Power Down Under - Job Safety Analysis Copy

• Site conducted

  Select

• Date

  Date

• Worksite / Location

• Conducted by

• Job Description

• Activity types covered by this form

  Select Traffic Management Environmental Excavation Project Activities Asset Location Maintenance Materials Handling Construction

  • Traffic Management
  • Environmental
  • Excavation
  • Project Activities
  • Asset Location
  • Maintenance
  • Materials Handling
  • Construction

• INSTRUCTIONS
  
  1. Please answer the questions below.
  2. Add photos and notes by clicking on the paperclip icon
  3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority, and due date
  4. Complete audit by providing digital signature
  5. Share your report by exporting as PDF, Word, Excel or Web Link

• Safety Note:
  This Safe Work Procedure does not cover exposing cables or pipes. Exposing cables and pipes requires special insulated tools

• Kind of operation

  Day Operations

  Night or Poor light Operation

• Note:
  Safety footwear, high visibility shirt or vest, sun protection if required (broad brim hat, sunscreen, tinted glasses)

• Note:
  Safety footwear, high visibility shirt or vest, sun protection if required (broad brim hat, sunscreen, tinted glasses) with safety vest or shirt suitable for night work (ie. Rated D/N with reflective strips)

Pre-Start Checks

• JOB REQUIREMENTS

  Select Dial Before You Dig plans in date Contractors dig permits in place Site inductions correct equipment on site equipment callibrated job scope discussed ATCO High pressure gas permit required High pressure gas locator APA high pressure gas locator DBNGP locator Confined space entry

  • Dial Before You Dig plans in date
  • Contractors dig permits in place
  • Site inductions
  • correct equipment on site
  • equipment callibrated
  • job scope discussed
  • ATCO High pressure gas permit required
  • High pressure gas locator
  • APA high pressure gas locator
  • DBNGP locator
  • Confined space entry

• Action by

Equipment Used

• Equipment Used

  Select Pipe and cable Locator GPR Mini Excavator Vacuum Excavator Shovel Prodder Crowbar

  • Pipe and cable Locator
  • GPR
  • Mini Excavator
  • Vacuum Excavator
  • Shovel
  • Prodder
  • Crowbar

Traffic Management

• Hazard(s)

  Select • Danger to vehicular and pedestrian traffic • Restricted traffic flow • Interference to local infrastructure • Risk of being hit by passing vehicles • Potential of fatality

  • • Danger to vehicular and pedestrian traffic
  • • Restricted traffic flow
  • • Interference to local infrastructure
  • • Risk of being hit by passing vehicles
  • • Potential of fatality

• Inherent Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Control Methods & Monitoring

  Select • Drive defensively • Park off the road not obstructing traffic or pedestrians • If the parked on road, vehicle warning signs used in accordance with local regulation, eg. mounted flashing orange lights and directional arrows • Work site must be protected from traffic, eg. Traffic management if needed • Signage included “workman ahead” or “Surveyors Ahead” if required • Signage required if worksite less than 3 metres from road edge, in accordance with local requirements such as the MUTCD • Traffic has clear view of at least 200 metres of workers • Temporarily reduce speed limit of traffic down 60kph or less • Motorists to observe road speed and any road directions

  • • Drive defensively
  • • Park off the road not obstructing traffic or pedestrians
  • • If the parked on road, vehicle warning signs used in accordance with local regulation, eg. mounted flashing orange lights and directional arrows
  • • Work site must be protected from traffic, eg. Traffic management if needed
  • • Signage included “workman ahead” or “Surveyors Ahead” if required
  • • Signage required if worksite less than 3 metres from road edge, in accordance with local requirements such as the MUTCD
  • • Traffic has clear view of at least 200 metres of workers
  • • Temporarily reduce speed limit of traffic down 60kph or less
  • • Motorists to observe road speed and any road directions

• Residual Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Action by

Site Awareness

• Hazards(s)

  Select • Possible damage to existing assets, eg underground cables and services • Risk of electric shock • Risk due to adjacent work activities • Risk due confined space; deep manholes • Potential of fatality

  • • Possible damage to existing assets, eg underground cables and services
  • • Risk of electric shock
  • • Risk due to adjacent work activities
  • • Risk due confined space; deep manholes
  • • Potential of fatality

• Inherent Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Control Methods & Monitoring

  Select • ‘Dial Before You Dig’ (phone 1100) contacted prior to work commencing and plan reviewed, Confirm location of HP gas using maps, locator and if needed proving. • Leave CP TP’s as found – no disconnection of cables • Assess hazards such as excavations adjacent to worksite • Confined space precautions including additional staff, harnesses, rescue procedures, continual gas monitoring, ect. • Precautions in place to manage risk of heat stroke including ample water consumption, sunscreen 30+ applied and reapplied as required, appropriate clothing (hat, loose trousers, tinted safety glasses, ect)

  • • ‘Dial Before You Dig’ (phone 1100) contacted prior to work commencing and plan reviewed, Confirm location of HP gas using maps, locator and if needed proving.
  • • Leave CP TP’s as found – no disconnection of cables
  • • Assess hazards such as excavations adjacent to worksite
  • • Confined space precautions including additional staff, harnesses, rescue procedures, continual gas monitoring, ect.
  • • Precautions in place to manage risk of heat stroke including ample water consumption, sunscreen 30+ applied and reapplied as required, appropriate clothing (hat, loose trousers, tinted safety glasses, ect)

• Residual Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Action by

Material Handling and Storage

• Hazard(s)

  Select • Exposure to hazardous chemicals • Damage to materials • Impact on access/egress to site • Theft/damage

  • • Exposure to hazardous chemicals
  • • Damage to materials
  • • Impact on access/egress to site
  • • Theft/damage

• Inherent Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Control Methods & Monitoring

  Select • Obtain Material Safety Data Sheets for any hazardous substances used on site • Protect equipment form weather, eg rain • Lock vehicle

  • • Obtain Material Safety Data Sheets for any hazardous substances used on site
  • • Protect equipment form weather, eg rain
  • • Lock vehicle

• Residual Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Action by

Sites Works

• Hazard(s)

  Select • Manual handling of pits and manholes • Injury caused by open pits or manholes • Injury caused by being struck by equipment • Injury caused by slippage or falls

  • • Manual handling of pits and manholes
  • • Injury caused by open pits or manholes
  • • Injury caused by being struck by equipment
  • • Injury caused by slippage or falls

• Inherent Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Control Methods & Monitoring

  Select Use of pit lid keys or alternative safety devises, eg manhole lid lifters Barrier guards placed around open pits and manholes Attach radio detection transmitter to cable sheath with Tom clamp Follow along the road or footpath with radio detection receiver observing existing hazards and environmental factors such as long grass and adverse weather conditions Spray paint identified cable location with appropriate colour as required by the service provider Maintain open communication with plant and machinery with two way radio Keep separation distances between LV's and plant

  • Use of pit lid keys or alternative safety devises, eg manhole lid lifters
  • Barrier guards placed around open pits and manholes
  • Attach radio detection transmitter to cable sheath with Tom clamp
  • Follow along the road or footpath with radio detection receiver observing existing hazards and environmental factors such as long grass and adverse weather conditions
  • Spray paint identified cable location with appropriate colour as required by the service provider
  • Maintain open communication with plant and machinery with two way radio
  • Keep separation distances between LV's and plant

• Residual Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Action by

Enviromental

• Hazard(s)

  Select • Dust • Noise • Oil • Waste • Pollution and sediment to storm water drains • Chemical/hazardous substances exposure

  • • Dust
  • • Noise
  • • Oil
  • • Waste
  • • Pollution and sediment to storm water drains
  • • Chemical/hazardous substances exposure

• Inherent Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Control Methods & Monitoring

  Select • Removal of waste from worksites • Check tyres and dispose of any contaminants appropriately

  • • Removal of waste from worksites
  • • Check tyres and dispose of any contaminants appropriately

• Residual Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Action by

Job Completion

• Hazard(s)

  Select Personal injury to passing pedestrians • Poor customer relations

  • Personal injury to passing pedestrians
  • • Poor customer relations

• Inherent Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Control Methods & Monitoring

  Select • Closes all pits and manholes • Remove all barriers, etc • Advise customers of completion of job and any observed hazards, eg broken or missing pit lids

  • • Closes all pits and manholes
  • • Remove all barriers, etc
  • • Advise customers of completion of job and any observed hazards, eg broken or missing pit lids

• Residual Risk Score

  Low

  Medium

  High

  Extreme

  N/A

• Action by

Working Team

• Is there more 1 person who participated on this job safety analysis

  Yes

  No

• IMPORTANT: All member is to provide a signature. Every new team member working on site needs to be added to this list. If substantial changes to JSA are required, then a new JSA must be completed.

• Working Team

Member

• • Name and Signature

  Sign

• Completed by (Name and Signature)

  Sign

• Supervisors phone number:

  Yes

  No

  N/A