Safety & Environmental Site Risk Assessment

Information

Purchase Order Number
Conducted on
Location
Prepared by

Job Details

Trading Name: Climat Air Control & Energy Centres Pty Ltd
Purchase Order #:
Date:
Builder:
- Rivergum
- Sekisui
- Hickinbotham
- Rendition
- Weeks Macklin
- Samuel James
- Happy Valley Homes
- Henley Homes
Site Address:

Section 1

101 Is the entrance to the site clear of materials and rubbish?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
102 Is your work area clear of materials and rubbish?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
103 Have you identified and managed risks to yourself from other trades working in your area?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
300 Is your electrical lead tagging current on your personal electrical equipment/tools?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
301 Have you ensured there is a RCD electrical safety switch from your power source?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
350 Is the safety certificate attached to the external scaffolding?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
351 Is the internal stair void scaffolding in place?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
352 Is the internal stair scaffolding safe and secure to industry standards?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
400 When working in and around trenches >1.5m deep, is there an appropriate bunting (barricading) and shoring up of sides?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
500 Are you using appropriate personal protective equipment as per OHS&W requirements?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?

Section 2

100 Is there a site sign with emergency contact details?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
150 Is there an on-site toilet?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
151 Is the on-site toilet easily accessible?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
152 Is the on-site toilet clean?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
153 Does the on-site toilet have sufficient water and is hygienic and clean for your use?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
200 Is thee a bin on site?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
201 Does the bin have sufficient room for your waste?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?
450 Is your work area clear of trip hazards?
Risk Rating Score (found by using the Risk Calculation Matrix):
Any actions taken by you to manage the hazard:
Risk Rating after managed:
Who took action to manage risk?

Risk Analysis

Comments and/or items that need to be addressed prior to construction:
Total Risk Rating Score:
Based on the risk rating score above, can you continue to perform your work safely?
If no, you must contact the relevant Climat salesman or the Climat warehouse prior to commencing work.
Date Contacted:
Action Taken: