Information

  • Conducted on

  • Area

Details of Equipment being assessed:

  • Machine Description

  • Asset Number

  • LOCATION

  • Answer each Question, making sure you click on the [...] to expand the full question details. Add details to reinforce the reason for your response.

Regulation 5 & 6 - Maintenance and Inspection

  • Is the Electrical supply to the machine and associated equipment such as wiring ,plugs switchgear and other controls in good order?

Regulation 14 - Controls for starting or making a significant change in operating conditions.

  • Is the equipment designed so that it can only be started (or re-started after being stopped*) by a deliberate action by an operator using clearly defined controls?<br><br>N.B. “being stopped” includes being stopped for ANY reason including due to any interlock or other safety device having been triggered.

Regulation 15 – Stop Controls

  • Has the equipment got readily accessible controls which will bring the work equipment to a safe condition in a safe manner?

  • Does the “Stop Control” bring the equipment to a complete stop and switch off all sources of energy after stopping the functioning of the work equipment?

Regulation 16 – Emergency Stop Controls

  • Has the equipment got one or more readily accessible emergency stop controls, and are they available at every location where a person may need to activate them in order to prevent danger or injury to themselves or others ?

  • Do the emergency controls “latch closed” so that they require a deliberate action to release and reset them before the equipment can be re-started ?<br>(N.B. the equipment must NOT re-start when the emergency stop is re-set unless deliberately re-started using one of the correct “Start Controls”.)

Regulation 17 – Controls

  • Are all controls for the equipment clearly visible and identifiable?

  • Are all controls for the equipment in a position where any person operating the equipment is not exposed to a risk to their health and safety?

  • Are all controls for the equipment in a position so that the operator of any control is able to ensure that no-one is in a place where they would be exposed to any risk to their health or safety as a result of the equipment being started ?

Regulation 18 – Control Systems

  • Are the control systems designed such that any fault in, or damage to any part of, the control system or the loss of supply of any source of energy used by the work equipment cannot result in additional or increased risk to health or safety?

Regulation 19 - Isolation from sources of energy

  • Are there clearly identifiable and readily accessible means of securely isolating the equipment from ALL sources of energy ?

  • Is the equipment designed such that re-connection of any energy source does not expose anyone to any risk to their health or safety?<br>(e.g. the equipment should not start operating as a result of re-connection of a power supply or other energy source.)

Regulation 21 - Lighting

  • Is there adequate lighting, taking account of the operations to be carried out during all modes of operation of the equipment? (e.g. This includes adequate lighting for maintenance of inaccessible parts of the equipment etc...)

Regulation 22 - Maintenance operations

  • Can all maintenance operations on the equipment which involve a risk to health or safety be carried out while the work equipment is shut down and isolated fully from all sources of energy?

Regulations 23 and 24 – Markings and Warnings

  • Has the equipment got appropriate markings and warnings and are they all unambiguous, easily perceived and easily understood?

  • Action Plan

General Observations and Comments

  • Any other comments

Assessment Sign Off : Sign off only when any non conformances have been closed out. A non conformance prevents the machine being put into service . An observation is any action required which requires intervention to improve the machine but is not critical to the safe operation of the machine. If No ACTION is required that selection must be made otherwise the assessment cannot be completed.

  • Electrical sign off : This assessment was performed by the undersigned and is a true and accurate reflection of the equipment on the date of the assessment.

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