#ITC03 Job Start Form

Information

Document No.
Job Name
Client
- Other
- Abernethy Contractors
- Asplundh
- Asset Managers Ltd
- Asset Monitoring Ltd
- Auckland Racing
- Auckland Sandblasting Ltd
- Auckland Waikato Cranes
- Aurecon
- Bishman Electrical Contractors
- Canadian Pacific Ltd
- Cassidy Construction
- Civic Events
- Civil Con
- Coastline
- Concrete-it ltd
- ConTech
- Counties Sandblasting
- CSR NZ Ltd
- DP Construction
- Drill Force
- Electrix Ltd
- Euro Plumbing
- Filltech
- Filtration Technology Ltd
- Fletchers - Christchurch
- Fulton Hogan Ltd
- Geotechnics
- Gubb Builders
- HEB Construction Ltd
- Hill Design Engineering Ltd
- HydroTech Drainage
- ITC
- Leightons
- Lend Lease
- MACHINERY MOVERS
- Mainline Construction Ltd
- McConnell Dowell Constructors Ltd CHC
- McMillan and Lockwood BOP Ltd
- MWH Global
- NGA Newmarket
- NZ STRONG
- Opus
- Parallaxx Limited
- Peter Campbell Matakana
- Peter Hill
- Peter Lehman
- Pipeline & Civil
- Prestige Events Ltd
- R M Paris.Co
- Scarbro Construction
- Selen Kurmar
- Sherry - Private
- Skin Tight Ltd
- Steel Roofing Ltd
- Temporary Traffic Control Ltd
- The Fletcher Construction Company Ltd
- Tree Fellas
- Troy Wheeler Civil Ltd
- Watercare
- Your Local Plumber
Enter Client Name Here
Time of Job Start for being completed
Prepared by
- Labour Hire
- Other
- Albert Heke
- Alister Martin
- Angaino Monty Timoti Tauti
- Apa Vila
- Arama Rubena
- Arthur Tapiki
- Asa Fitspatrick
- Ashley Young
- Banaba Kavana
- Billy Araipu
- Bobby-Joe Kelly
- Brian Mita
- Chris Perenara
- Dallah Kolone
- Daniel Bishop
- David Williams
- Dean Rua
- Dratio Strickland
- Dwayne Tapiki
- Edward Teura
- Eroni Baleilevuka
- George Mann
- George Tate
- Glen Ruma
- Jamie Lee Jerry
- Jessie Tekeu
- Jim Polima
- John Cook
- John Kelly
- John Keu
- John Maru
- John Williams
- Josh Heke
- Joshua Amohanga
- Joshua Harding
- Junior Katu
- Kaitapu Timoti
- Kelvin Tangiiti
- Kelvin Wichman - To'o
- Lance Seiuli
- Loma Tengere
- Malachi Batchellor
- Matai Vila
- Muri Williams
- Nelson Ravia
- Nicholas Repoama
- Nooroa Strickland
- Palepano Tukia
- Pete Sala
- Phillip Cooper
- Piri Kake
- Quincy Williams
- Refiti Manase
- Rhys Reuben
- Shaq Ono
- Shawn Tomlin
- Soul Suliasi Toa
- Te Rangihau Toi
- Teinakore Ngatoko
- Teruarau Tangiiti
- Villimoni Vunimasi
- Willy Green
Enter Name Here
Location of Job

1. LOOK - Do the Job START
2. TELL - My mate if he is being UNSAFE
3. TALK - About the Hazard Controls and Behaviours
Job Name
Onsite Client Representative
Job Number:
TMP Number:

Risk Rating Chart

1. What can harm me?
2. What can harm others?
3. What can harm the environment?
Common Hazards
- Traffic/Vehicles
- Pedestrians (footpath closed)
- Pedestrians (footpath detour)
- Excess Speed
- Visibility
- Cyclists (cycle lane diversion/allowance)
- Cyclists (with live traffic)
- Large Vehicles
- Weather
- Mobility Scooters
- Poor Road Surface
- Lots of contractor movements
Good toolbox (site entry procedures), designated site access, other work vehicles well away.
Side friction, speed restriction, additional advanced warning (new seal?)
Good road surface, additional pedestrian lane width, use of driveways
Additional lane width, turning circles, tapers at good length
Additional signage, condition of signage, additional cones, extra sandbags, cable tie signage to poles, additional safety zones
Additional lane width, visibility,shoulders available
Narrow lanes, speed restriction, side friction kerb line of cones, additional safety zones
1.2m wide, cone barrier arms/safety fencing to contain, no trip hazards on route
Placed where good visibility is achievable, out of worksite, TC on site, inside speed restriction
Positive Traffic Management, good delineation, side friction, RGs
Good signage visibility, centreline of cones, side friction, extra safety zone area
Mitigation:
Hazard Description
Likelihood of Harm
Potential Consequences
Risk Rating Before Controls

Hazard Controls (How can we reduce personal and environmental harm here?)

Behaviour/Action to eliminate, isolate or minimise:
Person or Team Responsible
- Labour Hire
- Other
- Albert Heke
- Alister Martin
- Angaino Monty Timoti Tauti
- Apa Vila
- Arama Rubena
- Arthur Tapiki
- Asa Fitspatrick
- Ashley Young
- Banaba Kavana
- Billy Araipu
- Bobby-Joe Kelly
- Brian Mita
- Chris Perenara
- Dallah Kolone
- Daniel Bishop
- David Williams
- Dean Rua
- Dratio Strickland
- Dwayne Tapiki
- Edward Teura
- Eroni Baleilevuka
- George Mann
- George Tate
- Glen Ruma
- Jamie Lee Jerry
- Jessie Tekeu
- Jim Polima
- John Cook
- John Kelly
- John Keu
- John Maru
- John Williams
- Josh Heke
- Joshua Amohanga
- Joshua Harding
- Junior Katu
- Kaitapu Timoti
- Kelvin Tangiiti
- Kelvin Wichman - To'o
- Lance Seiuli
- Loma Tengere
- Malachi Batchellor
- Matai Vila
- Muri Williams
- Nelson Ravia
- Nicholas Repoama
- Nooroa Strickland
- Palepano Tukia
- Pete Sala
- Phillip Cooper
- Piri Kake
- Quincy Williams
- Refiti Manase
- Rhys Reuben
- Shaq Ono
- Shawn Tomlin
- Soul Suliasi Toa
- Te Rangihau Toi
- Teinakore Ngatoko
- Teruarau Tangiiti
- Villimoni Vunimasi
- Willy Green
Completed By: (initials)
Date
Signed by All Workers or Visitors to site:
Signed