Site Specific Risk Assessment v 1

• Location
  Address

• Conducted on

  Date

• Uniti Wireless
  
  Support 1300 847 201
  Level 2, 15 Leigh Street, Adelaide 5000
  

• Add location
  Address

• Select date

  Date

General

• Job Type

  Select New Installation Upgrade Repair Other

  • New Installation
  • Upgrade
  • Repair
  • Other

• Description

Risks

• Access:

  Internal Hatch

  Ladder

  EWP

• Ladder has 3 points of contact, Do not use top step, use of safety equipment

• Installer Operating EWP has the required licence

• Risk of Confined Spaces

  Safe

  At Risk

  N/A

• Use of protective clothing, Face Mask (if required), Identify any animal hazards

• Structural Hazards

  Safe

  At Risk

  N/A

• Weather Condition

  Safe

  At Risk

  N/A

• Asbestos

  Safe

  At Risk

  N/A

• Do not perform installation

• Tripping and Falls

  Safe

  At Risk

  N/A

• Power Tools

  Safe

  At Risk

  N/A

• Heavy Lifting

  Safe

  At Risk

  N/A

• Chemical Hazards

  Safe

  At Risk

  N/A

• Electrical Hazards

  Safe

  At Risk

  N/A

• Dust and Fumes

  Safe

  At Risk

  N/A

• Vehicle and Pedestrian Risk

  Safe

  At Risk

  N/A

• Other:

• Add media

  Media

SHWEMS

• All Personnel on site have read, understood and signed off on Uniti Wireless's Monthly SHWEMS

Personnel

• Who is present on site?

  Select Matthew Webber Lachlan Johncock Jamie Dowling Allan Banks Wade Denham Caleb Buhren

  • Matthew Webber
  • Lachlan Johncock
  • Jamie Dowling
  • Allan Banks
  • Wade Denham
  • Caleb Buhren

Sign Off

• I certify that all Risks have been Assessed, Controlled and Mitigated and that I comply with Uniti Wireless's Working At Heights Policy.

  Sign

• Additional Installer

  Sign

• Additional Installer

  Sign

• Additional Installer

  Sign

• Additional Installer

  Sign