ICE - SAFE ACT OBSERVATION (SAO)

• Document No. - ICE-ECD-058

• Project Number -

• Client / Site

• Conducted on

  Date

• Completed by -

• Location
  Address

• Personnel

RISK ASSESSMENTS

• RISK ASSESSMENT TYPE?

  Select JSEA SWMS TAKE 5 PROJECT RISK ASSESSMENT

  • JSEA
  • SWMS
  • TAKE 5
  • PROJECT RISK ASSESSMENT

RISK ASSESSMENT OBSERVATION

• Is the risk assessment followed

  Yes

  No

  N/A

• Is the risk assessment adequate

  Yes

  No

  N/A

• Is the Risk Assessment understood?

  Yes

  No

  N/A

• Is the risk assessment available <br>

  Yes

  No

  N/A

• How would you do the task better?

  Yes

  No

  N/A

• What controls are required for the job you're doing?

  Yes

  No

  N/A

TOOLS AND EQUIPMENT

• Are the tools and equipment used in good condition

  Yes

  No

  N/A

• Are the tools and equipment used correctly

  Yes

  No

  N/A

• Do the tools and equipment used require calibrating

  Yes

  No

  N/A

SYSTEMS AND PROCEDURES

• Is a Permit to Work required for the task?

  Yes

  No

  N/A

• Please select permit type

  Select Hot Work Permit Cold Work Permit Working at Heights Permit Confined Space Permit Electrical Work Permit Excavation Permit

  • Hot Work Permit
  • Cold Work Permit
  • Working at Heights Permit
  • Confined Space Permit
  • Electrical Work Permit
  • Excavation Permit

ELECTRICAL

• Does any plant or equipment require Isolation?

  Yes

  No

  N/A

• Is there a Lock Out / Tag Out procedure in place?

  Yes

  No

  N/A

• Have you Tested For Dead?

  Yes

  No

  N/A

• Are all electrical equipment inspected and tagged in date?

  Yes

  No

  N/A

• Are RCD's being used on all electrical equipment?

  Yes

  No

  N/A

• Are the extension cords elevated off the ground

  Yes

  No

  N/A

• Is all the documentation in place to proceed with the task?

  Yes

  No

  N/A

• Have you completed the documentation required to complete the task. Eg ITP's, ITS's, COC

  Yes

  No

  N/A

EXCAVATIONS

• Is there a requirement for excavation?

  Yes

  No

  N/A

• Has area been checked for existing services?

  Yes

  No

  N/A

• Is there an excavation permit in place?

  Yes

  No

  N/A

• Is the trench shored and battered correctly. Eg spoil 600mm from the trench, shoring after 1.2m

  Yes

  No

  N/A

• Is there safe access and egress in the trench?

  Yes

  No

  N/A

• Has the trenching area been segregated and bunted off and or covered to protect the public and wildlife at the end of each shift?

  Yes

  No

  N/A

TRAINING AND COMPETENCIES

• Have you completed the required ICE and site inductions?

  Yes

  No

  N/A

• Have you been trained and competent to complete the task?

  Yes

  No

  N/A

• Do you hold a certificate or ticket to operate the plant and equipment?

  Yes

  No

  N/A

COMMUNICATION & CONSULTATION

• Did you attend this mornings project Pre-Start meeting?

  Yes

  No

  N/A

• Can you name some of the site hazards that have been identified on site?

  Yes

  No

  N/A

• Was the weather conditions communicated at the mornings Pre-Start meeting?

  Yes

  No

  N/A

• Is there a risk that the Weather conditions may create a hazard while completing the task?

  Managing Heat / Stroke

  Rain

  Cyclonic conditions

• How often do you attend the site Toolbox meeting?

  Yes

  No

  N/A

• If so do you know any of the HSE topics that were discussed?

  Yes

  No

  N/A

• Have you had any input into the toolbox meetings in regard to HSE matters?

  Yes

  No

  N/A

• What are 3 of the main signs of Heat Stroke..?

  Safe

  At Risk

  N/A

• Three warning signs to prevent Heat Stroke

  Select High body temperature Red, hot dry skin Rapid pulse Headaches Dizziness, confusion Nausea

  • High body temperature
  • Red, hot dry skin
  • Rapid pulse
  • Headaches
  • Dizziness, confusion
  • Nausea

HOUSEKEEPING

• Is the work area clean and tidy

  Yes

  No

  N/A

• Is there efficient light in the work area?

  Yes

  No

  N/A

• Do you clean during and at the end of the shift?

  Yes

  No

  N/A

INCIDENTS

• Who would you contact first in the event that you or a workmate were injured?

  Yes

  No

  N/A

• Who do you report Near Misses too, and when?

  Yes

  No

  N/A

• Have you reported any hazards on the project in the last few weeks?

  Yes

  No

  N/A

PPE

• What is the PPE standard for all ICE employees on the projects in which they work?

  Yes

  No

  N/A

• Name 3 types of PPE that is ICE standard?

  Select Hard hat Safety Glasses High viz, long pants & sleeves Gloves

  • Hard hat
  • Safety Glasses
  • High viz, long pants & sleeves
  • Gloves

• When using a grinder or cut off saw the ICE standard is to use double eye protection?

  Yes

  No

  N/A

• Are the Fall Arrest Harnesses inspected and tagged in date?

  Yes

  No

  N/A

HAZARDOUS SUBSTANCES

• Are any Hazardous Substances are required for the task you are doing?

  Yes

  No

  N/A

• Do you know where the hazardous substances cabinet is kept?

  Yes

  No

  N/A

• Have you reviewed the Safety Data Sheet?

  Yes

  No

  N/A

• Have you reviewed the Risk Assessment that accompanies the Hazardous Substance?

  Yes

  No

  N/A

ENVIRONMENTAL ASPECTS

• Have you identified any environmental issues that may cause a risk to the task?

  Yes

  No

  N/A

• Who do you report any Environmental Incidents too?

  Yes

  No

  N/A

HAZARDS IDENTIFIED

APPROVAL SIGNATURE

• Yes

  No

  N/A

• HSE Manager Signature

  Sign

• Supervisor Signature

  Sign