Page 1: Project Info
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Site Risk Assessment No.
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Location
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Conducted on
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Conducted by
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Client
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Project name
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Town or Suburb
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Road
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Weather (choose multiple if required)
- Clear Sky
- Cloudy / Overcast
- Drizzle
- Raining
- Windy
- Hazy / Foggy
- Hot
- Cold
- Other
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Ground conditions (choose multiple if required)
- Muddy
- Wet
- Damp
- Dry
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Activities being carried out on site today
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DISCLAIMER
The assessor believes the information contained within this report to be
correct at the time of printing. The assessor does not accept responsibility
for any consequences arising from the use of the information herein. The
report is based on matters which were observed or came to the attention of
the assessor during the day of the assessment and should not be relied
upon as an exhaustive record of all possible risks or hazards that may exist
or potential improvements that can be made.
Information on the latest WHS laws can be found at the relevant State
WorkCover / WorkSafe Authority.
Page 2: Site Risk Assessment Details
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How many "PERSONNEL" are on site today
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Are personnel on site wearing the correct "PPE"
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Do you identify any of the following "SERVICES HAZARDS"
- Overhead power
- Telstra
- Water (covers / valves)
- Stormwater (manholes)
- Underground services
- Other
- Nil
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Is an Overhead Power Electrical "SPOTTER" required
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Do you identify any of the following "OBSTACLE HAZARDS"
- Overhanging branches
- Tree roots
- Buildings / structure overhands
- Poles
- Vehicles
- Other
- Nil
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Do any of the following "SAFETY HAZARDS" apply
- Pedestrian / vehicle traffic
- Working with plant
- Slips / trips / falls
- Working with chemicals
- Falling from heights
- Other
- Nil
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Do any of the following "ENVIRONMENTAL HAZARDS" apply
- Spills
- Noise
- Dust
- Rubbish
- Waterways
- Other
- Nil
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Did you discuss the control & management of the above "HAZARDS" with on "SITE PERSONNEL"
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Is the "IPMP - INTEGRATED PROJECT MANAGEMENT PLAN" on site
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Are personnel on site signed onto "SWMS" (visual check)
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Who is the "FIRST AID OFFICER" on site
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Is there a "FIRST AID KIT" on site (visual check)
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Is there a "SPILL KIT" on site (visual check)
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Is "TRAFFIC MANAGEMENT" required
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Traffic control company
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Have "MACHINERY PRE-START INSPECTIONS" been carried out on plant (visual check)
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Are appropriate "EROSION SEDIMENT CONTROLS" in place
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Are there any on site "ISSUES" that need to be discussed with Client / Management
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"ISSUES" details
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Did you carry out a "TOOLBOX TALK"
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What was your "TOOLBOX TALK TOPIC / S"
Page 3: Sign Off Details
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I verify I have carried out the following "SITE RISK ASSESSMENT" & discussed with the on site personnel. Any issues raised have been documented
Personnel -
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Personnel sign off
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QLD Construction Induction Card no.
