SIEMENS INDUSTRY - Pre Start Safety Analysis V1.2_Sept 2014

• Pre Start Safety Analysis No.

• Service Order No. - Job/Contract No. (Optional)

• Client / Site - Customer Contact Details.

• Conducted on

  Date

• This Safety Analysis Prepared by:

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• What tasks are you going to do today? Use the drop down box at right or type in additional tasks.

  Select TEST FOR FAULT PERIODIC INSPECTION SERVICE CALL EQUIPMENT MODIFICATION INSTALLATION COMMISSIONING WORKS WARRANTY WORKS OTHER

  • TEST FOR FAULT
  • PERIODIC INSPECTION
  • SERVICE CALL
  • EQUIPMENT MODIFICATION
  • INSTALLATION
  • COMMISSIONING WORKS
  • WARRANTY WORKS
  • OTHER
• Location
  Address

• Any Additional Personnel Completing This Task:

  YES

• Sign here.

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• Sign here.

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• Sign here.

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START HERE.

• Have you completed a customerJSEA or SOP/SWMS for this task/s with hazards listed and controls identified and in place.

  no

  yes - take a photo of JSEA

• YOU MUST COMPLETE THE HAZARD CHECKLIST BELOW

• Add media

  Media

• Are you feeling well rested and fit enough to complete the task/s?

  YES

  NO

• Stop all work and consult your manager

• Are you familiar with the task/s ? <br>

  YES

  NO

• Stop all work and consult your manager

• Are the necessary tools/PPE to carry out the planned task/s available?<br>Ensure that any tools and PPE are in good condition prior to use.

  YES

  NO

• Stop all work and consult your manager

• Have you carried out this task at THIS worksite previously?

  YES

  NO

• Ensure that you have the correct licence AND training prior to completing the task/s and that you fully understand all risks prior to starting any work.

• Are you licenced AND trained for the task(s) that you are planning to do today?

  YES

  NO

• Ensure that you have the correct licence and training prior to starting work. If required consult your manager for direction.
  NOTE: Understand your license limitations especially regarding work with electricity!

• Will you be working alone to carry out the work?

  YES

  NO

• Ensure that you have organised a person to check on you periodically eg. SCCC/manager/customer when working remotely.
  or defer the work until a standby person can be found to assist you.

• Are there any other hazards that you can identify?<br>

  YES

  NO

• BEFORE STARTING WORK - Ensure that you have reviewed the supplied JSEA and any SOP/SWMS available . You may also add any additional hazards and controls in the text box below. YOU CAN WORK THROUGH THE HAZARDS BELOW ( IN Black Headings) and select controls that you have in place for each.

ALL IDENTIFIED HAZARDS SHOULD BE CONTROLLED USING THE HIERARCHY OF CONTROLS AND SHOULD BE SELECTED USING THE HIGHEST CONTROL POSSIBLE SO AS TO ACHIEVE AS LOW AS REASONABLY PRACTICABLE (ALARP) LEVEL OF RISK.

Site related hazards - work environment (slips,lighting,noise)

• Site related hazards - work environment (slips,lighting,noise)

• Slip/Trips and housekeeping hazards are present

  YES

  NO

• Ensure work area cleaned up prior to work and during.
  Ensure footwear is adequate for task/s
  Ensure that care is taken on stairs/uneven surfaces/slippery surfaces ( 3 points of contact, no distractions)
  

• Take a photo if required to record work area condition.

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• The lighting in the work area is inadequate.

  YES

  NO

• Ensure external lighting is in place prior to work starting.

• Work area is noisy.

  YES

  NO

• Remove noise hazard if able. Ensure PPE is used to protect hearing from noise.

• The work area is exposed to Wind/UV/Rain or other environmental hazard?

  YES

  NO

• Move to an area under cover if possible, use sunscreen and other PPE to minimise the effects of these hazards.
  

• Do you require PPE or barricading/protection/signage to safely carry out the work?

  YES

  NO

• Use barriers and protection where required around hazards with signage.

• ANY OTHER SITE, WORK ENVIRONMENT HAZARDS OR ISSUES?<br><br>

  YES

  NO

• Describe them briefly with controls that you have in place. (Take a photo if required)

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Electricity

• What voltage/s are you working with? Use the selection boxes below to select voltage ranges.

• ELV up to 50VAC/120VDC

• This is extra low voltage (ELV) - Continue work but ensure that no other voltage above 50 Volts AC (120V DC ripple free) is present.
  ISOLATE WHERE AT ALL POSSIBLE OR HAVE CONTROLS IN PLACE TO AVOID CONTACT WITH LIVE TERMINALS AND CONNECTIONS.
  Work can be carried out with training and competency, no licence required.
  
  

• LV up to 1000VAC/1500VDC

• Can the electricity supply be isolated?<br>

  YES

  NO

• Do you have a permit for work/isolation permit with risk assessment for energy sources AND controls listed.

  YES

  NO

• ENSURE THAT YOU HAVE A PERMIT TO WORK FOR THE PLANNED WORKS PRIOR TO STARTING ANY WORK

• Do you have a personal lock on an isolating device in place?

  YES

  NO

• PRIOR TO ANY TESTING OR STARTING WORK, ISOLATION POINTS FOR ENERGY SOURCES MUST HAVE A PERSONAL LOCK IN PLACE

• Is your test equipment fit for purpose AND have you tested your test equipment to a known source?

  YES

  NO

• TEST EQUIPMENT MUST HAVE INSULATED PROBES AND BE TESTED IN A KNOWN POWER SOURCE PRIOR TO USE. MULTIMETER MUST BE AUTO RANGING TYPE.

• Have you tested circuits for dead prior to touching any exposed terminals and connections?

  YES

  NO

• TEST FOR DEAD PRIOR TO ANY WORK USING TEST EQUIPMENT FITTED WITH 'TOUCH PROOF' TERMINALS. ENSURE THAT ALL ENERGY FROM UPS/CAPACITORS AND OTHER SOURCES IS ELIMINATED PRIOR TO ANY WORK.

• Is there any chance of coming into contact with exposed and energised parts?

  YES

  NO

• PROCEED WITH WORK ENSURING NO CONTACT WITH ANY EXPOSED AND ENERGISED PARTS.

• STOP ALL WORK AND CONSULT YOUR MANAGER FOR GUIDANCE - DO NOT WORK ON ANY EQUIPMENT WHERE YOU CAN CONTACT ENERGISED PARTS.

• HV Above 1000VAC/1500VDC

• Can the electricity supply be isolated?<br>

  YES

  NO

• Do you have a permit for work/isolation permit with risk assessment for energy sources AND controls listed.

  YES

  NO

• ENSURE THAT YOU HAVE A PERMIT TO WORK FOR THE PLANNED WORKS PRIOR TO STARTING ANY WORK

• Do you have a personal lock on an isolating device in place?

  YES

  NO

• PRIOR TO ANY TESTING OR STARTING WORK, ISOLATION POINTS FOR ENERGY SOURCES MUST HAVE A PERSONAL LOCK IN PLACE

• Is your test equipment fit for purpose AND have you tested your test equipment to a known source?

  YES

  NO

• TEST EQUIPMENT MUST HAVE INSULATED PROBES AND BE TESTED IN A KNOWN POWER SOURCE PRIOR TO USE. MULTIMETER MUST BE AUTO RANGING TYPE.

• Have you tested circuits for dead prior to touching any exposed terminals and connections?

  YES

  NO

• TEST FOR DEAD PRIOR TO ANY WORK USING TEST EQUIPMENT FITTED WITH 'TOUCH PROOF' TERMINALS. ENSURE THAT ALL ENERGY FROM UPS/CAPACITORS AND OTHER SOURCES IS ELIMINATED PRIOR TO ANY WORK.

• Is there any chance of coming into contact with exposed and energised parts?

  YES

  NO

• PROCEED WITH WORK ENSURING NO CONTACT WITH ANY EXPOSED AND ENERGISED PARTS.

• STOP ALL WORK AND CONSULT YOUR MANAGER FOR GUIDANCE - DO NOT WORK ON ANY EQUIPMENT WHERE YOU CAN CONTACT ENERGISED PARTS.

OTHER Energy Sources Present

• OTHER Energy sources present? Pneumatic / Gravity / Heat / Hydraulic / Radiation ETC.

• Select the identified energy source(s) from the drop down box/s.

  Select Communications Towers Fire Gravity Heat/Steam/Thermal Hydraulic Laser Pressurised Fluids/Gasses Pneumatic Radioactivity/Radiation Vibration OTHER

  • Communications Towers
  • Fire
  • Gravity
  • Heat/Steam/Thermal
  • Hydraulic
  • Laser
  • Pressurised Fluids/Gasses
  • Pneumatic
  • Radioactivity/Radiation
  • Vibration
  • OTHER

• Describe the "OTHER" energy source in this text box.

• Have you ensured the energy source is isolated and the hazard has been controlled to reduce the risk to As Low As Reasonably Practicable (ALARP)? <br>

  YES

  NO

• Select which level of control(s) you have in place to manage the risks from the hazard selected above using the drop down box.

  Select ELIMINATION SUBSTITUTION ISOLATION ENGINEERING ADMINISTRATIVE PPE

  • ELIMINATION
  • SUBSTITUTION
  • ISOLATION
  • ENGINEERING
  • ADMINISTRATIVE
  • PPE

• Stop all work until the energy source can be isolated.

• Please describe the controls that you have put in place to manage the hazard.

• Have you verified the isolation (no energy state) for the identified energy source?

  YES

  NO

• Stop all work until the energy source can be isolated and verified.

• Have you applied a personal isolating lock/ danger tag to isolation points (control valves/pins/group isolation board etc.) <br>

  YES

  NO

• Stop all work until the energy source can be isolated, you have verified it and have applied your personal lock to the isolation point(s).

• Please take a photo of any identified hazards that you feel may be relevant.

  Media

Work At Heights / Falls from Height / Open Holes / Excavations and Falling Objects

• Work At Heights / Falls from Height / Open Holes / Excavations and Falling Objects

• Select the Work At Heights hazard from the drop down box at the right.

  Select Work At Height Falling or suspended objects Open Holes / Excavated Holes OTHER

  • Work At Height
  • Falling or suspended objects
  • Open Holes / Excavated Holes
  • OTHER

• Please describe the additional work at heights hazard(s) in the text box below.

• Please select control measures in above multiple choice boxes or describe the controls that you have put in place to manage the hazard.

  Select Work at Ground Level Work on solid platform (not ladder) Use of approved harness/restraint system Use of edge protection/barrier Work on ladder with additional controls

  • Work at Ground Level
  • Work on solid platform (not ladder)
  • Use of approved harness/restraint system
  • Use of edge protection/barrier
  • Work on ladder with additional controls

• Add additional controls here if required.

• Please select control measures in above multiple choice boxes or describe the controls that you have put in place to manage the hazard.

  Select Work at Ground Level Work on solid platform (not ladder) Use of approved harness/restraint system Use of edge protection/barrier Work on ladder with additional controls

  • Work at Ground Level
  • Work on solid platform (not ladder)
  • Use of approved harness/restraint system
  • Use of edge protection/barrier
  • Work on ladder with additional controls

• I HAVE - ENSURED THAT IF A HARNESS OR OTHER FALL RESTRAINT SYSTEM IS USED, and I have been trained in its use and have assessed the equipment prior to use.

  YES

  NO

• Do not carry out any work at heights using harnesses or fall restraint systems unless you have appropriate training. Seek clarification from your manager/supervisor.

• Add additional controls here if required.

• Please take a photo of any identified hazards that you feel may be relevant.

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Confined Space - Environments with a likelihood of having reduced oxygen levels or contaminated air.

• Confined Space - Environments with a likelihood of having reduced oxygen levels or contaminated air.

• DO NOT ENTER the confined space unless:
  

• YOU have carried out as much work as possible outside the Confined Space <br>(Tried to eliminate need to enter where possible)

  YES

  NO

• DO NOT enter the confined space. Complete as much of the task as possible external to the Confined Space.

• YOU have received Confined Space Entry training and it is current. (Annual)

  YES

  NO

• DO NOT enter the confined space if you do not have training and it is current .
  Consult your manager or site person in charge for further instruction.

• YOU have a completed confined Space Entry Permit. <br>It has gas readings verified prior to entry.

  YES

  NO

• DO NOT enter the confined space unless you and the work team including standby persons
  have completed a CSE Permit and assessed the task inc. gas test.

• YOU have carried out a detailed risk assessment and identified controls are in place. <br>These might be specified on the JSEA and CSE permit.

  YES

  NO

• DO NOT enter the confined space unless you have controls in place for identified risks including
  ventilation and monitoring of the environment.

• YOU have a rescue plan with standby person/s outside of CS area and rescue equipment is appropriate for task.

  YES

  NO

• DO NOT enter the confined space until you have established a means for rescue
  should it be required including equipment and standby person(s).

• YOU have a personal gas detector that has been tested prior to entry with a 'BUMP' test

  YES

  NO

• DO NOT enter the confined space without having a personal gas detector with a current
  service tag and having done a "BUMP" test in last 24 hrs.
  

• YOU have a means of contacting emergency services if required. (A working, charged phone with mobile service or a landline)

  YES

  NO

• DO NOT enter the confined space until you have available a means of contacting emergency services should they be required.
  

• Please take a photo of any identified hazards that you feel may be relevant.

  Media

Chemicals and Hazardous Substances

• Chemicals and Hazardous Substances

• Select the identified substances using the drop down box at right.

  Select Asbestos Present Biological Hazards Present Chemicals Present Fibres/Glass/Plastics Present Flammable Materials Present Gases/Fumes/Vapours Present Toxic Substances Present Water/Brine/Effluent Present OTHER -Specify

  • Asbestos Present
  • Biological Hazards Present
  • Chemicals Present
  • Fibres/Glass/Plastics Present
  • Flammable Materials Present
  • Gases/Fumes/Vapours Present
  • Toxic Substances Present
  • Water/Brine/Effluent Present
  • OTHER -Specify

• Ensure controls are in place as per site requirements and assessed risks prior to starting work. Please add these in the text box below.

• Select all controls that are in place for Asbestos hazard.

  Select Asbestos is labelled Asbestos is on site register Controls are known and in place

  • Asbestos is labelled
  • Asbestos is on site register
  • Controls are known and in place

• DO NOT CONTINUE WORK UNLESS CONTROLS ARE IN PLACE THE ITEMS ARE LABELLED AND ON THE SITE REGISTER. Consult the your manager for further advice.

• Specify substance name here:

• I have an up to date (Less than 5 years old) MSDS for the substance/s and/or chemicals I am working with/near.<br>

  YES

  NO

• Continue work ensuring appropriate PPE and other controls are used when working with or near the substances/chemicals.

• Ensure that all exposure hazards are known & controlled prior to using them or working nearby.

• Please take a photo of any identified hazards that you feel may be relevant.

  Media

Machinery with moving parts - risk of entanglement or contact with vehicles. Forklift and other equipment interactions.

• Machinery with moving parts - risk of entanglement or contact with vehicles.

• Select identified hazard from drop down box.

  Select Cranes Overhead Fork Lift Trucks Mobile Plant/Machinery Other Risk of Entanglement

  • Cranes Overhead
  • Fork Lift Trucks
  • Mobile Plant/Machinery
  • Other
  • Risk of Entanglement

• Select appropriate controls that are in place prior to work being carried out that are not identified in other permits/JSEA.

  Select Barriers to cordon off area Signage for others Contact with other plant operators Guarding removed - isolated machinery

  • Barriers to cordon off area
  • Signage for others
  • Contact with other plant operators
  • Guarding removed - isolated machinery

• ENSURE THAT AFTER THE TASK ALL GUARDS ARE REPLACED AND AREA IS MADE SAFE

• Please take a photo of any identified hazards that you feel may be relevant.

  Media

Manual Tasks - Lifting, awkward positions, impacts, over exertion

• Manual Tasks - Lifting, awkward positions, impacts, over exertion

• Select from the drop down box the hazard/s identified.

  Select Use mechanical aids to lift Use correct lifting techniques Correct PPE for task Reduce the size of load

  • Use mechanical aids to lift
  • Use correct lifting techniques
  • Correct PPE for task
  • Reduce the size of load

• Select appropriate controls that are in place prior to work being carried out that are not identified in other permits/JSEA.

  Select Use mechanical aids to lift Use correct lifting techniques Correct PPE for task Reduce the size of load

  • Use mechanical aids to lift
  • Use correct lifting techniques
  • Correct PPE for task
  • Reduce the size of load

• Please take a photo of any identified hazards that you feel may be relevant.

  Media

Environmental - Spills/Pests,Vermin/Flora&Fauna interactions , Cultural Heritage.

• Environmental - Spills/Pests,Vermin/Flora&Fauna interactions , Cultural Heritage.

• Select from the drop down box the hazard/s identified.

  Select Potential for spills Generation of waste Pests/Vermin contact Contamination of air/water/soil Flora/Fauna Interactions Damage to cultural important sites

  • Potential for spills
  • Generation of waste
  • Pests/Vermin contact
  • Contamination of air/water/soil
  • Flora/Fauna Interactions
  • Damage to cultural important sites

• Select control you have identified and that you have in place prior to carrying out any work using drop down box.

  Select Appropriate bunds in place Cultural controls in place Pest controls used Spill control kit available Waste disposed of appropriately Waste recycled where possible

  • Appropriate bunds in place
  • Cultural controls in place
  • Pest controls used
  • Spill control kit available
  • Waste disposed of appropriately
  • Waste recycled where possible

• Please take a photo of any identified hazards that you feel may be relevant.

  Media

FINAL SIGN OFF

• FINAL SIGN OFF -By signing below.
  I have ensured that the job hazards are covered with appropriate controls,
  AND - That at the end of the task, the worksite will be made safe, be clean and all guards replaced.

• Add signature

  Sign

• Any additional personnel work ing on the task to also sign here.

  Sign

• Any additional personnel work ing on the task to also sign here.

  Sign

• Any additional personnel work ing on the task to also sign here.

  Sign

• Any additional personnel work ing on the task to also sign here.

  Sign

• Any additional personnel work ing on the task to also sign here.

  Sign

FEEDBACK -

• Use the checkbox to provide feedback as to how satisfied you are with the pre start application.

• Use the slider to score the app. 1 being needs improvement and 10 being its perfect don't change a thing.

• If there was anything that could be improved please add a brief note in the text box below.

•