PRE-START SAFETY PLAN - New Version

• Job Number

• Conducted on

  Date

• Prepared by

• Site Address
  Address

GUIDELINES SUMMARY (tap here to minimise)

PURPOSE

• This form is to advise staff and subcontractors of BCD Group of the H&S policies and procedures to adhere to when undertaking site work in order to ensure everyone goes home safely

H&S REPRESENTATIVE

• Karly Boast | M: 021 831 902 | E: karlyb@bcdgroup.nz

H&S RESPONSIBILITIES

• You must be aware of the following legal obligations and comply with:
  - Health and Safety at Work Act 2015;
  - Health and Safety in Employment Act 2015; and
  - Department of Labour Codes of Practices and Guidelines.

CODE OF CONDUCT

• BCD Group has developed and implemented a structured Health and Safety Management Plan to establish and maintain a consistently high standard of safety performance, provided that all parties actively participate. The success of this policy will only be achieved by the active participation of all staff and contractors. Do not do anything that can cause harm to yourself or others.
  
  Ensure that before leaving for site that you take this form and ensure it is filled out in collaboration with the subcontractor on site prior to any work being undertaken. Ensure you have the approval of the client, applicant, contractor or agent to be entering the site.

PPE EQUIPMENT

• All persons on site are required to wear as a minimum the following:
  - Steel toe capped footwear
  - Hi-visibility vest/shirt
  Note: depending on the site and specific hazards present additional protective equipment may be required. This must be determined after undertaking the site-specific hazard identification form on the following page. This gear is available in all BCD Group vehicles, as well as in all offices.

FIRST AID FACILITIES

• There is a first aid kit and a fire extinguisher in the BCD Group motor vehicle

ACCIDENT REPORTING AND INVESTIGATIONS

• You shall immediately notify the BCD Group health and safety representative (Karly Boast) of any accidents or near misses that occur throughout the duration of your work on site. All accidents will be investigated, and we ask that you are honest and help with all investigations. Advise the health and safety representative if any first aid items or the fire extinguisher is used. All accidents will be recorded on the BCD group Incident/Accident register

SERVICE LOCATORS

• Are you performing work that takes place under the ground?

  Yes

  No

  N/A

• BCD requires at a minimum a before u dig and service plans from the client.
  
  When performing work that takes place under the ground, there is the potential to come in to contact with buried services. This can be a major hazard as it can cause damage to major infrastructure that will cost a lot to remediate or even high levels of injury and even death

  

• If the before U dig and client plans show definitively that services will not be affected, or the site is greenfield then works may proceed.
  
  If the site is considered brownfield, a detailed as-built service plan and/or confirmation from the client on site can be used to confirm buried service locations.
  
  If any doubt over the location of buried services occurs than a competent service locator will need to be used.
  
  Be sure to ask one or more senior co-workers if you are unsure of any buried service locations. DO NOT FEEL PRESSURED by contractors or even co-workers to work in an area if you are worried about a potential buried service, you’re the person doing the work!

• Is a Service Locator required?

  Yes

  No

  N/A

DESIGNATED EVACUATION AREA

• To prepare for the unlikely event of an emergency where an evacuation must be executed, please map out the designated evacuation area below:

  Drawing

SITE HAZARD IDENTIFICATION

• BCD TEAM MEMBERS:

  Select John Smith Ian Brown Anna King Harry Thomas Karen Stuart Michael Green Other

  • John Smith
  • Ian Brown
  • Anna King
  • Harry Thomas
  • Karen Stuart
  • Michael Green
  • Other

• "Other" BCD Team Member

• SUBCONTRACTORS

• SUBCONTRACTOR PERSONNEL:

• OTHER PERSONNEL:

• HAVE YOU DONE A SITE WALK-OVER? WHAT OTHER HAZARDS CAN YOU SEE?

• Would you like to see examples of hazards to help identify them?

  No

  Yes

  N/A

• Tap on table image below to zoom in on hazard examples.

  
HAZARD

• HAZARD (refer to examples table above if need be):

  Select Falls, Slips & Trips Hit by moving objects/machinery Contact with animals Noise Burns, Radiation and Electricity Chemicals and other substances Mental stress People Working around Public Sun/Dehydration Confined space Excavated trench Working at height Working with Geotech Equipment Services: Overhead and underground Working Alone Working around Traffic Other Hazard

  • Falls, Slips & Trips
  • Hit by moving objects/machinery
  • Contact with animals
  • Noise
  • Burns, Radiation and Electricity
  • Chemicals and other substances
  • Mental stress
  • People
  • Working around Public
  • Sun/Dehydration
  • Confined space
  • Excavated trench
  • Working at height
  • Working with Geotech Equipment
  • Services: Overhead and underground
  • Working Alone
  • Working around Traffic
  • Other Hazard

• Specify "Other Hazard" here

• CONTROLS REQUIRED:

  Select Be aware and survey the surroundings before entering the site. Avoid obvious unstable land and take extra care when crossing difficult areas. High Visibility Clothing or Vest Foot Protection Other Control(s)

  • Be aware and survey the surroundings before entering the site.
  • Avoid obvious unstable land and take extra care when crossing difficult areas.
  • High Visibility Clothing or Vest
  • Foot Protection
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Survey the surrounding area before entering the site. If machinery or vehicles are operating on site, ensure the operator is aware of your presence and only enter the site once the operator has given their approval. Stay away from pinch points and/or areas where you could be pinned. Safety Helmets High Visibility Clothing or Vest Other Control(s)

  • Survey the surrounding area before entering the site.
  • If machinery or vehicles are operating on site, ensure the operator is aware of your presence and only enter the site once the operator has given their approval.
  • Stay away from pinch points and/or areas where you could be pinned.
  • Safety Helmets
  • High Visibility Clothing or Vest
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Assess the site for potentially dangerous animals and only enter if safe to do so. Do not enter if you have any doubt or concern over your personal safety. Other Control(s)

  • Assess the site for potentially dangerous animals and only enter if safe to do so.
  • Do not enter if you have any doubt or concern over your personal safety.
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Ensure you understand the potential risks before arriving at site, speak with the applicant or agent and ensure you have authority to be on site. Assess the site for any machinery and use PPE if there is any excessive noise on the site. Hearing Protection Other Control(s)

  • Ensure you understand the potential risks before arriving at site, speak with the applicant or agent and ensure you have authority to be on site.
  • Assess the site for any machinery and use PPE if there is any excessive noise on the site.
  • Hearing Protection
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Ensure you understand the potential risks before arriving at site, speak with the applicant or agent and ensure you have authority to be on site. Assess the site for any additional hazards, proceed with caution and use correct PPE. Protective Clothing Other Control(s)

  • Ensure you understand the potential risks before arriving at site, speak with the applicant or agent and ensure you have authority to be on site.
  • Assess the site for any additional hazards, proceed with caution and use correct PPE.
  • Protective Clothing
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Assess the site for any of these hazards, proceed with caution and use correct PPE. If a Material Safety Data Sheet is available read this prior to entering the site. Safety Glasses Protective Clothing Other Control(s)

  • Assess the site for any of these hazards, proceed with caution and use correct PPE.
  • If a Material Safety Data Sheet is available read this prior to entering the site.
  • Safety Glasses
  • Protective Clothing
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Be aware of yourself and your physical/mental limits. Stop work immediately if you are fatigued or lethargic Ensure adequate breaks are taken throughout the day or whilst driving. Other Control(s)

  • Be aware of yourself and your physical/mental limits.
  • Stop work immediately if you are fatigued or lethargic
  • Ensure adequate breaks are taken throughout the day or whilst driving.
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Contact the land owners/ neighbours prior to entering the site Should the landowner or neighbour appear threatening upon arrival, neutralise the situation by leaving the property immediately. Tenants must be made aware by their landlords that someone is going to be on their property, if they are unaware you will need to leave the site. Other Control(s)

  • Contact the land owners/ neighbours prior to entering the site
  • Should the landowner or neighbour appear threatening upon arrival, neutralise the situation by leaving the property immediately.
  • Tenants must be made aware by their landlords that someone is going to be on their property, if they are unaware you will need to leave the site.
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Make sure all equipment is contained to a specific area and that it is easily seen. Do not create a trip hazard or block any emergency exits. Other Control(s)

  • Make sure all equipment is contained to a specific area and that it is easily seen.
  • Do not create a trip hazard or block any emergency exits.
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Assess the site for any of these hazards, proceed with caution and use correct PPE. If a Material Safety Data Sheet is available read this prior to entering the site. Safety Glasses Protective Clothing Other Control(s)

  • Assess the site for any of these hazards, proceed with caution and use correct PPE.
  • If a Material Safety Data Sheet is available read this prior to entering the site.
  • Safety Glasses
  • Protective Clothing
  • Other Control(s)

• CONTROLS REQUIRED:

  Select A buddy must be present at all times with open communication maintained Asides from this, all confined space work must be left to a certified professional unless prior approval has been given by BCD Directors on a case by case basis Safety Helmet Other Control(s)

  • A buddy must be present at all times with open communication maintained
  • Asides from this, all confined space work must be left to a certified professional unless prior approval has been given by BCD Directors on a case by case basis
  • Safety Helmet
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Legislation states not to get into a test pit more than 1.5 metres, however staff are advised 1 metre is the limit Other Control(s)

  • Legislation states not to get into a test pit more than 1.5 metres, however staff are advised 1 metre is the limit
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Staff are advised not to go within 3metres of an unprotected edge. Staff must be protected when at heights at all times BCD Policy is that if a ladder is being used, this must be done with 2 staff; one to hold the ladder while the other one climbs Ladder must be physically secured, level stable base and ladder appropriately rated while maintaining 3 points of contact. Other Control(s)

  • Staff are advised not to go within 3metres of an unprotected edge.
  • Staff must be protected when at heights at all times
  • BCD Policy is that if a ladder is being used, this must be done with 2 staff; one to hold the ladder while the other one climbs
  • Ladder must be physically secured, level stable base and ladder appropriately rated while maintaining 3 points of contact.
  • Other Control(s)

• CONTROLS REQUIRED:

  Select The user of these items must have been shown how to correctly use them by a more senior team member. Their training should be recorded in the BCD training files. Foot Protection Other Control(s)

  • The user of these items must have been shown how to correctly use them by a more senior team member.
  • Their training should be recorded in the BCD training files.
  • Foot Protection
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Ensure the correct PPE and sun protection (sun screen/clothing) is worn at all times and drink plenty of fluids whilst on site. Sun Protective Equipment must be worn on site Other Control(s)

  • Ensure the correct PPE and sun protection (sun screen/clothing) is worn at all times and drink plenty of fluids whilst on site.
  • Sun Protective Equipment must be worn on site
  • Other Control(s)

• CONTROLS REQUIRED:

  Select Someone must know where you are going, and you should have a communication line set up if you get injured or in trouble If the location of works is out of range, a call-in time should be established. Other Control(s)

  • Someone must know where you are going, and you should have a communication line set up if you get injured or in trouble
  • If the location of works is out of range, a call-in time should be established.
  • Other Control(s)

• CONTROLS REQUIRED:

  Select A barrier of some type (i.e. cones/fencing) should be set up between the work area and public/traffic and high visibility must be used. Vest High Visibility Clothing Other Control(s)

  • A barrier of some type (i.e. cones/fencing) should be set up between the work area and public/traffic and high visibility must be used.
  • Vest
  • High Visibility Clothing
  • Other Control(s)

• BCD GROUP OUTCOME SEVERITY TABLE

  

• BCD GROUP LIKELIHOOD TABLE

  

• Risk Score - Severity

  Minor (1)

  Low (2)

  Medium (3)

  High (4)

  Major (5)

• Risk Score - Likelihood

  Very Likely (5)

  Probable (4)

  Possible (3)

  Unlikely (2)

  Rare (1)

• Risk Score - Likelihood

  Very Likely (5)

  Probable (4)

  Possible (3)

  Unlikely (2)

  Rare (1)

• Risk Score - Likelihood

  Very Likely (5)

  Probable (4)

  Possible (3)

  Unlikely (2)

  Rare (1)

• Risk Score - Likelihood

  Very Likely (5)

  Probable (4)

  Possible (3)

  Unlikely (2)

  Rare (1)

• Risk Score - Likelihood

  Very Likely (5)

  Probable (4)

  Possible (3)

  Unlikely (2)

  Rare (1)

• IS THE RESIDUAL RISK REDUCED TO LOW OR ELIMINATES FOLLOWING IMPLEMENTATION OF CONTROLS?

  Yes

  No

• IF NO, WORK MUST STOP AND ALTERNATIVE METHODS INVESTIGATED. IF ANY DOUBT EXISTS, DISCUSS WITH A SENIOR MEMBER OF BCD OR H&S REPRESENTATIVE.
  
  **If a serious harm incident occurs, the site must be left as is until otherwise advises by a director, or WorkSafe NZ.

  

• Click "Add Hazard" above to identify another Hazard at this site.

SUBCONTRACTOR'S TASK RISK ANALYSIS

• Are there any subcontractors working on the job with you today?

  Yes

  No

  N/A

• HAS THE SUBCONTRACTOR PROVIDED THEIR OWN TASK RISK ANALYSIS OF THE SPECIFIC RISKS ASSOCIATED WITH THE ACTIVITY THEY WILL BE UNDERTAKING ON SITE?

  Yes

  No

• DOES THE FORM PROVIDED SUFFICIENTLY ADDRESS THE ASSOCIATED RISKS INTRODUCED BY THE SUBCONTRACTOR?

  Yes, it is sufficient

  No, it is insufficient

  No form provided

SIGN OFF

• BY SIGNING BELOW, YOU CONFIRM AGREEMENT TO THE SITE HAZARD IDENTIFICATION ASSESSMENT AND TASK ANALYSIS, AND YOU ALSO AGREE TO FOLLOW THE REQUIRED CONTROLS AT ALL TIMES.

BCD STAFF MEMBER(S):

• Full name and signature

  Sign
SUBCONTACTOR PERSONNEL:

• Full name and signature

  Sign
OTHER PERSONNEL:

• Full name and signature

  Sign

SUGGESTED MANAGEMENT

• PPE REQUIRED

  Yes

  No

  N/A

• Falls, Slips & Trips

  Yes

  No

  N/A

• Drains, ditches, ramps, steep and unstable land, steps etc

  Yes

  No

  N/A

• Be aware and survey the surroundings before entering the site. Avoid obvious unstable land and take extra care when crossing difficult areas

  Yes

  No

  N/A

• Hit by moving objects/machinery

  Yes

  No

  N/A

• Vehicles, machinery, moving equipment etc

  Yes

  No

  N/A

• Survey the surrounding area before entering the site. If machinery or vehicles are operating on site, ensure the operator is aware of your presence and only enter the site once the operator has given their approval. Stay away from pinch points and/or areas where you could be pinned

  Yes

  No

  N/A

• Contact with animals

  Yes

  No

  N/A

• Aggressive livestock, bees/wasps, dogs etc

  Yes

  No

  N/A

• Assess the site for potentially dangerous animals and only enter if safe to do so. Do not enter if you have any doubt or concern over your personal safety

  Yes

  No

  N/A

• Noise

  Yes

  No

  N/A

• Machinery, gun shots, blasting etc

  Yes

  No

  N/A

• Ensure you understand the potential risks before arriving at site, speak with the applicant or agent and ensure you have authority to be on site. Assess the site for any machinery and use PPE if there is any excessive noise on the site

Burns, Radiation and Electricity

• Fire, machinery, electric fences, power lines etc

  Yes

  No

  N/A

• Ensure you understand the potential risks before arriving at site, speak with the applicant or agent and ensure you have authority to be on site. Assess the site for any additional hazards, proceed with caution and use correct PPE

• Chemicals and other substances

  Yes

  No

  N/A

• Chemical storage areas, petrol tanks, spray storage areas, etc

  Yes

  No

  N/A

• Assess the site for any of these hazards, proceed with caution and use correct PPE. If a Material Safety Data Sheet is available read this prior to entering the site

  Yes

  No

  N/A

• Mental stress

  Yes

  No

  N/A

• Working late/long hours, driving, workload, personal

  Yes

  No

  N/A

• Be aware of yourself and your physical/mental limits. Stop work immediately if you are fatigued or lethargic. Ensure adequate breaks are taken throughout the day or whilst driving

  Yes

  No

  N/A

People

• Aggressive land owners/neighbours/tenants

  Yes

  No

  N/A

• Contact the land owners/ neighbours prior to entering the site. Should the landowner or neighbour appear threatening upon arrival, neutralise the situation by leaving the property immediately. Tenants must be made aware by their landlords that someone is going to be on their property, if they are unaware you will need to leave the site

  Yes

  No

  N/A

• Working around Public

  Yes

  No

  N/A

• In a mix used space. i.e. carpark

  Yes

  No

  N/A

• Make sure all equipment is contained to a specific area and that it is easily seen. Do not create a trip hazard or block any emergency exits

  Yes

  No

  N/A

Sun/Dehydration

• Sun exposure, heat

  Yes

  No

  N/A

• Ensure the correct PPE and sun protection (sun screenclothing) is worn at all times and drink plenty of fluids whilst on site

  Yes

  No

  N/A

• Confined space

  Yes

  No

  N/A

• House foundations, roof cavities

  Yes

  No

  N/A

• A buddy must be present at all times with open communication maintained. Asides from this, all confined space work must be left to a certified professional unless prior approval has been given by BCD Directors on a case by case basis

  Yes

  No

  N/A

• Excavated trench

  Yes

  No

  N/A

• Test pits

  Yes

  No

  N/A

• Legislation states not to get into a test pit more than 1.5 metres, however staff are advised 1 metre is the limit

  Yes

  No

  N/A

• Working at height

  Yes

  No

  N/A

• Ladders, second floor and above

  Yes

  No

  N/A

• Staff are advised not to go within 3metres of an unprotected edge. Staff must be protected when at heights at all times. BCD Policy is that if a ladder is being used, this must be done with 2 staff; one to hold the ladder while the other one climbs. Ladder must be physically secured, level stable base and ladder appropriately rated while maintaining 3 points of contact

  Yes

  No

  N/A

Working with Geotech Equipment

• Scala Penetrometer, Hand Auger, Shear Vane, Clegg hammer

  Yes

  No

  N/A

• The user of these items must have been shown how to correctly use them by a more senior team member. Their training should be recorded in the BCD training files

  Yes

  No

  N/A

Services:

• Overhead and underground

  Yes

  No

  N/A

• Overhead power lines buried waste/storm water pipes

  Yes

  No

  N/A

• An exclusion zone should be used around any overhead utilities in the area when preforming Geotech Investigations. A close approach or stand over may be required for overhead utilities when working with large machinery. A service locator is required when the location of buried services is unknown, and work may interfere with them

• Working Alone

  Yes

  No

  N/A

• Unaccompanied on site

  Yes

  No

  N/A

• Someone must know where you are going, and you should have a communication line set up if you get injured or in trouble. If the location of works is out of range, a call-in time should be established

  Yes

  No

  N/A

• Working around Traffic

  Yes

  No

  N/A

• Working in an active parking area

  Yes

  No

  N/A

• A barrier of some type (i.e. cones/fencing) should be set up between the work area and public/traffic and high visibility must be used

  Yes

  No

  N/A

• Have you done a site walk-over? what other hazards can you see?

  Yes

  No

  N/A

BCD GROUP OUTCOME SEVERITY

• SCORE

• SEVERITY

  Yes

  No

  N/A

HEALTH

• REPUTATIONAL

  Yes

  No

  N/A

SERVICE QUALITY

FINANCIAL LOSS

• Minor

  Yes

  No

  N/A

Minor – First Aid Only

• Unknown / No Impact

• Professional services fail to meet industry standards

  Yes

  No

  N/A

• No business interruption

  Yes

  No

  N/A

• Injury requiring medical attention

  Yes

  No

  N/A

• Known in the industry

  Yes

  No

  N/A

• Client complains verbally

  Yes

  No

  N/A

• Disruption to >5 staff for hours

  Yes

  No

  N/A

• $1k to $10k

  Yes

  No

  N/A

• Potentially life threatening, temporary disability

  Yes

  No

  N/A

• Local Reporting & Loss of community reputation

  Yes

  No

  N/A

• Client complains in writing

  Yes

  No

  N/A

• Branch interrupted for up to 1 day

  Yes

  No

  N/A

• $10k to $100k

  Yes

  No

  N/A

• Life threatening/ permanent disability

  Yes

  No

  N/A

• National Reporting & Loss of community reputation

  Yes

  No

  N/A

• Client advises no future business

• Business interruption for up to 5 days

  Yes

  No

  N/A

• $100k to $1M

  Yes

  No

  N/A

• Major

  Yes

  No

  N/A

• Fatality(s)

  Yes

  No

  N/A

• National Reporting with primetime TV coverage & Loss of national reputation

  Yes

  No

  N/A

• Loss of substantial market share

  Yes

  No

  N/A

• Business interruption over one week

  Yes

  No

  N/A

BCD GROUP LIKELIHOOD TABLE

LIKELIHOOD

• DESCRIPTION

• Occurs in the business annually

  Yes

  No

  N/A

Probable

• Has occurred in the business

  Yes

  No

  N/A

• Possible

• May occur in the business

  Yes

  No

  N/A

• Heard of in the industry

  Yes

  No

  N/A

• Rare

  Yes

  No

  N/A

• Unheard of in the industry

  Yes

  No

  N/A

• BCD GROUP OVERALL RISK LEVEL

  Yes

  No

  N/A

• OVERALL SCORE

LEVEL

• ACTION REQUIRED

• Permitted. Provided the risk reduction measures are followed, the level of risk is acceptable

  Yes

  No

  N/A

• Specific controls necessary as per risk reduction measures to ensure rick is effectively mitigated. Requires regular review/monitoring. Staff should have training or refer to team member with experience

  Yes

  No

  N/A

• The risk is unacceptable and therefore the hazard must be avoided or eliminated. Daily review and discussions with directors

SITE HAZARD IDENTIFICATION

• SITE ADDRESS:

• SUBCONTRACTORS:

  Yes

  No

  N/A

• DATE:

  Date

SUBCONTRACTOR PERSONNEL:

BCD TEAM MEMBERS:

OTHER PERSONNEL:

• HAZARD:

  Yes

  No

  N/A

• (refer to previous table)

  Yes

  No

  N/A

• CONTROLS REQUIRED:

• RISK LEVEL: (high/med/low) refer to table above

  Yes

  No

  N/A

• IS THE RESIDUAL RISK REDUCED TO LOW OR ELIMINATES FOLLOWING IMPLEMENTATION OF CONTROLS?

• *IF NO, WORK MUST STOP AND ALTERNATIVE METHODS INVESTIGATED. IF ANY DOUBT EXISTS, DISCUSS WITH A SENIOR MEMBER OF BCD OR H&S REPRESENTATIVE

• **If a serious harm incident occurs, the site must be left as is until otherwise advises by a director, or WorkSafe NZ

• Has the subcontractor provided their own task risk analysis of the specific risks associated with the activity they will be undertaking on site?

  Yes

  No

• does the form provided sufficiently address the associated risks introducted by the subcontractor? if no, the form must be completed.

  Yes

  No

• TASK RISK ANALYSIS – This section is to be used to identify any task specific hazards introduced to site by subcontractors

SUB CONTRACTOR TASKS

TASKS AND ASSOCIATED HAZARDS:

• BY SIGNING BELOW, YOU CONFIRM AGREEMENT TO THE SITE HAZARD IDENTIFICATION ASSESSMENT AND TASK ANALYSIS, AND YOU ALSO AGREE TO FOLLOW THE REQUIRED CONTROLS AT ALL TIMES

• BCD STAFF MEMBER(S):

  Yes

  No

  N/A

• NAME:

SIGN:

• DATE:

  Date

SUBCONTACTOR PERSONNEL:

OTHER PERSONNEL:

• WHEN YOU RETURN FROM SITE, ENSURE THIS FORM IS SCANNED AND ADDED TO THE JOB FOLDER

• Revision

• Approved

  Yes

  No

  N/A

• Released

  Yes

  No

  N/A

• Review Due

• DJH & KB

  Yes

  No

  N/A