Southern USI Risk Assessment for train SAV installation 2019

• Document No.

• Name of Supervisor/Leading Hand

• Name of worker conducting assessment?

• Site Number and Location

• Conducted on

  Date

• Task Being Carried Out

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Have all workers on site read and understood the SWMS and Site Cards for this site?

  Yes

  No

• Read SWMS and Site Card immediately

• Are you using mobile scaffolding?

• If yes has the power been shut down?

• If the power is shut down has all installers placed their padlocks on the shut out switch?

  yes

  no

• Are you using water with soap for this install

  Yes

  No

• Is there any chemicals being used?

  Yes

  No

• If yes what chemicals are being used?

• Is the surface suitable to work/ install over?

  Yes

  No

• If yes what type of surface are you installing over?

• Is work being carried out during trade hours?

  Yes

  No

• Have you signed in at the front gate?

  Yes

  No

  N/A

• List any site specific hazards you may come across

• List any site specific hazards you may come across

• List any site specific hazards you may come across

Team sign off

• Team leader

  Sign

• Team member

  Sign

• Team member

  Sign

• Team member

  Sign

• Team member

  Sign

• Team member

  Sign

Once the job is complete please remove your padlock from the power shut down switch and signed out at the front desk and front gate before leaving site