Information
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Document No.
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Client / Customer Name
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Conducted on
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Prepared by (Site Supervisor)
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Location
Vehicle
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Is a vehicle/s being used on this job?<br>If YES, note Rego. No. of vehicle and complete the "drop down" pre-start checklist!
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Registration number Vehicle 1:
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Registration number Vehicle 2:
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Registration number Vehicle 3:
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Oil, water and fuel levels.<br>Check for oil and / or fuel leaks.
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Check condition of all tyres for correct inflation, wear and damage.<br>(Including spare tyre)
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Check condition and operation of horn, all lights and reversing alarm.<br>Check condition and operation of wipers and washers.
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Check the operation of all gauges.
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Load restraint as per National guidelines (2004).
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The First-Aid kit is sufficiently stocked and easily accessible.
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Check tow hitch and chipper / trailer attachments for wear and security.
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Visually inspect, note and report any broken springs.
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After starting engine, listen for belt squeal indicating loose belts.
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Check operation of brakes.<br>Apply brakes at low speed as soon after take-off as possible, to ensure operation.
Machinery
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Are chainsaws required on this job?<br>If YES, complete "drop down" pre-start checklist!
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Chainsaw model/s being used:
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Smooth operation of throttle trigger.<br>Throttle trigger cannot be pulled until "lock-out" is depressed.
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Chain catcher is undamaged.
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Air filter is clean and undamaged.
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Turn bar daily for even wearing.<br>Check bar lubrication hole is not clogged.<br>Clean out chain groove.<br>Lubricate bar tip sprocket.<br>Check oiler function to ensure proper lubrication of bar and chain.
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Sharpen the chain and check chain tension and condition.<br>Check the drive sprocket for wear.
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Check starter and starter cord for wear or damage.<br>Clean the air intake slots on the starter housing.
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Check for any loose nuts, bolts and screws and re tighten as necessary.
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Test the "stop" switch to ensure it shuts off the engine.<br>Test the chain brake to ensure it functions correctly.
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Chainsaw Safe Work Method Statement: All workers present have been consulted, inducted and understand the SWMS for their job.
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"Chainsaw" SWMS attached:
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Is a wood-chipper required for this job?<br>If YES, complete the "drop down" pre-start checklist!<br><br><br>
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What model / registration number wood-chipper is being used?
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FEED ROLLER FLAP - clean daily to prevent bearing damage.<br>Clear in-feed hopper of any foreign objects.
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Check entire machine for any loose nuts, bolts or parts.
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Check hydraulic pump and motor shaft for fit and tightness.
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Grease all chipper related bearings.
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Clean and check radiator and debris screen.
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Check fuel, engine oil and coolant levels.<br>Check hydraulic level is always at 7/8 full.
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Inspect all hoses and fittings for wear or damage.
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Check the condition of the knives, anvil, hardware and fan blades.<br>Rotate the chipper disc carefully to ensure proper anvil clearance.
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Reinsert the hood pin and padlock after closing chipper hood.<br>Ensure the hood pin is tight and secure.<br>Ensure the chipper hood engine disable plug is installed correctly and the spring lock for hood pin springs back into position.
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Adjust belt tension on chipper belt drives.
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Check air cleaner and pre-cleaner.
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Make sure all guards are tight and securely in place.
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Check clutch for proper engagement tension and lubrication.<br>Frequently adjust and grease.
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Maintain and service the "last chance" stop system so it is always operational.
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Chipper Safe Work Method Statement: All workers present have been consulted, inducted and understand the SWMS for their job.
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"Chipper" SWMS attached:
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Is the Vermeer S925TX mini skid-steer loader required for this job? <br>If YES, complete the "drop down" pre-start checklist!
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Check track condition for wear. <br>Check loader frame, pins and bushes for movement. <br>Check all grease points are greased. <br>Check all hoses for damage.
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Check engine oil, fuel, coolant and hydraulic fluid levels. <br>Check engine bay for oil / fuel leaks and loose belts.<br>Check the condition of all cylinders for leaks and damage.
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Check attachments (bucket / log grapple) and ensure attachments are correctly fitted and the locking mechanism is secure.
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Turn on ignition key and check warning lights are operational.
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Start machine and check that isolation platform "non-pressure" prevents controls from operating.<br>Check controls for smooth operation.
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Vermeer Loader Safe Work Method Statement: All workers present have been consulted, inducted and understand the SWMS for their job.
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"Vermeer Loader" SWMS attached:
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Is a stump-grinder required for this job.<br>If YES, complete the "drop down" pre-start checklist!
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Check cutting teeth are sharp. <br>Check for missing or loose cutting teeth.<br>Check cutter head rotates freely and is not obstructed.
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Check belts appropriately tensioned and in good order.<br>Check tyre pressure is correct.
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Check levels of oils and fluids.<br>Check hoses are undamaged.
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Check all guards for belt, PTO (power take-off) and grinder head are in place.<br>Check debris curtain is present and in good working order.
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Check "kill switch" clearly identifiable and working correctly.<br>Check that "dead man" is working correctly.
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Expose stump surrounds manually, checking for and removing any foreign bodies.<br>Moisten surrounds, as required.
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Determine exclusion zone for safe work operations.<br>Isolate exclusion zone with barriers and signs.
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Confirm work zone cleared prior to starting cutter head.<br>Communicate with team during operations using voice, hand and whistle signals.
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Stump-grinder Safe Work Method Statement: All workers present have been consulted, inducted and understand the SWMS for their job.
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"Stump Grinder" SWMS attached:
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Is an EWP required for this job?
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What company is supplying the EWP / Cherry Picker? EWP operator to sign this form!
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Check load rating, emergency controls, service and maintenance.<br>Safety signs and exclusion zones set up.<br>Licensed operator present.
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Is a crane truck and operator required for this job?
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What company is supplying the crane truck? Crane truck operator to sign this form!
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Check load rating, emergency controls, service and maintenance.<br>Safety signs and exclusion zones are set up.<br>Licensed operator is present.
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Crane Truck Safe Work Method Statement: All workers present have been consulted, inducted and understand the SWMS for their job.
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"Crane Truck" SWMS attached:
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Is any other equipment required for this job.
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Additional equipment:
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Additional equipment:
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Additional equipment:
On - site hazards
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Check for overhead service lines:<br>High voltage power-lines or service lines to property.<br>Staff are trained, regulation distances are maintained, appropriate equipment is on hand.
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Check for underground services:<br>Accurate detection.
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Check for vehicle and pedestrian access:<br>Exclusion zones are set up with signs and cones in place; staff are trained and understand requirements.
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"Working in Public Area" SWMS attached:
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Is traffic control required?
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Who / what company is carrying out Traffic Control? Traffic control operators to sign this form!
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Building and assets - terrain and access:<br>Are the safe working distances maintained, is the equipment appropriate for the location, are staff trained.
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Is there any existing damage? PHOTO IS REQUIRED IN "DROP DOWN" SECTION:<br>Check the work area fully for any existing damage. <br>Identify areas where this job may impact on any structure on the property.
Weather
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Heat / cold / wind / rain:<br>Modify work practises if required, weather protection gear (including sunscreen) is supplied and used.<br><br>
Tree
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Check the tree for defects: PHOTO IS REQUIRED IN "DROP DOWN" SECTION:<br>Is the tree unstable / split / decaying / dead.<br>Are there nails, wire, spikes, vines, nests or insect colonies in the tree.<br>Are the branches diseased, are branches intruding from other trees or is the crown leaning heavily.<br>Identify areas where this job may impact on any structure on the property.<br>Inspect thoroughly, ensure appropriate access methods are chosen and fall path is assessed.
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Is a climber required for this job.<br>If YES, who is climbing.
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Climber #1:
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Climber #2:
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Climber #3:
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Work at Heights Safe Work Method Statement: All workers present have been consulted, inducted and understand the SWMS for their job.
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"Work at Heights - Tree Climbing" SWMS attached:
Safety Equipment required
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Ropes, harnesses and pole belts:<br>Check for wear, damage and safety.<br><br>
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First aid kit and fire extinguisher:<br>Is first aid kit fully stocked and accessible.<br>Is fire extinguisher in date and accessible.<br>
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Personal Protection Equipment: <br>Are all staff wearing the appropriate PPE, including chainsaw pants, steel cap boots and hi-vis shirt.<br>
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Aerial Rescue equipment:<br>Check aerial rescue gear is present, fully checked and staff are trained appropriately.
Staff
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COVID-19 RESPONSE: In signing this Job Site Assessment (JSA) staff are declaring that they are well and fit for work duties.
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Training and task allocation:<br><br>In signing this Job Site Assessment (JSA), you are agreeing that you have been consulted in, and trained on the agreed controls contained within the attached Safe Work Method Statements, and that you will ensure the risk controls listed in the SWMS will be implemented and complied with.<br>All staff read and understand Workplace Health & Safety (WH&S) rules.<br>Rescue plans have been discussed.
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Site Supervisor to sign Name:
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Name:
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Name:
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Name:
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Name:
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Name:
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Name:
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Name:
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Name:
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