Sample - Pay TV Cable Installation Risk Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Worksite setup

• Pedestrian management assessed

  Yes

  No

  N/A

• Traffic management assessed

  Yes

  No

  N/A

• Appropriate signage and guarding utilised

  Yes

  No

  N/A

Assess/review the job and it's surrounds

• Presence of snakes, spiders and sharps assessed

  Yes

  No

  N/A

• Sufficient traffic and pedestrian access

  Yes

  No

  N/A

• All appropriate PPE on site

  Yes

  No

  N/A

• Weather conditions suitable

  Yes

  No

  N/A

• Light sufficient for all tasks

  Yes

  No

  N/A

Accessing underground plant

• Correct manual handling tools used

  Yes

  No

  N/A

• Manholes double guarded

  Yes

  No

  N/A

• Pits guarded

  Yes

  No

  N/A

• Gas detector used and nil gas present

  Yes

  No

  N/A

• Trip hazards, slippery ground assessed near open plant

  Yes

  No

  N/A

• Presence of snakes, spiders and sharps assessed

  Yes

  No

  N/A

• Plant under 1.5m deep

  Yes

  No

  N/A

• Spotter present for plant over 1.5m

  Yes

  No

  N/A

• Obstructions cleared to allow egress from plant

  Yes

  No

  N/A

• Sufficient light

  Yes

  No

  N/A

• Asbestos risk assessed

  Yes

  No

  N/A

• Unattended plant able to be guarded and safe

  Yes

  No

  N/A

Accessing customers premises

• Ground surfaces assessed for trips and slips

  Yes

  No

  N/A

• Noise, electrical and chemical hazards assessed

  Yes

  No

  N/A

• Presence of dogs,snakes, gases assessed

  Yes

  No

  N/A

• Exposed asbestos assessed

  Yes

  No

  N/A

• Breathing protection used in concealed/confined spaces

  Yes

  No

  N/A

• isolation of electrical hazards assessed

  Yes

  No

  N/A

• Underground/overhead services assessed

  Yes

  No

  N/A

• 3rd party present for concealed/confined space access

  Yes

  No

  N/A

• Faulty CLP assessed

  Yes

  No

  N/A

• Working at height assessed

  Yes

  No

  N/A

• CPE assessed as safe

  Yes

  No

  N/A

Cable flash testing, heat shrinking

• Burns, lead-poisoning and explosions assessed

  Yes

  No

  N/A

• Fire extinguisher present and accessible

  Yes

  No

  N/A

• Emergency contact possible

  Yes

  No

  N/A

Hauling and jointing

• Correct manual handling tools available

  Yes

  No

  N/A

• Fluid hazard assessed

  Yes

  No

  N/A

• Sharp tooling used with guards and away from body

  Yes

  No

  N/A

• All combustibles removed from work area

  Yes

  No

  N/A

Pit and pipe trenching and repair

• Public utilities identified

  Yes

  No

  N/A

• Hazardous materials assessed

  Yes

  No

  N/A

• Asbestos handling assessed

  Yes

  No

  N/A

• Appropriate guarding present

  Yes

  No

  N/A

Aerial cable installation

• Pole integrity assessed

  Yes

  No

  N/A

• Clearance from power assessed

  Yes

  No

  N/A

• Clear fall area assessed

  Yes

  No

  N/A

• Ground surface level and clear for ladder footing

  Yes

  No

  N/A

• Sufficient lean possible for 4:1 ladder angle

  Yes

  No

  N/A

Additional comments

• Additional comments

• Add signature

  Sign