Roofing Pre-Start - Extreme Roofing

• Conducted on

  Date

• Project Name and/or Job Number

• Site Address

• Form completed by

• Project Manager

• Supervisor

• Location
  Address

• Attach Photo's of Worksite Entrance and Roof you will be working on - Capture all sides of the Roof Structure.

  Media

• When this form is complete forward it onto the Office and Client before work gets underway.

GENERAL

• Task Analysis/Safe Work Method Statement on site and suitable for job?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Has high risk work been identified and risk controls documented?

  Yes

  No

• Update Task Analysis/Safe Work Method Statement so that it has this information

• Task Analysis/Safe Work Method has been signed by all workers?

  Yes

  No

  N/A

• Ensure all workers sign on before they starting on the job.

• Are there any young or inexperienced workers?

  Yes

  No

  N/A

• Have they got an appropriate supervisor on site and working with them for the day?

  Yes

  No

  N/A

• Toolbox talks up to date?

  Yes

  No

  N/A

• Induction toolbox completed by all workers?

  Yes

  No

  N/A

• Safety Nets installed or Purlins installed with 500mm Centres.

  Yes

  No

• Nets should be pulled tight with minimal sag and bracing not installed in a safe way. Refer to the following WorkSafe document https://worksafe.govt.nz/topic-and-industry/working-at-height/safe-use-of-safety-nets/

• Stop work. Contact Project manager and organise a work plan to ensure that some for of fall protection is in place prior to work continuing.

PPE, FIRST AID, FIRE

• Steel Cap Boots/shoes

  Yes

  No

  N/A

• Suitable Gloves

  Yes

  No

  N/A

• Safety Glasses

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Face Masks (if grinding etc)

  Yes

  No

  N/A

• Suitable Gloves

  Yes

  No

  N/A

• Hard Hats

  Yes

  No

  N/A

• First Aid Kit

  Yes

  No

  N/A

• Sunscreen

  Yes

  No

  N/A

• Fire Extinguisher

  Yes

  No

  N/A

• Is there any hot work or work that could require a fire extinguisher being done on site?

  Yes

  No

• Has the fire extinguisher been serviced or purchased within the last year?

  Yes

  No

• Notify Supervisor/Project Manager. If Fire Extinguisher is damaged or Dated greater than 5 years a good, working fire extinguisher should be bought to site before any work that could cause fire is begun.

ROOFING WORK

• Is There Roofing Work Underway - Includes Installation of Roof Sheets, Flashings, Trusses, Rafters and Purlins etc

  Yes

  No

• Is there scaffold set up on site that provides adequate protection for all roofing work?

  Yes

  No

  Not in all areas

• A task analysis must be produced and followed for all areas where there is no protection. If it is work that can be measured in minutes, not hours working from a harness may be appropriate.

• Is it short duration work? i.e Work that can be measured in minutes, not hours?

  Yes

  No

• This job may be one that can be completed by a harness. Ensure task analysis is in place and and workers are signed on with appropriate qualifications starting the work. Ensure workers are signed on to the task analysis and workers hold appropriate qualifications before starting work.

• Do you confirm that you understand the following process and will attach a task analysis for the work or contact the Foreman/Supervisor to complete the form.

  Yes

  No

• Workers Signature

  Sign

• Ensure suitable edge protection in installed then complete another task analysis or safe work method statement prior to beginning the task.

• What is the roof pitch?

  +25 Degrees

  -25 Degrees

• Where the platform is located below the roof edge, it should be within 300 mm.
  Install the mid rail and bottom rail at 500 mm centres. Install the top guardrail 900 – 1100 mm above where the roof line projection intersects the guardrailing.
  

  

• Is the scaffold set up appropriately?

  Yes

  No

• Stop work on the roof and contact site foreman/scaffolder to fix. Contact your Manager

• Scaffold must be set up so that its platform is within 1m of the roof edge and appropriate rail height - see image

  

• Is the Scaffold setup appropriately?

  Yes

  No

• Stop work on the roof and contact Scaffolders to fix.

• Is Work Being Done on Roof or Roof structure within 2 metre's of the Gable Ends?

  Yes

  No

  N/a

• Does The Scaffold Have Gable End Protection Offering The Same Protection As The One In The Picture

  

• Is Scaffold setup to provide correct protection?

  Yes

  No

  N/A

• Scaffold is not set up for work within 2 metres of the gable ends without other controls being implemented.
  Contact Project Manager/Supervisor to organise a Scaffolder. Complete a Task Analysis and document any ongoing work.

• Site manager must be contacted. . No work is to be undertaken on the roof within 2 metres of the gable ends if protection is missing. Warning Barrier Must Be Put Up To Stop Worker Encroaching On 2 Metre Exclusion Zone. This applies for timber work.

FALL PROTECTION EQUIPMENT

• Harness Register up to date?

  Yes

  No

  N/A

• Do required workers have Working At Heights tickets?

  Yes

  No

  N/A

• All equipment tagged and in good condition?

  Yes

  No

  N/A

• Suitable anchor plates / static lines in use?

  Yes

  No

  N/A

• Suitable fall protection / fall restraint system for desired use? (pendulum effect etc)

  Yes

  No

  N/A

• Rescue Kit on site and accessible?

  Yes

  No

  N/A

• Workers trained in use of Rescue plan?

  Yes

  No

  N/A

• If rescue with crane required, has it been tested and recorded?

  Yes

  No

  N/A

LADDERS / TRESTLES / MOBILE SCAFFOLDS

LADDERS

• Are ladders going to be used on the job?

  Yes

  No

• Are the ladders in good condition? I.e. No bends or buckles, all rivets in place, stays in good working condition, feet not worn through and in good condition, steps free of debris.

  Yes

  No

• Ladders that are not in a good condition must be removed from site immediately.

• Trade Rated

  Yes

  No

• Remove ladder from site and find suitable option.

• Working Within Manufacturers Recommendations

  Yes

  No

• Stop work on ladder and find an appropriate ladder or appropriate working platform.
  https://worksafe.govt.nz/topic-and-industry/working-at-height/equipment-for-working-at-height/

• Site Manager To Contact Contractor And Forward On Information And Create Follow Ups
  https://worksafe.govt.nz/topic-and-industry/working-at-height/equipment-for-working-at-height/

• Three Points Of Contact

  Yes

  No

  N/A

• Are Ladders Used For Access Being Secured At The Top & Bottom

  Yes

  No

  N/A

• WorkSafe - Equipment for Working at Height
  https://worksafe.govt.nz/topic-and-industry/working-at-height/equipment-for-working-at-height/

• WorkSafe Guidelines - Safe working with ladders and stepladders
  https://worksafe.govt.nz/dmsdocument/20-safe-working-with-ladders-and-stepladders

MOBILE SCAFFOLDING

• Is Mobile Scaffolding On Site And In Use Or Being Setup For Use

  Yes

  No

• Refer to the following guidelines for information around the requirements for Mobile Scaffolding.

• https://worksafe.govt.nz/topic-and-industry/working-at-height/scaffolding-in-new-zealand/#lf-doc-20099

• Is the scaffold suitable for the purpose for which it is being used?

  Yes

  No

• Stop using the scaffold, reassess the situation and re-do a task analysis immediately.

• Does the mobile have ladder access to all deck levels?

  Yes

  No

  N/A

• Ensure appropriate suitable access is available for scaffold. Refer to Manufacturers instructions on scaffold if needed.

• Is the mobile fully decked, with the decks secured from moving?<br>If the mobile is not fully decked does it have guardrails to protect the voids?

  Yes

  No

  N/A

• Fully deck the platform so that there is no void for workers to fall through

• Are the top guardrails between 900 mm and 1100 mm high?

  Yes

  No

• Stop Using Scaffold, Set It Up As Per Manufacturers Recommendations.

• Are the castors lockable and marked with their SWL?

  Yes

  No

  N/A

• Ensure wheels are locked when scaffold is in use.

  Yes

  No

  N/A

• Is the scaffold stable (3 to 1 for 2 m or above, 2:1 for under 2 m) see below?

  Yes

  No

  N/A

• Ensure bracing is in place to manage the scaffold

  Yes

  No

  N/A

• Is the mobile more than 2.0 m away from the edge of a building and any floor penetrations, voids etc?

  Yes

  No

• Does the mobile have a plan brace if not fully decked within 3 m of the base?

  Yes

  No

  N/A

• Are the people using the mobile trained in its use?

  Yes

  No

• Refer to the following link for information around Mobile Scaffolding

• https://worksafe.govt.nz/topic-and-industry/working-at-height/scaffolding-in-new-zealand/#lf-doc-20099

HARNESS WORK

• Will work be undertaken from a harness?

  Yes

  No

FALL PROTECTION EQUIPMENT

• Harness Register up to date?

  Yes

  No

  N/A

• All workers have Working At Heights tickets?

  Yes

  No

  N/A

• All equipment tagged and in good condition?

  Yes

  No

  N/A

• Suitable anchor plates / static lines in use?

  Yes

  No

  N/A

• Suitable fall protection / fall restraint system for desired use? (pendulum effect etc)

  Yes

  No

  N/A

• Rescue Kit on site and accessible?

  Yes

  No

  N/A

• Workers trained in use of Rescue plan?

  Yes

  No

  N/A

• If rescue with crane required, has it been tested and recorded?

  Yes

  No

  N/A

• Has a TA been developed for this?

  Yes

  No

• Ensure all workers sign onto this and all controls are in place prior to beginning.

• Stop work and develop Task Analysis before beginning job. Ensure all workers are signed on before beginning

EWP

• Are Elevated Work Platforms going to be used on site?

  Yes

  No

• Only licensed operators using EWP?

  Yes

  No

  N/A

• Log books filled out daily?

  Yes

  No

  N/A

• EWP pre-starts up to date?

  Yes

  No

  N/A

• Correct PPE worn for EWP?

  Yes

  No

  N/A

• Exclusion Zones needed and maintained?

  Yes

  No

  N/A

• EWP is adequate for the job?

  Yes

  No

  N/A

• EWP is being used correctly and within load limits?

  Yes

  No

  N/A

ELECTRICAL

• Electrical equipment in good condition? i.e No damaged casing, no exposed wiring, no damaged plugs

  Yes

  No

  N/A

• Guards on Equipment

  Yes

  No

  N/A

• Guards must be installed back on plant before being used.

• Are workers trained in the safe use of the tools and PPE expectations?

  Yes

  No

• All electrical items tagged and in date?

  Yes

  No

  N/A

POWER LINES

• Is work going to be undertaken within 4 metres of power lines?

  Yes

  No

• 4m exclusion zone being enforced near all Low Voltage Power Lines, including plant, ladders, scaffold, handrail, carrying roof sheets?

  Yes

  No

  N/A

• Has the lines company been obtained if the 4m exclusion zone needs to be breached?

  Yes

  No

  N/A

• Has an electrician been notified/used to kill the power if 1.5m exclusion zone needs to be breached?

  Yes

  No

  N/A

ASBESTOS

• Is there the potential for asbestos on this job?

  Yes

  No

• Is this planned work?

  Yes

  No

• Contact Site Foreman/Project Manager and advise of potential asbestos

• Have all notifications been completed?

  Yes

  No

  N/A

• Has a Clearance Inspection been organised / completed?

  Yes

  No

  N/A

• All workers have the correct tickets (removal, supervisor, license #)?

  Yes

  No

  N/A

• Control Plan on site and filled out correctly?

  Yes

  No

  N/A

• Asbestos Register completed or up dated?

  Yes

  No

  N/A

• Controls in place?

  Yes

  No

  N/A

• Exclusion zones - Barrier / fence?

  Yes

  No

  N/A

• Signage on all entry and exit points?

  Yes

  No

  N/A

• Plastic, bags, tags, rags, tape etc?

  Yes

  No

  N/A

• Decontamination wash down area / shower?

  Yes

  No

  N/A

• Industrial Hepa Vacuum with spare bags?

  Yes

  No

  N/A

• Adequate PPE?

  Yes

  No

  N/A

• Minimum P2 Respirators with spare cartridges?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Safety glasses?

  Yes

  No

  N/A

• No work clothes on beneath overalls (just board shorts or similar?)

  Yes

  No

  N/A

• Disposable overalls?

  Yes

  No

  N/A

• Rubber boots?

  Yes

  No

  N/A

• Rubber gloves?

  Yes

  No

  N/A

• No power tools - unless they are dedicated to asbestos work and stored correctly?

  Yes

  No

  N/A

• All areas wiped, or vacuumed down?

  Yes

  No

  N/A

• All areas sealed with Bondcrete?

  Yes

  No

  N/A

• All tools, boots, gloves, vacuum wiped down?

  Yes

  No

  N/A

• All rags, overalls, vacuum bags, asbestos - bagged, tagged and disposed of with licensed operator?

  Yes

  No

  N/A

HOUSEKEEPING

• Yes

  No

  N/A

• Are all exclusion zones on the ground erected and maintained (EWPs, Falling objects, around materials)?

  Yes

  No

  N/A

• All materials on the ground are stacked neatly and secured?

  Yes

  No

  N/A

• All materials on the roof are secured with metal strapping?

  Yes

  No

  N/A

• All rubbish cleaned up daily and placed in bins?

  Yes

  No

  N/A

NOTES

• Enter any extra information here

• Additional photos

  Media

SIGNATURE

• Supervisor

  Sign

• Site Manager / Foreman

  Sign

• Workers Name

  Sign

• Workers Name

  Sign

• Workers Name

  Sign

• Workers Name

  Sign

• Workers Name

  Sign

• Workers Name

  Sign

• Workers Name

  Sign

• Workers Name

  Sign

• Workers Name

  Sign

• Workers Name

  Sign

• Workers Name

  Sign