Information

  • This Risk Assessment is to be used in conjunction the departments generic risk assessments.

  • RAMS Conducted on

  • This document will assist you in completing the Risk Assessment. Please take a few minutes to complete all elements within this assessment. Once complete ensure you sign off the document and also include any other Team Members who are involved in the task/activity. Once complete please forward to your Supervisor / Manager. Thank you for your co-operation.

  • Machine Model & Serial Number

  • Site location

  • Risk Assessment & Method Statement carried out by

Pre-Visit Planning - COVID-19

  • Is the visit Customer or Business Critical?

  • Can the work be performed remotely or scheduled in the future when COVID-19 risk level is lowered.

  • Is the location within a COVID-19 high density area?

  • Where possible the visit should be postponed.

  • Can the site to be visited supply a copy or talk through their COVID-19 action plan?

  • This should be an area of concern and a high influencer as to if the visit is given approval. There should be details on how the site is adhering to social distancing and their cleaning arrangements.

  • Has the site being visited had a potential or confirmed case of COVID-19 in the last 7 days?

  • what cleaning procedures have been actioned to contain the spread?

  • Communicate to Customer that there is an expectation that they must inform Terex if they have any potential or confirmed cases of COVID-19 up to 7 days after the visit. Also inform the customer that Terex will inform them if the visiting TM has any COVID-19 symptoms in the 7 days following the visit. If the Customer does not agree the visit should not be approved.

  • How is the Terex TM going to travel to and from the site? Flights and public transport should be avoided where possible.

  • Does the Terex TM have hand cleaning facilities? Soap and water is the preferred option, carrying hand sanitiser is another option. It must not be relied upon that the site will have hand cleansing options.

  • Will at any time the visit require the TM to be within 2m/6ft of other persons?

  • Special procedures and PPE will be required and a risk assessment performed.

  • Will the TM be required to touch/operate a product or machine?

  • Pre-operation cleaning procedures must be in place.

  • Will a hotel be required during the visit?

  • Does the hotel have a robust COVID-19 action plan? The plan must give details on how the hotel is adhering to social distancing and their cleaning arrangements.

  • Contact your Supervisor for further guidance.

Day Before Visit

  • The site to be visited must reconfirm they have not had a potential or confirmed case of COVID-19 in the last 7 days. If they cannot confirm or cannot give details on cleaning procedures that have been actioned to contain the spread the visit should be postponed.

  • Is the Terex TM free of COVID-19 symptoms and had no contact with any persons with COVID-19 symptoms in the last 7 days?

  • An alternative TM must be sent or the visit postponed.

  • Does the Terex TM have adequate levels of hand/ cleaning products and COVID-19 associated PPE?

  • The visit must be postponed until stocks are received or contact your supervisor to make alternative arrangements.

Day Of Visit

  • Has the Terex TM completed the Self Check?

  • If the TM has not completed the Self Check or has COVID-19 symptoms or has had contact with any persons with COVID-19 symptoms in the last 7 days the visit must be postponed or an alternative TM sent.

  • When arriving at site the Terex TM must comply with all site procedures, if at any time the Terex TM feels the procedures in place expose them at an unreasonable level to COVID-19 then a job pause must be initiated and management contacted. If suitable procedures are not in place the TM should leave site.

  • If the Terex TM is required to work within 2m (6ft) of another person the following must be asked;
    ‘Are you free of COVID-19 symptoms and had no contact with any persons with COVID-19 symptoms in the last 7 days?’. If the other person has COVID-19 symptoms or has had contact in the last 7 days with a person who has COVID-19 symptoms, the TM should leave site.

Arrival at Site

  • Did you have a formal induction covering the emergency arrangements and site HSE procedures or have been made aware of these?

  • Ask your site contact what the emergency arrangements and site HSE procedures are.

  • Who is the point of contact on site and how is contact established?

  • Does the site require you to have a permit to work? If yes, state type of permit and retain a copy with your documents.

  • What type of permit is required?

  • Please provide a job description and step by step of the work you are going to carry out to support this Risk Assessment

  • Evaluate the ground conditions and site conditions and familiarise yourself with the machine Operations Manual and any other relevant information

  • If the equipment has a pre-operation inspection, please complete this.

Risk Assessment

  • Risk Matrix.JPG
  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify Hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

  • Do you wish to select additional hazards?

  • Identify hazard

  • Risk Rating Result

  • Please state countermeasures

The Environment

  • Are the weather and ground conditions suitable to complete the job? (e.g. is the area free of any manholes, potholes or visible underground services that could cause a risk).

  • Are you aware of the site procedures for traffic control and pedestrian traffic?

  • Are there roadways, potential traffic and/or people in the direct area? If yes, could the machine be moved to a safe location, roadway be closed and/or barrier used?

  • Is there suitable space to work around the machine removing any potential Line of Fire exposures?

  • Will I be working alone? Has approval from your supervisor been approved? If yes, outline agreed communication channel and who with.

  • If yes, outline agreed communication channel and who with.

The Task & Systems

  • I have performed pre-use checks and confirmed calibration/inspection dates of all tooling and equipment required to complete the task.

  • Will I be working at height? If yes, list equipment, controls used, rescue plans, rescuer etc.

  • Description of task/ reason why working at height is necessary?

  • Rescuer(s)

  • Competent person

  • First Aider

  • Emergency contact

  • Method of contact

  • Other:

  • Rescue Equipment

  • Location of Equipment

  • Other:

  • Have alternatives to using fall arrest equipment been considered?

  • Has rescue equipment been inspected and in good shape?

  • Is equipment adequate for the rescue plan?

  • Have communication devices been identified, located and tested?

  • Are all rescuers familiar with the use of rescue equipment?

Critical Rescue Factors:

  • Anchor Points

  • Landing Area

  • Rescue Obstructions or Hazards

  • Other

  • Will i be working with or in the vicinity of rigging? If yes, can I stand clear? If performing Rigging have I completed a Rigging Plan?

  • Will I be required to manually handle anything that requires lifting equipment or a second person?

  • Will the task involve the use of a forklift, telehandler, excavator or other equipment? If yes, is it in good condition and the operator is trained?

  • Will I be working in a confined or restricted space? If yes, 'Pause the Job' and seek advice.

  • Will I be working with another person(s)? If yes, is there a work plan and an agreed three way communication procedure. If working with person(s) under the age of 18 take into account lack of experience and knowledge.

  • Will I be performing a task that involves hazardous energy(s)? If yes, identify the hazardous energy(s), system(s) being worked on, list control measures and how you will verify the control measures are effective.

  • Gravity

  • Risk Level

  • How will I control and verify?

  • Pressure

  • Risk Level

  • How will I control and verify?

  • Motion

  • Risk Level

  • How will I control and verify?

  • Electrical

  • Risk Level

  • How will I control and verify?

  • Temperature

  • Risk Level

  • How will I control and verify?

  • Radiation

  • Risk Level

  • How will I control and verify?

  • Chemical & Biological

  • Risk Level

  • How will I control and verify?

  • Physical & Mental

  • Risk Level

  • How will I control and verify?

  • What are the specific steps (including barriers and communication) we will use when re-energizing?

  • What are the specific triggers to Pause this Job and re-evaluate?

  • Do I have: The correct PPE for the job and is it in good condition?

Confirmation and Sign-Off

  • Risk Assessment Complete?

By signing this:

  • I understand the nature of the work to be carried out, the risks and hazards involved and the control measures required.

  • Only plant and equipment specified in this document will be worked on and no attempt will be made by me or anyone under my control to use or work on any other plant/equipment.

  • I have assessed the risks associated with the site, the environment and the task that I am required to complete.

  • I am able to follow the Terex Life Saving Behaviours.

  • I feel confident that I perform the task safely and can ask for assistance if required.

  • I will advise the customer/site contact and/or my supervisor of anything I consider to be unsafe.

  • I am empowered to 'Pause the Job' and contact my supervisor if a "Job Pause" is required.

  • All site notices, rules and instructions will be observed and complied with in full.

  • Engineer/Assessor Signature:

  • Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:

  • Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:

  • Are there any other Team Members / Customer representatives / Dealer representatives / Contractor representatives/ Suppliers or Visitors present and/or involved in the task?

  • Please ensure all those involved have read, understood and signed above or below.

  • Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:

  • Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:

  • Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:

  • Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:

  • Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:

  • Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:

  • Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:

Notifications

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.