Southern USI site Risk Assessment for rail sites

• Document No.

• Name of Supervisor/Leading Hand

• Name of worker conducting assessment?

• Site Number and Location

• Conducted on

  Date

• Task Being Carried Out

  Select Copy Change Graffiti Clean Maintenance Vegetation Site Measure Site Inspection Private Job Site Clean Up Installation

  • Copy Change
  • Graffiti Clean
  • Maintenance
  • Vegetation
  • Site Measure
  • Site Inspection
  • Private Job
  • Site Clean Up
  • Installation

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

  Yes

  No

• Read SWMS and Site Card immediately

• Check box if more than skin is being installed at a single location

• Are the weather conditions suitable for safe work?

  Yes

  No

• Select from list regarding weather hazards

  Work is indoor, not relevant

  Extra installers will minimise risk

  Changing install method will minimise risk

  Site needs to be held

• Does this site require you to sign in with Site Management or Security?

  No

  Yes

• If yes who was contacted?

• Do you consider the Site safe for all workers and the public?

  Yes

  No

• How can site be made safe for workers and public?

• Can all material and equipment used be transported to the site safely?

  Yes

  No

• Explain method?

• Are all vehicles parked correctly?

  Yes

  No

• Parking location

• Insert photo of parking hazard

  Media

• Has worksite been cordoned off correctly?

  Yes

  No

  N/A

• Equipment used to secure worksite?

  Select Witches hats Barricades Tape Signage Other

  • Witches hats
  • Barricades
  • Tape
  • Signage
  • Other

• For other, describe cordon method

• In case of emergency - call 000, stay calm and describe the situation clearly to emergency operator. Then cal a coordinator, secure the site and begin to complete an incident report

• Are all installer aware of emergency procedures for this site?

  Yes

  No

• Hold site until all workers are aware of emergency procedures

• Has an ambulance pick up point been identified?

  Yes

  No

• Hold site until all workers are aware of emergency procedures

• What is the Pick up point location and suburb?

• What is the nearest cross street?

• Is there an abseiler on site

  Yes

  No

  N/A

• Do you have the safety rescue pulley on site?

  Yes

  No

• Have all Electrical Hazards been identified and recorded on Site Cards

  Yes

  No

• What hazards have been added to site cards?

• Are there Overhead Power lines (OHPL)?

  Yes

  No

• What is the distance (m) and voltage (kV)?

• What hazard elimination method has been used?

  Shortened Tracking

  Isolation off power lines

  Caution

  Other

• List other method used to eliminate hazard of OHPL?

• Has power to the light box been turned off?

  Yes

  No

  N/A

• Where is the switch and who turned power off?

• If working near an electrical area like switchboard, have precautions been taken?

  Yes

  No

  N/A

• What precautions have been taken?

• Why can no precautions be taken?

• Insert photo of any electrical hazards?

  Media

• Are all workers using fall protection devices like harnesses and are they wearing helmets?

  Yes

  No

• Why are workers not wearing fall protection?

• Are there any height hazards for this site?

  Yes

  No

• What is the install method for this site?

  Select Fixed ladder Portable ladder Scaffold EWP Abseil Other

  • Fixed ladder
  • Portable ladder
  • Scaffold
  • EWP
  • Abseil
  • Other

• Is fixed ladder in good condition?

  Yes

  No

• What size ladder is used for this site?

• Can ladder be placed on even ground and secured to sign?

  Yes

  No

• How is ladder secured?

  Select Ladder brackets Ratchets

  • Ladder brackets
  • Ratchets

• Insert photo of ladder hazards?

  Media

• Is ladder being used by one person at a time, footed correctly and the climber has three points of attachment?

  Yes

  No

• Describe restrictions in ladder use?

• Is scaffold in good working order?

  Yes

  No

• Insert photo of scaffold hazard

  Media

• Who is ticketed operator?

• Has operator deemed EWP suitable to task, set up on firm, level ground and completed logbook?

  Yes

  No

• Explain EWP hazards?

• Are all workers trained and deemed competent by management?

  Yes

  No

• Hold install and call coordinators immeditely

• Are all ropes and gear in good condition?

  Yes

  No

• Hold installs and ring Coordinator immediately

• Are anchor points assessed as suitable?

  Yes

  No

• Hold installs and call Coordinator immediately

• Explain other height hazards that may exist?

• Are all permanent anchor points / static lines on site considered safe?

  Yes

  No

  N/A

• Hold install and call coordinators immeditely

• Insert photo of height hazards

  Media

• Is there a one way pulley being used on site?

  Yes

  No

• What type of communication is to be used between person setting up one way pulley and rope and persons on the ground?

  verbal communication

  mobile phone

  hand signals

• Name of person setting up one way pulley and rope.

• Is the person setting up one way pulley and rope trained and competent to safely and correctly set up the pulley for materials to be lifted?

  Yes

  No

• If No then stop work and have another crew member assist in safely setting up pulley

• A tag line should be used every time material is being lifted using the one way pulley, this will give the person on the ground all the control when material gets caught on any structure or rope gets tangled.

• Are you using a tag line while lifting the material?

  Yes

  No

• If no follow the below procedure.

• Should the material become caught on the structure without a tag line set up the person who set up the one way pulley is to inform the person hauling the skin from the ground to stop pulling the rope and let go of the rope, once the person on the ground has stopped pulling and let go of the rope then the person on the structure is to proceed to free the material from the structure. Once the material is free from structure and the person on the structure has moved away from the rope and pulley the the person on the ground is to proceed to pull the material up to site.

• Have all team members read and understood this procedure?

  Yes

  No

• Are all tools in good condition and been accounted for?

  Yes

  No

  N/A

• Explain tool hazards

• Are tools and equipment able to be secured when used at heights

  Yes

  No

  N/A

• Explain tool hazards

• Are all tools required to be used able to be kept inside cordoned off area?

  Yes

  No

  N/A

• Explain tool hazards

• Is there an MSDS for all chemicals being used on site?

  Yes

  No

  N/A

• Stop work and ring a Coordinator immediately

• Have chemical spill procedures been discussed?

  Yes

  No

  N/A

• Stop work and ring a Coordinator immediately

• Supervisors must make sure to write down and discuss hazards and controls as well as any other hazard not recorded elsewhere on the risk assessment

• Insert toolbox talk topics

• Is work to be performed on a Rail site?

  Yes

  No

• Does this site require a TFPC?

  Yes

  No

• Will all equipment remain clear of the rails, and not cause damage to trains or rail operator property?

  Yes

  No

• Hold site and contact Coordinator immediately

• Any accident or incident on Rail Sites needs to be reported management immediately.

Work group supervisor pre-work briefing.

• Track vehicle registration (plant guard) confirmed valid?

  Select Yes No

  • Yes
  • No

• Yes or no requires an appropriate comment.

• Is works it within a environment/ heritage protected area?

  Select Yes No

  • Yes
  • No

• Yes or no requires an appropriate comment.

• Area above/ below ground pipelines in the worksite?

  Yes

  No

  N/A

• Yes or no requires an appropriate comment.

• List additional & work related hazards.

• List controls.

• Provide all relevant safe work method statement numbers & titles.

• No.

• Title

• Provide particulars for scope of work, pre-work briefing & emergency management.

• Scope of work:

• Rail corridor number:

• PPE requirements:

• H. V. Permit sighted/nos:

• Evacuation point:

• Works outside rail corridor

  Select Yes No

  • Yes
  • No

• Works outside danger zone

  Select Yes No

  • Yes
  • No

• Briefing location:

• Time/ date:

• P.F.T holder:

• P.T.F mobile No.

• First aider:

• W.G.S. Depot:

• Nearest hospital:

• Spill kit location:

• Yes

  No

  N/A

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• Name of worker and R.I.W number:

• The work group supervisor MUST deliver a pre-work briefing & sign on all rail safety workers prior to commencing work on site

• Supervisor sign off: this risk assessment have been checked by me and verified as true and correct

• I declare that I am fit for duty, qualified in the role, hold a valid RIW/MTM card, attended the briefing and understood the task & hazards.

• Insert TFPC name:

  Sign

• Insert Supervisors name

  Sign

• Does the site card or power card require updating for this site

  Yes

  No

• Once both the risk assessment and SWMS have been consulted and completed, please sign below to state that you have read and understood all the safety conditions

• Insert Worker signature

  Sign

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  Sign

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  Sign

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  Sign

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  Sign

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  Sign

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  Sign

• Insert Worker signature

  Sign

• Insert any photos of miscellaneous hazards here

  Media