Johns Lyng Initial Site Assessment

• Project Number

• Client Site

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  Media

• Conducted By:

• Conducted on

  Date

Hazards identified on site

Hazard - Site Access

• Off street parking available

  Yes

  No

  N/A

• Clear access to the site (minimum 900mm wide)

  Yes

  No

  N/A

• Children or pets on site

  Yes

  No

  N/A

• Sloping site

  Yes

  No

  N/A

• Long grass , dense vegetation

  Yes

  No

  N/A

• Roof pitch is less than 22.5 degrees

  Yes

  No

  N/A

• Roof pitch is over 26 degrees

  Yes

  No

  N/A

• Does the structure have multiple storys

  Yes

  No

  N/A

Hazard -Structural integrity

• Is there visible structural damage

  Yes

  No

  N/A

• Are the fire effected walls , floors

  Yes

  No

  N/A

• Is there fire effected roofing , trusses , Metal sheeting and tiles

  Yes

  No

  N/A

• Are the visible deflections in floors

  Yes

  No

  N/A

• Is there flood or water damage

  Yes

  No

  N/A

• Are any structures and objects unsupported

  Yes

  No

  N/A

• Is there any penetrations and openings

  Yes

  No

  N/A

Hazard - Services

• Is there live electricity on site

  Safe

  At Risk

  N/A

• Is there any exposed cables or dislodged GPO's

  Safe

  At Risk

  N/A

• Overhead power-lines within 3 meters of the roof line

  Yes

  No

  N/A

• Overhead power-lines within 6.4 Mts. of the expected unloading area for materials

  Yes

  No

  N/A

• Is there natural gas or LPG cylinders on site

  Yes

  No

  N/A

• Has mains water or sewage been disconnected

  Yes

  No

  N/A

Hazard - Personnel Exposures

• Trip , slips and falls

  Yes

  No

  N/A

• Falls , unprotected edges , Penetrations or Excavations

  Yes

  No

  N/A

• Exposed edges

  Yes

  No

  N/A

• Confined spaces

  Yes

  No

  N/A

• Difficult entry and exit form confines spaces

  Yes

  No

  N/A

• Reduced visibility or lighting

  Yes

  No

  N/A

• Hazardous Chemicals , Gas , fumes

  Yes

  No

  N/A

• Flammable or combustable materials

  Yes

  No

  N/A

• Suspended loads

  Yes

  No

  N/A

• Working at height ( Access roofs )

  Yes

  No

  N/A

Hazards -Environmental

• Air emissions (Dust , Fumes)

  Yes

  No

  N/A

• Habitat disruption

  Yes

  No

  N/A

• Hazardous wastes , Hydrocarbons , chemical spills .

  Yes

  No

  N/A

• Erosion , soil disturbance , contaminated soil

  Yes

  No

  N/A

• Asbestos , synthetic mineral fibres

  Yes

  No

  N/A

• PCB's

  Yes

  No

  N/A

• Mould on site

  Yes

  No

  N/A

Use this section to below to add any hazards identified that are not on the list above

• Hazard Identified

• Risk

• control

• Hazard identified

• Risk

• Control

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