JSEA

• Document No.

• Client / Site

• Location
  Address

• Conducted on

  Date

• Prepared by

• Additional Personnel

Common hazards

• Aware of site safety requirements e.g. PPE to be won on site

  Yes

  No

  N/A

• Aware of site traffic requirements

  Yes

  No

  N/A

• Aware of where to locate equipment

  Yes

  No

  N/A

• Aware of where to drop off or pick up equipment

  Yes

  No

  N/A

• Fit for work

  Yes

  No

  N/A

• Permit for work required?

  Yes

  No

Control measures

• Report to site office to get directions

  Yes

  No

  N/A

• Report to site supervisor

  Yes

  No

  N/A

• Report to site personnel

  Yes

  No

  N/A

• Accurate directions supplied from transport controller, hire office or service controller

  Yes

  No

  N/A

• Attended site induction

  Yes

  No

  N/A

• Escorted around site by site personnel

  Yes

  No

  N/A

• Do not need to enter site

  Yes

  No

  N/A

• Where required, Permit to work issued by site supervisor

  Yes

  No

  N/A

• Ensure adequate rest period has been taken between shifts

  Yes

  No

  N/A

• Not effected by alcohol or drugs (as per Coates Alcohol and Drug Policy)

  Yes

  No

  N/A

Is the job site safe?

• Yes

  Off

  On

Common hazards

• Roadways

  Yes

  No

• Vehicles or cyclists

  Yes

  No

• Public walkways

  Yes

  No

• Pedestrians or general public in the area

  Yes

  No

• Other workers in the area

  Yes

  No

• Equipment working in the area

  Yes

  No

• Blind corners

  Yes

  No

• Positioning of moving vehicle/ crane/ equipment

  Yes

  No

• Railway/ tram lines/ crossings

  Yes

  No

• Aircraft/ runways

  Yes

  No

• Shipping/ wharf activites

  Yes

  No

• Other

Control measures

• Physical barriers

  Yes

  No

  N/A

• Qualified traffic controller

  Yes

  No

  N/A

• Traffic signs

  Yes

  No

  N/A

• Physical separation of activites

  Yes

  No

  N/A

• Roadwork/ warning signage

  Yes

  No

  N/A

• Traffic control plan

  Yes

  No

  N/A

• Barrier mesh/ tape/ bunting

  Yes

  No

  N/A

• Witches hats

  Yes

  No

  N/A

• Use a spotter when moving vehicle/ crane/ equipment, especially when reversing

  Yes

  No

  N/A

• Persons stay in safety zones during loading

  Yes

  No

  N/A

• Travel speed maximum 10km/h or per site conditions

  Yes

  No

  N/A

• Engage rotating beacon

  Yes

  No

  N/A

• Engage hazard warning lights

  Yes

  No

  N/A

• Motion/ reversing alam

  Yes

  No

  N/A

• Ensure only essential personnel are in the work area

  Yes

  No

  N/A

• Other

Is the job site safe?

• Yes

  Off

  On

Common hazards

• Stable, even, non-slippery ground surfaces

  Safe

  At Risk

  N/A

• Site housekeeping

  Safe

  At Risk

  N/A

• Wet or waterlogged ground conditions

  Safe

  At Risk

  N/A

• Waterways/ drainage nearby

  Safe

  At Risk

  N/A

• Trenches/ backfilled nearby

  Safe

  At Risk

  N/A

• Trees/ flora

  Safe

  At Risk

  N/A

• Buildings

  Safe

  At Risk

  N/A

• Onsite facilities/ structures or equipment

  Safe

  At Risk

  N/A

• Bridges

  Safe

  At Risk

  N/A

• Other overhead obstruction

  Safe

  At Risk

  N/A

• Other

Control Measures

• Ground conditions assessed by competent person

  Yes

  No

  N/A

• Vehicle/ crane/ equipment is on FIRM LEVEL ground

  Yes

  No

  N/A

• Fully extend outriggers on cranes or equipment where fitted

  Yes

  No

  N/A

• Suitable packing is to be used under outriggers/ stabilisers

  Yes

  No

  N/A

• Set up a crane/ equipment's nearest outrigger to the trench, as far away from the trench as the trench is deep

  Yes

  No

  N/A

• Ensure adequate distance/ protection is maintained for all onsite facilties, structures or equipment

  Yes

  No

  N/A

• Relocate position of crane or equipment if necessary

  Yes

  No

  N/A

• Use a tag line

  Yes

  No

  N/A

• Use a spotter

  Yes

  No

  N/A

• Obtain authority to trim trees/ flora if trimming is required

  Yes

  No

  N/A

• Use trak mats

  Yes

  No

  N/A

• Advise site supervisor of site housekeeping issues that will affect the job

  Yes

  No

  N/A

• Wear suitable protective footwear/ clothing

  Yes

  No

  N/A

• Other

Is the job site safe?

• Yes

  Off

  On

Look up and Live. Common hazards

• Locate power lines

  Safe

  At Risk

  N/A

• Overheard services

  Safe

  At Risk

  N/A

• Live Aerial conductors (power lines)

  Safe

  At Risk

  N/A

• Gas Transmission Lines

  Safe

  At Risk

  N/A

• Above ground pipes

  Safe

  At Risk

  N/A

• Installing Earth stakes for portable generators

  Yes

  No

• Other

Control measures

• Locate power lines

  Yes

  No

  N/A

• Locate and mark all services

  Yes

  No

  N/A

• Maintain safe working distance

  Yes

  No

  N/A

• Observe no go restrictions

  Yes

  No

  N/A

• Use a QUALIFIED spotter

  Yes

  No

  N/A

• Contact authorities and isolate power if necessary

  Yes

  No

  N/A

• Ring "Dial Before You Dig" 1100

  Yes

  No

  N/A

• Obtain approval for work in Gas Transmission pipeline areas

  Yes

  No

  N/A

• Relocate task to another area

  Yes

  No

  N/A

• Other

Is the job site safe?

• Yes

  Off

  On

Common hazards

• Windy or stormy conditions

  Yes

  No

• Electrical storm/ heavy rain

  Yes

  No

• Extreme heat

  Yes

  No

• Poor visibility, night work

  Yes

  No

• Extreme cold/ icy conditions

  Yes

  No

• Other

Control Measures

• Do not operate equipment or cranes during an electrical storm or heavy rain

  Safe

  At Risk

  N/A

• Do not operate EWP's or cranes if wind speed exceeds wind speed rating

  Safe

  At Risk

  N/A

• Use a tag line when lifting a load with a crane

  Safe

  At Risk

  N/A

• Install artifical lighting if working at night or in dark conditions

  Yes

  No

  N/A

• Wet weather clothing

  Yes

  No

  N/A

• Postpone all work until suitable conditions are present

  Yes

  No

  N/A

• Ensure hydration levels are maintained to safe working level

  Yes

  No

  N/A

• Take appropriate breaks if required

  Yes

  No

  N/A

• Sun protection e.g. hat and sunscreen

  Yes

  No

  N/A

• Wear adequate clothing during cold/ icy conditions

  Yes

  No

  N/A

• Wear adequate footwear

  Yes

  No

  N/A

• Other

Is job site safe?

• Yes

  Off

  On

Common Hazards

• Edge protection

  Yes

  No

  N/A

• Working from a ladder

  Yes

  No

• Working above 2 metres

  Yes

  No

• Operating a boom lift

  Yes

  No

• Risk of a fall

  Yes

  No

• Climbing on to equipment

  Yes

  No

• Other

Control Measures

• Maintain 3 points of contact when working with a ladder

  Yes

  No

  N/A

• Ensure ladders are adequately secured both top and bottom

  Yes

  No

  N/A

• Use a person to assist in securing a ladder

  Yes

  No

  N/A

• Use a work platform

  Yes

  No

  N/A

• Use an EWP

  Yes

  No

  N/A

• Pre sling loads

  Yes

  No

  N/A

• Ensure all surfaces are non slip and there is no risk of a fall

  Safe

  At Risk

  N/A

• Do not go within a 2m distance of an unprotected edge

  Yes

  No

  N/A

• Wear a harness when operating an EWP

  Yes

  No

  N/A

• Employ fall arrest equipment when working from heights

  Yes

  No

  N/A

• Ensure surface is not fragile or unstable

  Safe

  At Risk

  N/A

• Other

Is the job site safe?

• Yes

  Off

  On

Common Hazards

• Have identified a confined space

  Yes

  No

• Required to enter confined space

  Yes

  No

• Other

Control Measures

• Assess site for confined spaces

  Yes

  No

  N/A

• Suitably trained and qualified to enter a confined space

  Yes

  No

  N/A

• Suitably equipped to enter a confined space

  Yes

  No

  N/A

• Have obtained a confined space entry permit

  Yes

  No

  N/A

• Other

Is the job site safe?

• Yes

  Off

  On

Common Hazards

• PPE required to perform task

  Yes

  No

• PPE in bold print MANDATORY for dogging and personnel in loading/unloading area

  Yes

  No

• Task involve manual handling

  Yes

  No

• Other

Control Measures

• Hard hat

  Safe

  At Risk

  N/A

• Hand protection

  Safe

  At Risk

  N/A

• Eye protection

  Safe

  At Risk

  N/A

• Protective clothing & hi vis garments

  Safe

  At Risk

  N/A

• Fire resistant clothing (petrochemical plants)

  Safe

  At Risk

  N/A

• Appropriate safety footwear

  Safe

  At Risk

  N/A

• Hearing protection

  Safe

  At Risk

  N/A

• Respiratory protection

  Safe

  At Risk

  N/A

• Never lift more than 20kg

  Safe

  At Risk

  N/A

• Use mechanical lifting aids

  Yes

  No

  N/A

• Site PPE requirements observed

  Yes

  No

  N/A

• Have adhered to Coates Hire PPE policies

  Yes

  No

  N/A

Is the job site safe?

• Yes

  Off

  On

Common Hazards

• Need to conduct an inspection of equipment

  Yes

  No

• Need to use hand tools

  Yes

  No

• Need to use electrical equipment

  Yes

  No

• Other

Control measures

• Daily inspection of equipment/cranes and lifting gear has occured

  Yes

  No

  N/A

• Daily inspection has been recorded in a log book

  Yes

  No

  N/A

• Hand tools are inspected before use

  Yes

  No

  N/A

• Electrical equipment is adequately tested and tagged

  Yes

  No

  N/A

• Other

Is the job site safe?

• Yes

  Off

  On

Only proceed if it safe to do so

• Signature

  Sign