Preliminary Hazard ID - New

Information

This Preliminary Hazard ID Checklist must be completed before the Site Specific Safety Plan is generated. Hazards ID'd are to be transferred to the hazard board and register.
Site:
Document No.
Prepared by

Day One Hazards

List all hazards that will exist more or less at the start of the job, including any that are pre,existing before we enter the home. These will be transferred to the hazard board and any appropriate paperwork will be entered.

You do not need to enter Hazards that will develop onsite unless specifically asked for, only those present on "Day one" of the job. Hazards

From the start of the job, the following will exist onsite..
PAINTS, Solvents, Chemicals
DUST, excessive amounts off
ELECTRICAL, existing electrical hazard
LAWN, uneven / cluttered. Or likely to turn to mud when wet
TENNANTS, unpredictable, high-risk or unstable tenants (will not be transferred to hazard board)

Compulsory Information

ASBESTOS , Was the site built after 1995, OR, have their been any major renovations after 1995, OR, Do you have any other reasons to suspect ACM to be present?
Instructions

Perform a visual inspection of these items and mark them according to the following;

YES - Asbestos likely / Confirmed - Item will be treated as Positive
TEST - Select if item needs to be tested (specify in details)
NO - Only select if you're positive it doesn't have asbestos
N/A - Select ONLY if we're not doing work on these areas, and it's unlikely to be added to scope later
FLOORING Is there vinyl or lino sheet or tile flooring?
Any further info?
Location
- Lounge
- Dining
- Wash House
- Bathroom
- Toilet
- Hall
- Bed 1
- Bed 2
- Bed 3
- Bed 4
- Other
CEILINGS Do the ceilings have a textured finish? Are ceiling tiles present? Do the ceilings have a lathe and plaster (skim coat?)
Location
- Lounge
- Dining
- Wash House
- Bathroom
- Toilet
- Hall
- Bed 1
- Bed 2
- Bed 3
- Bed 4
- Other
Any further info?
ROOFING Is the roofing corrugated cement or slate? Check guttering, downpipes, rainwater heads
Location
- Lounge
- Dining
- Wash House
- Bathroom
- Toilet
- Hall
- Bed 1
- Bed 2
- Bed 3
- Bed 4
- Other
Any further info?
SOFFITS Are the Soffit linings cement board or similar?
Location
- Lounge
- Dining
- Wash House
- Bathroom
- Toilet
- Hall
- Bed 1
- Bed 2
- Bed 3
- Bed 4
- Other
Any further info?
Interior linings Do walls have a sprayed or textured finish? Are walls lathe and plaster? Are walls made from cement sheet? Is there insulation board around fireplaces or similar? Is there plasterboard lining and a jointing compound?
Location
- Lounge
- Dining
- Wash House
- Bathroom
- Toilet
- Hall
- Bed 1
- Bed 2
- Bed 3
- Bed 4
- Other
Any further info?
CLADDING Is the cladding cement sheet board or shingle? Is imitation brick/stone cladding present?
Location
- Lounge
- Dining
- Wash House
- Bathroom
- Toilet
- Hall
- Bed 1
- Bed 2
- Bed 3
- Bed 4
- Other
Any further info?
INSULATION Is asbestos-based insulation in walls or ceiling suspected? Is lagging used for insulation? Is the hot water cylinder insulated?
Location
- Lounge
- Dining
- Wash House
- Bathroom
- Toilet
- Hall
- Bed 1
- Bed 2
- Bed 3
- Bed 4
- Other
Any further info?
OTHER Have the flues been inspected? Has the fire cement in older chimneys been inspected? Has the night store heater been inspected? Have fences been inspected? Are there other areas where asbestos or ACM is suspected?
Location
- Lounge
- Dining
- Wash House
- Bathroom
- Toilet
- Hall
- Bed 1
- Bed 2
- Bed 3
- Bed 4
- Other
Any further info?
INSULATION Is asbestos-based insulation in walls or ceiling suspected? Is lagging used for insulation? Is the hot water cylinder insulated?
Location
- Lounge
- Dining
- Wash House
- Bathroom
- Toilet
- Hall
- Bed 1
- Bed 2
- Bed 3
- Bed 4
- Other
Any further info?
Fuse Box Have fuse boards (millboards) or the lining in fuse holders been inspected?
Location
- Lounge
- Dining
- Wash House
- Bathroom
- Toilet
- Hall
- Bed 1
- Bed 2
- Bed 3
- Bed 4
- Other
Any further info?
CHILDREN, Will there be children under the age of 16 onsite during the repair?
If YES, inform the homeowner that while Cornerstone will take every precaution for their children's safety, it is their responsibility to watch them, and to keep them out of our trades person's way.
Decant Required (specify Reason if Yes)
DOGS present onsite, even if small and harmful
The homeowner must take all practical steps to ensure both our contractors and the dog(s) are safe and their work is not disturbed. Outline them below.
How will the dogs be managed?
- Dog Will be removed from site during repair
- Dog will be shut up in separate room (specify)
- Contractors are required to contact the tenant before entering site
- Other (specify)
Specify
Please note, Cornerstone may choose to suspend the work until the dog is safely contained

Critical Risks

The following information will assist in preparing the necessary permits and Task Analysis
Asbestos Removal, NON FRIABLE, to be done by Cornerstone staff.
Specify details of work
Photos of ACM to be removed
CONFINED SPACE - Ceiling Work
Specify type of work
CONFINED SPACE - Underfloor, other
Specify type of work
HEIGHTS - Permanent / Fixed Scaffolding
Specify type of work
HEIGHTS - Temporary Movable scaffolding
Specify type of work
HEIGHTS - Work of an extended ladder
Specify type of work
HEIGHTS - Work of the roof
Specify type of work
Overhead Power Lines / power lines entering house at soffiets?
How Close will we be working?
Power will need to be disconnected at the pole fuse, HS officer will action. Notify the tenant that power will be out for 8 hours that day and that they will need to make arrangements for any freezers, fridges or other appliances that require a constant supply of electricity.
Close approach consent required. Power will remain on. HS officer will action.