Title Page

  • Conducted on

  • Prepared by

  • Location

Plant or Equipment Details

  • Name of Plant or Equipment

  • Where and how is the Plant or Equipment used?

  • Does the Plant or Equipment require registration with the regulator?

  • Describe the layout and physical conditions of areas of operation (including access and egress).

Drawing In / Trapping

  • Can a part of the body be drawn into or trapped in a 'nip-point’?

  • Drawing in or Trapping Hazards.PNG
  • Drawing in or Trapping Hazards 2.PNG

Entanglement

  • Can anyone’s hair, clothing, gloves, necktie, jewellery, cleaning brushes, rags or other materials become entangled with moving parts of the plant, or materials in motion?

  • Entaglement Hazards.PNG
  • Entaglement Hazards2.PNG
  • Entaglement Hazards 3.png

Crushing

  • Can anyone be crushed due to:<br>• material falling off the plant?<br>• uncontrolled or unexpected movement of the plant or its load?<br>• lack of capacity for the plant to be slowed, stopped or immobilised?<br>• the plant tipping or rolling over? <br>• parts of the plant collapsing?<br>• coming into contact with moving parts of the plant during testing, inspection, operation, maintenance, cleaning or repair?<br>• being thrown off or under the plant?<br>• being trapped between the plant and materials or fixed structures?

  • Crushing Hazards.PNG

Cutting, stabbing and puncturing

  • Can anyone be cut, stabbed or punctured?

  • Cutting Hazards.PNG
  • Stabbing & Puncturing Hazards.PNG

Shearing

  • Can anyone’s body parts be sheared between two parts of the plant or between a part of the plant and a work piece or structure?

  • Shearing Hazards.PNG
  • Shearing Hazards 2.PNG

Friction

  • Can anyone be burnt due to contact with moving parts or surfaces of the plant, or material handled by the plant?

  • Friction & Abrasion Hazards.PNG

Striking / Impact

  • Can anyone be struck by moving objects due to:<br>• uncontrolled or unexpected movement of the plant or material handled by the plant? <br>• the plant, parts of the plant or work pieces disintegrating? <br>• work pieces being ejected? <br>• the mobility of the plant?<br>

  • Impact Hazards.PNG

Other Hazards

  • Can anyone come into contact with fluids under high pressure due to plant failure or misuse of the plant?

  • Can anyone be injured by electrical shock or burnt due to:<br>• the plant contacting live electrical conductors <br>• the plant working in close proximity to electrical conductors? <br>• overload of electrical circuits?<br>• damaged or poorly maintained electrical leads or cables? <br>• damaged electrical switches? <br>• water near electrical equipment?<br>• lack of isolation procedures?<br>

  • Can anyone be injured by explosion of gases, vapours, liquids, dusts or other substances triggered by the operation of the plant or by materials handled by the plant?

  • Can anyone using the plant, or in the vicinity of the plant, slip, trip or fall due to:<br>• uneven or slippery work surfaces?<br>• poor housekeeping?<br>• obstacles being placed in the vicinity of the plant?<br>

  • Can anyone fall from a height due to:<br>• lack of proper work platform?<br>• lack of proper stairs or ladders?<br>• lack of guardrails or other suitable edge protection?<br>• unprotected holes, penetrations or gaps?<br>• poor floor or walking surfaces such as the lack of slip resistant surface?<br>• steep walking surfaces?<br>• collapse of the supporting structure?<br>

  • Can anyone be injured due to:<br>• poorly designed seating?<br>• repetitive body movement?<br>• constrained body posture or the need for excessive effort?<br>• design deficiency causing mental or psychological stress?<br>• inadequate or poorly placed lighting?<br>• lack of consideration given to human error or human behaviour?<br>• mismatch of the plant with human traits and natural limitations?<br>

  • Can anyone be suffocated due to lack of oxygen or atmosphere contamination?

  • Can anyone be injured by fire or come into contact with objects at high temperature?<br>

  • Can anyone suffer ill-health due to exposure to high or low temperatures?

  • Can anyone be injured or suffer ill health from exposure to:<br>• chemicals<br>• toxic gases or vapours<br>• fumes<br>• dust<br>• noise<br>• vibration <br>• radiation

Current Controls

  • Is guarding installed?

  • Select guarding installed...

  • Guarding combo.PNG
  • Are emergency stops installed at key areas of plant or equipment that are in reach of the operator?

  • 2.jpg
  • Is there a permit or isolation process implemented to ensure that plant and equipment cannot be energized in maintenance, cleaning or repair?

  • 1.jpg
  • Is training provided for operation of the Plant or Equipment?

  • Is there signage and warning stickers on or near the Plant or Equipment?

  • Is the Original Equipment Manufacturer (OEM) booklets or information available?

  • Are there Safe Work Method Statements / Job Safety Analysis / Standard Operating Procedures / Safe Work Instructions completed?

  • Is the Plant or Equipment regularly inspected?

Risk Rating

  • Based on the current risk controls implemented, what is the risk rating (align the likelihood and consequence on the risk matrix below to identify)?

    image (8).jpg

Further Controls

  • Can hazards present be eliminated?

  • Can the Plant or Equipment be substituted for a safer alternative?

  • Can engineering controls be introduced to reduce the risk to workers (consider additional guarding examples below)?

  • Add actions above detailing what must be done and by who.

  • Examples of types of Guarding to consider if not already present:

    Fixed Guard.PNG
  • Full enclosed.PNG
  • Guard for head and tail.PNG
  • Interlocking Guard.PNG
  • Self adjusting guard.PNG
  • Physical barrier.PNG
  • Machine Guards.PNG
  • Combination.PNG
  • Light curtain.PNG
  • Light curtain 2.PNG
  • Pressure sensitive.PNG
  • Perimeter Fence.PNG
  • Can administrative controls be added to reduce the risk to workers?

  • Can Personal Protective Equipment be provided?

Final Risk Rating (based on new controls being added)

  • Based on the new risk controls implemented, what is the risk rating (align the likelihood and consequence on the risk matrix below to identify)?

    image (8).jpg
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.