Kiosk CCC

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Are High Risk Task Present

  Yes

  No

  N/A

Lifting Operations

• Is exclusion zone in place around entire lifting area?

  Yes

  No

  N/A

• Does exclusion zone have 360 degree coverage?

  Yes

  No

  N/A

• Does the barricading for the task take into account the load shadow for an unexpected release of energy?

  Yes

  No

  N/A

• Is the exclusion zone clearly defined? I.e tape, barricades, cones, warning signs, tags

  Yes

  No

  N/A

• Are there only the authorised personnel inside the barricaded area during lift?

  Yes

  No

  N/A

• If you are in the controlled zone, are you clear of the suspended load by maintaining a safe distance?

  Yes

  No

  N/A

• Are controls in place to manage overhead hazard?

  Yes

  No

  N/A

• Have you determined that the weather conditions will allow for a safe lift?

  Yes

  No

  N/A

• Is the capacity of the lifting equipment determined?

  Yes

  No

  N/A

• Has the lifting equipment been inspected as per requirements?

  Yes

  No

  N/A

• Does the work team have agreed communication method?

  Yes

  No

  N/A

• Are the ground conditions stable for the position of outriggers?

  Yes

  No

  N/A

• Have all the critical items in the prestart been checked and confirmed to be functioning?

  Yes

  No

  N/A

• Are guards, barriers and barricades in place, installed and effective?

  Yes

  No

  N/A

• Have guards, barriers and barricades been inspected?

  Yes

  No

  N/A

• Are deadman switches, emergency stops tested and functional?

  Yes

  No

  N/A

Excavation Around Buried Services

• Before excavating, have all buried services been located and marked up?

  Yes

  No

  N/A

• Do you require an excavation or ground penetration permit?

  Yes

  No

  N/A

• Are you authorised to operate excavation equipment?

  Yes

  No

  N/A

• Have all the critical items on the Pre-start been checked and confirmed to be functioning correctly?

  Yes

  No

  N/A

• Is there an exclusion zone in place around the excavation area?

  Yes

  No

  N/A

• When personnel are within the slew radius of the excavating equipment, will the bucket be grounded and hydraulics disengaged?

  Yes

  No

  N/A

• Will operator wear the seatbelt?

  Yes

  No

  N/A

Contact With Electricity

• Are the HV cabinet panels clear and accessible, in accordance with local regulations or site requirements?

  Yes

  No

  N/A

• Have you checked that an approved isolation procedure has been followed?

  Yes

  No

  N/A

• Have you placed a personal lock on the appropriate isolation points?

  Yes

  No

  N/A

• Has the electrical isolation been verified by testing for absence of voltage? Via multimeter or approved device.

  Yes

  No

  N/A

• For troubleshooting and commissioning task on live equipment, are you following the approved procedure?

  Yes

  No

  N/A

• Have you checked the Arc flash label for the correct PPE?

  Yes

  No

  N/A

• Is the your electrical PPE in good condition?

  Yes

  No

  N/A

• Have you checked most recent electrical drawings?

  Yes

  No

  N/A

• Is portable earthing equipment properly connected and tested?

  Yes

  No

  N/A

• Is earth leakage protection (circuit interrupters) used in conjunction with general purpose outlets?

  Yes

  No

  N/A

• Are tools being used for electrical work properly rated for voltage that maybe present?

  Yes

  No

  N/A

• Are electrical tools in good condition and not modified in any way?

  Yes

  No

  N/A

• Has the meter been checked on a known live source before and after the test of absence of voltage?

  Yes

  No

  N/A

Fall from Heights

• Have you completed and read the SWMS?

  Yes

  No

  N/A

• Have you inspected your harness prior to use?

  Yes

  No

  N/A

• Have all other fall protection equipment been inspected prior to use?

  Yes

  No

  N/A

• Is your selected fall protection equipment adequate for task?

  Yes

  No

  N/A

• Are you trained and competent to be performing work at heights?

  Yes

  No

  N/A

• Have you selected the appropriate ladder or mobile platform?

  Yes

  No

  N/A

• Have you conducted a pre-use safety check?

  Yes

  No

  N/A

• Are you using the correct mobile work platform?

  Yes

  No

  N/A

• Have you checked the weather conditions allow for safe use?

  Yes

  No

  N/A

• Have ground conditions for mobile platform been accessed and allowed for?

  Yes

  No

  N/A

• Have you visually inspected the mobile scaffold?

  Yes

  No

  N/A

• Is the scaffold protected from moving vehicles and equipment?

  Yes

  No

  N/A

• Is the ladder being used appropriately?

  Yes

  No

  N/A

• Is the ladder set up on suitable foundations?

  Yes

  No

  N/A

Working at Heights

• Are you authorised and competent to work at heights?

  Yes

  No

  N/A

• Are you wearing fall protection equipment?

  Yes

  No

  N/A

• Have you inspected the fall protection equipment?

  Yes

  No

  N/A

• Is the fall protection equipment in date?

  Yes

  No

  N/A

• Do you require a height rescue plan?

  Yes

  No

  N/A

• Is an exclusion zone placed below?

  Yes

  No

  N/A

• Is the ladder of mobile platform appropriate for the task?

  Yes

  No

  N/A

• If working on a fixed structure has the structural integrity been visually assessed as safe?

  Yes

  No

  N/A