M4E Safety Essential Verification - Working at Heights Rev -2

• 

• WestConnex M4E - Parramatta Rd Civil

• Safety Essential Verification - Working at heights - Rev 1

• Conducted on

  Date

Area Supervisor:-

• Select Simon Baldwin Michael Paton Ben Ashcroft David Wilson Brandon Leong Dave King Ben Forbes Vaughan Kimmins Mitch Stevens Bob Isaac John Kim Joe Vu Danielia Cullura Christian Timney Pauruc Smith Peter Masiroski Bo Yang Karly Douglas

  • Simon Baldwin
  • Michael Paton
  • Ben Ashcroft
  • David Wilson
  • Brandon Leong
  • Dave King
  • Ben Forbes
  • Vaughan Kimmins
  • Mitch Stevens
  • Bob Isaac
  • John Kim
  • Joe Vu
  • Danielia Cullura
  • Christian Timney
  • Pauruc Smith
  • Peter Masiroski
  • Bo Yang
  • Karly Douglas

Lead Inspector:-

• Select Simon Baldwin Michael Paton Ben Ashcroft David Wilson Brandon Leong Dave King Ben Forbes Vaughan Kimmins Mitch Stevens Bob Isaac John Kim Joe Vu Danielia Cullura Christian Timney Pauruc Smith Peter Masiroski Bo Yang Karly Douglas

  • Simon Baldwin
  • Michael Paton
  • Ben Ashcroft
  • David Wilson
  • Brandon Leong
  • Dave King
  • Ben Forbes
  • Vaughan Kimmins
  • Mitch Stevens
  • Bob Isaac
  • John Kim
  • Joe Vu
  • Danielia Cullura
  • Christian Timney
  • Pauruc Smith
  • Peter Masiroski
  • Bo Yang
  • Karly Douglas

Other members of the inspection team?

• Select Simon Baldwin Michael Paton Ben Ashcroft David Wilson Brandon Leong Dave King Ben Forbes Vaughan Kimmins Mitch Stevens Bob Isaac John Kim Joe Vu Danielia Cullura Christian Timney Pauruc Smith Peter Masiroski Bo Yang Karly Douglas

  • Simon Baldwin
  • Michael Paton
  • Ben Ashcroft
  • David Wilson
  • Brandon Leong
  • Dave King
  • Ben Forbes
  • Vaughan Kimmins
  • Mitch Stevens
  • Bob Isaac
  • John Kim
  • Joe Vu
  • Danielia Cullura
  • Christian Timney
  • Pauruc Smith
  • Peter Masiroski
  • Bo Yang
  • Karly Douglas

• Another auditor

• Discuss with workers and Supervisor - was performing the work at ground level or pre fabrication or preparing materials prior to arrival to site considered prior to undertaking the task?

• Take a photo of the working at heights area.

  Media

• Are Above the line controls being used for work at heights?

  Safe

  At Risk

• What type of work is being performed at heights

  Select Are fixed handrails in place Fixed or mobile scaffolding Ewp being used Work box Man box Platform ladders

  • Are fixed handrails in place
  • Fixed or mobile scaffolding
  • Ewp being used
  • Work box Man box
  • Platform ladders

• What type of protection is in place when working at heights?

  Select Exclusion Zone around the whole operation tgat has barriers to orevent access to workers not workingin the area A drop zone that will capture any dropped objects and does not allow workers access. Hard Barriers Danger Tape Working above signs Flagging Spotter in place

  • Exclusion Zone around the whole operation tgat has barriers to orevent access to workers not workingin the area
  • A drop zone that will capture any dropped objects and does not allow workers access.
  • Hard Barriers
  • Danger Tape
  • Working above signs
  • Flagging
  • Spotter in place

• Are all penetration covered and where required rated covers with Safe Working Loads on the cover?

  Safe

  At Risk

  N/A

• Are workers secured to a rated anchor point when using a Lanyard and Safety Harness

  Safe

  At Risk

  N/A

• Have platform ladders only been used where its not practical to use scaffold or an EWP?

  Yes

  No

  N/A

• Are workers familure with the fall protection equipment?

  Yes

  No

  N/A

• What should they be doing to maintain the equipment and ensure it's serviceable?

  Select Identify the need for fall arrest (Shock obsorber) Identify the need for fall restraint (No fall). Inspect all components before each use Is it tagged correctly? Rescue plan

  • Identify the need for fall arrest (Shock obsorber)
  • Identify the need for fall restraint (No fall).
  • Inspect all components before each use
  • Is it tagged correctly?
  • Rescue plan

• During EWP operations are workers aware if the risks of being pinned.

  Safe

  At Risk

  N/A

• Any comments from the inspectors?

Action required?

• Action

• Allocated to

• Action due

  Date

• Provide evidence action has been controlled or eliminated

• Select date

  Date

• Names of inspectors

  Select Simon Baldwin Michael Paton Ben Ashcroft David Wilson Brandon Leong Dave King Ben Forbes Vaughan Kimmins Mitch Stevens Bob Isaac John Kim Joe Vu Danielia Cullura Christian Timney Pauruc Smith Peter Masiroski Bo Yang Karly Douglas

  • Simon Baldwin
  • Michael Paton
  • Ben Ashcroft
  • David Wilson
  • Brandon Leong
  • Dave King
  • Ben Forbes
  • Vaughan Kimmins
  • Mitch Stevens
  • Bob Isaac
  • John Kim
  • Joe Vu
  • Danielia Cullura
  • Christian Timney
  • Pauruc Smith
  • Peter Masiroski
  • Bo Yang
  • Karly Douglas

• Lead Inspector to sign

  Sign