Site Safety Survey

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• APPENDIX 1: VF SSS Flowchart

  

INITIAL QUESTIONS PRIOR TO BEGINNING WORK

• Question 1: Have you recently reviewed all relevant JSA's? (If YES, go to Question 2) (If NO, you must complete Question 4)

  Yes

  No

  N/A

• If the JSA doesn't address the Hazards, identify the Hazards and assign Controls and Follow-up actions in the Hazard Identification section below.

• Question 2: Have you visited this site before? (If YES, go to Question 3) (If NO, you must complete Question 4)

  Yes

  No

  N/A

• Question 3: Are conditions the same as at your last visit to the site? (If NO, you must complete Question 4)

  Yes

  No

  N/A

• If you have answered YES to Questions 1, 2 & 3, you can PROCEED WITH WORK

HAZARD IDENTIFICATION

• Identify Hazards here and suggest Controls and Follow-up actions (refer to Apendicies for examples).

• Example: HAZARD: Hung up tree located 20m from Eastern boundary. CONTROL: Set up exclusion zone with flagging tape until tree can be safely removed by a harvester. FOLLOW-UP: GPS waypoint the location and add to Hazard register.

• Question 4: Can ALL Hazards be adequately controlled?

  Yes

  No

  N/A

• If the answer is NO, then DO NOT PROCEED WITH WORK.
  - Discuss Hazard control options with your Supervisor and/or OH&S and Safety staff before allowing safe work to continue

• If the answer is YES, the you can PROCEED WITH WORK.

• Question 5: Could any identified Hazards pose a risk to others?

  Safe

  At Risk

  N/A

• If the answer is AT RISK, Identify and implement follow-up actions (ie: How you will inform others)

APPENDICIES

• APPENDIX 2: Hazards to consider

  

• APPENDIX 3: VicForests JSA's

  

• APPENDIX 4: Possible Follow-up Actions