventing a repeat.

• 1. Eliminate any risk to health or safety associated with construction work.
  2. Substituting a new activity, procedure, plant, process or substance
  3. Isolating persons from the hazard, such as barricading, fencing or guard-railing
  4. Engineering controls, such as mechanical or electrical devices.
  5. Administrative controls, such as changing the way the work is done.
  6. PPE: Provide appropriate personal protective equipment and clothing
  

• Can this be prevented in the future?

  Yes

  No

  N/A

• Please explain your response

• Can it be prevented or the risk minimalism by any of the following?

  Select Elimination Subsitution Isolation Engineering Controls Administrative Controls Personal Protective Equipment and Clothing

  • Elimination
  • Subsitution
  • Isolation
  • Engineering Controls
  • Administrative Controls
  • Personal Protective Equipment and Clothing

Results of Investigation - Determine whether the HAZARD / INCIDENT is likely to cause an injury and explain what factors caused the event.

• Has the HAZARD / INCIDENT caused an injury, unsafe work practice or unsafe environment?

  Yes

  No

  N/A

• ADD PHOTOS IF NEEDED

  Media

• List Factors leading to or causing an injury, unsafe work practice or unsafe environment.

Action Taken - Supervisor / Site Manager to identify actions to prevent injury or illness

Action Taken

• ACTION TAKEN

• Person(s) Responsible for action:

• Date for action to be completed

  Date

• Please ensure this Report is emailed to the following Markscon Personnel:
  richard.ingram@marksgroup.com.au

• Employee Representative (HSR) Name & Signature:

  Sign

• Managers Name & Signature:

  Sign