Title Page
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Date and Time
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Site conducted
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SMAT Leader
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SMAT Receiver
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Who is the SMAT receiver?
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Employee Type
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Department
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What area is the receiver working?
- Maternini
- Poggi 1
- Poggi 2
- Poggi 3
- Press 39
- Press 40
- Press 56
- Press 58
- Maintenance
- Packing
- Grain Store
- Norton Store
- Testing
- Loading & Unloading
- Ovens
- Other
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What area?
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What area is the receiver working?
- Belt Line
- Slitter 1
- Slitter 2
- Slitter 3
- Sysco Press
- Silane Treatment
- Schon
- Samco
- Office
- Heat Tunnel
- Flexor 1
- Flexor 2
- Biko
- Other
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What area?
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What area is the receiver working?
- HR
- IT
- Customer Service
- Pod 1
- Pod 2
- Pod 3
- Finance
- Purchasing
- Sales
- Other
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What area?
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What area is the receiver working?
- Packing
- Receiving
- Bunnings
- Export
- Office
- Other
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What area?
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What area is the receiver working?
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Describe Task Performed
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Is this task routine or non-routine?
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How frequently do they do this task?
Checklist
Observations
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Procedures and Pre-Job Inspection
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Why is this a concern?
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Environment (5S, Exposure, Temp)
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Why is this a concern?
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Use of PPE
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Why is this a concern?
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Ergonomics and Manual Handling
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Why is this a concern?
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Pace
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Why is this a concern?
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Tools and Equipment
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Why is this a concern?
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Electrical hazards
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Is the electrical equipment tested and tagged?
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Is the equipment secured/locked/isolated?
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Is there any visible damage or exposed wires?
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Can you identify a high gravity risk?
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Describe the high gravity risk?
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Can you identify a high frequency risk?
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Describe the high frequency risk?
Completion
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SMAT Leader Additional Actions & Comments
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SMAT Receiver Comments & Improvement Suggestions
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Signature