SIL Take 5 - RSS

• Site conducted

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• Job ID

• Description of Work Activity

• Location
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• Task Location (e.g. Cabinet 1, Plant room)

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• Conducted On

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Job details (For RSS only)

• For Service

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• Please enter site details if not in drop down list

• For Solutions

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• Please enter site details if not in drop down list

• Will you be completing any High Risk Construction work as part of this task?

  Yes

  No

  See Guideline

• A SWMS must be in place to perform the scope of work. If SWMS are not in place, develop and implement before proceeding. Appropriate training, PPE and safe systems of work must be implemented.

• Please review the attached guideline to determine if the work about to be completed is classified as High Risk Construction Work and take the appropriate action.

• Does the area you are working in have any devices or equipment which require isolation i.e. Fire curtain, Electrical/ Mechanical srevices etc...?

  Yes

  No

  See Guideline

• Do you feel fatigued or unfit for work?

  Yes

  No

  See Guideline

• Please escalate to your line manager or the EHS Team

  Yes

  No

  N/A

• Please review the attached guidelines and answer yes / no to the question.

• Do you have appropriate PPE for the tasks to be complete?

  Yes

  No

  See Guideline

• Please review the attached guideline and answer yes / no to the question. ***

• Please escalate to your line manager or EHS Team and ensure appropriate PPE is available prior to commencing the task.

• Additional Comments:

• Will you be using Siemens subcontractors as part of the scope of work?

  Yes

  No

• Are the subcontractors completing High Risk Construction Work?

  Yes

  No

  N/A

• Have you checked the subcontractors have signed on to approved SWMS for the task?

  Yes

  No

• High Risk Construction Work must ot proceed unless approved SWMS have been signed on to.

• Have you considered COVID-19 as a hazard and are adequate controls in place?

  Yes

  No

  See Guideline

• Please review attached guideline document for further information and answer yes / no to the question.

• Can controls be put in place to mitigate the potential hazards arising from COVID-19?

  Yes

  No

  N/A

• Please escalate to line manager or EHS Team for further guidance.

• Additional Comments:

• Is the area free from Slips, Trips and Falls?

  Yes

  No

  See Guideline

• Can controls be put in place to mitigate or reduce potential hazards arising from Slips, Trips and Falls ?

  Yes

  No

Please escalate to line manager or EHS Team for further guidance.

• Additional Comments.

• Please review attached guideline document and answer the question again.

• Is there a risk of damaging noise in your work area?

  Yes

  No

  See Guideline

• Please review attached guideline document for further information and answer yes / no to the question.

• Can controls be put in place to mitigate the potential hazards arising from damaging noise?

  Yes

  No

  N/A

• Please escalate to your line manager or EHS Team for further guidance.

• Are you working remotely / alone?

  Yes

  No

  See Guideline

• Can controls be put in place to mitigate or reduce potential hazards arising from lone working?

  Yes

  No

• Please escalate to your line manager or EHS team for further guidance.

• Please review attached guideline document for further information and answer yes / no to the question.

• Is there safe emergency access / egress to and from your working location?

  Yes

  No

  See Guideline

• Can controls be put in place to mitigate or reduce potential hazards arising from unsafe emergency access/egress?

  Yes

  No

• Please escalate to your line manager or EHS Team for further guidance.

• Please review attached guideline document for further information and answer yes / no to the question.

• Is there a risk of being struck by vehicle traffic?

  Yes

  No

  See Guideline

• Can controls be put in place to mitigate the potential hazards arising form vehicle traffic?

  Yes

  No

  N/A

• Please escalate to your line manager or EHS Team for further guidance.

• Please review attached guideline document for further information and answer yes /no to the question.

• Is there appropriate lighting in your working area?

  Yes

  No

  See Guideline

• Can controls be put in place to mitigate or reduce potential hazards arising from poor lighting?

  Yes

  No

• Please escalate to your line manager or EHS Team for further guidance.

• Please review attached guideline document and answer the question again.

• Is there a risk you may be exposed to harmful dust, fumes or vapours?

  Yes

  No

  See Guideline

• Please review the attached guideline for further information and answer yes / no to the question. ***

• Can controls be put in place to mitigate or reduce potential hazards arising from harmful dust, fumes or vapours?

  Yes

  No

  N/A

• Please escalate to your line manager or EHS Team for further guidance.

• Is there any likelihood of exposure to asbestos during your work?

  Yes

  No

• Is there an asbestos register?

  Yes

  No

• Is the work area/material where you are about to perform your scope of works listed in the Asbestos register?

  Yes

  No

A SWMS must be in place to perform the scope of work. If SWMS are not in place, develop and implement before proceeding, appropriate training, PPE and safe systems of work must be implemented. Note: Siemens are not to remove asbestos (This requires specialist licenced contractors).

• Additional Comments

Beware aware of possible asbestos containing materials. If you suspect asbestos containing material/s stop work and notify relevant line manager/site persons.

• Additional Comments

Check with building/site management if there is an Asbestos Register and if available, check working areas. If building is pre-December 2003 then there may be a risk of Asbestos Containing Materials being present, escalate to Manager / Supervisor. (Note: Only necessary if disturbing materials in working areas ie drilling walls/doors/ceilings, routing cabling, accessing cavities behind walls or in roof spaces, works where dust is created either manually or mechanically etc).

• Additional comments

• Are you using hazardous substances or dangerous goods?

  Yes

  No

  See Guideline

• Can controls be put in place to mitigate or reduce the potential hazards arising from hazardous substances or dangerous goods?

  Yes

  No

• Please escalate to your line manager or EHS Team for further guidance.

• Please review attached guideline document and answer yes / no to the question.

• Are you exposed to extreme temperatures / adverse weather?

  Yes

  No

  See Guideline

• Can controls be put in place to mitigate or reduce potential hazards arising from exposure to extreme temperatures / adverse weather?

  Yes

  No

• Please escalate to your line manager or the EHS Team for further guidance.

• Additional Comments:

• Please review attached guideline and answer yes / no to the question.

• Are you potentially exposed to any electrical hazards or using electrical equipment in your working area or within the scope of work you are performing?

  Yes

  No

  See Guideline

• Can controls be put in place to mitigate or reduce potential hazards arising from exposure to electrical hazards or electrical equipment?

  Yes

  No

SWMS/JSEA to be amended to reflect controls and then communicated to the relevant stakeholders

• Additional Comments

• Electrical work must not be performed live. Electrical workers must hold the relevant competency in accordance with Siemens Electrical Safety Standard. Identify and check for electrical hazards in the work area such as exposed connectors, exposed conductors, poor installations, unterminated cables, overhead power lines, live adjacent electrical equipment. If LOTO is required, individuals must apply own lock and tag and test for dead guidelines must be performed prior to starting works on the circuit. Apply suitable controls in accordance with Siemens Electrical Safety Standard. Ensure all electrical equipment is test and tagged and fit for purpose.

Potential hazards arising from electrical equipment to be discussed with relevant line manager.

• Additional Comments

• Please review attached guideline and answer the question again.

• Are you working in an area where there is a risk of falling objects, either from above or objects on your level falling to a level below?

  Yes

  No

  See Guideline

• Can controls be put in place to mitigate or reduce potential hazards arising from falling objects?

  Yes

  No

• Please escalate with your line manager or EHS Team for further guidance.

• Please review attached guideline document and answer the question again.

• Are you performing manual handling tasks?

  Yes

  No

  See Guideline

• Can controls be put in place to mitigate or reduce potential hazards arising from Manual Handling?

  Yes

  No

• Please escalate to your line manager or the EHS Team

• Please review attached guideline and answer the question again.

• Are you using a ladder?

  Yes

  No

  See Guideline

• Have you completed a ladder inspection within the last 30 days and the ladder has been free from damage during that time?

  Yes

  No

  N/A

• Please complete a ladder inspection be fore proceeding with the task.

• Please review attached guideline and answer the question again.

• Are there any uncontrolled environmental hazards? (e.g. waste)

  Yes

  No

  See Guideline

• Please review attached guideline and answer yes / no to the question. ***

Sign Off:

• I / we understand the scope of this work and have received the training/induction and am fit to carry out this task

• I am / we are legally licensed to carry out this work

• I / we confirm that the appropriate PPE / tools are available and will be used

• I / we feel safe performing the works and I'm / are able to focus on the task at hand

• Sign:

  Sign

• Additional Worker

Additional Worker

• Sign:

  Sign