Monthly Operations monitoring external areas

• Conducted on

  Date

• Prepared by

• Location
  Address

• Signage clear and readable, No hedge/ tree coverage on road, yard, loading/unloading areas?

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Yard markings clear and being followed by personnel?

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Roller doors and access routes being observed by staff?

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Is high visibility clothing being worn by staff in designated areas?

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Material handler drivers wearing seatbelts while operating?

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Visibility mirrors in good order and undamaged

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Materials Handler giving way to pedestrians or incoming/outgoing vehicles

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Access to vehicle beds being carried out with working at height controls (internal staff and external contractors)

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• HGV parked in designated park and loading bays?

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• General floor conditions suitable for loading and unloading.

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Housekeeping in the area suitable and not encroaching loading and unloading areas?

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Lighting levels externally suitable for loading and unloading

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Vehicle parking restricted to designated areas? (staff parking area)

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Material handlers when parked up and unattended have no keys in, hand break applied?

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Spill kits in place and checked for content

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Loading gas and fuel carried out with no other vehicle movements

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

• Material handlers traveling at 5 or less mph?

  Select No issues identified Procedural Non-Compliance Machinery Contact Cuts and/or Abrasions Manual Handling Injury Slip, Trip, Fall (Same / Level) Fall from Height Struck by Flying / Moving Object Exposure to Hazardous Substances Entrapment Entanglement Electrocution Impact Burns and/or Scalds Fire and/or explosion Accumulative Effects Other

  • No issues identified
  • Procedural Non-Compliance
  • Machinery Contact
  • Cuts and/or Abrasions
  • Manual Handling Injury
  • Slip, Trip, Fall (Same / Level)
  • Fall from Height
  • Struck by Flying / Moving Object
  • Exposure to Hazardous Substances
  • Entrapment
  • Entanglement
  • Electrocution
  • Impact
  • Burns and/or Scalds
  • Fire and/or explosion
  • Accumulative Effects
  • Other

• Corrective action taken

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other
Additional findings

• Other issues

  Compliant

  Non-Compliant

  N/A

• Details

• Corrective Action

  Select Procedure Advised to Personnel Hazard eliminated no further action needed. SSoW amended or reinforced Re-training instigated / required Machinery requiring repair Safety guarding applied Maintenance undertaken to repair Reported to overseer for correction. Inspection and further action required. Improve housekeeping PPE/RPE to be checked / repaired / replaced Other

  • Procedure Advised to Personnel
  • Hazard eliminated no further action needed.
  • SSoW amended or reinforced
  • Re-training instigated / required
  • Machinery requiring repair
  • Safety guarding applied
  • Maintenance undertaken to repair
  • Reported to overseer for correction.
  • Inspection and further action required.
  • Improve housekeeping
  • PPE/RPE to be checked / repaired / replaced
  • Other

Person responsible: -

• Signature: -

  Sign

• Date: -

  Date