Information
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Alpha Code
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Site
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Project
- SRAN
- RAN-BAU
- Maintenance
- eDMR
- 2300 TDD
- WBB
- Other
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Serco
- Spark
- Connect 8
- Skycomms
- Broadspectrum
- Downers
- Other
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Prepared by
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Phone number:
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Other personnel on site
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Date
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Location
Section 1.0 - Site planning and Information
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For this assessment the following applies
Safe -
At Risk -
Fail -
Site Management and Planning
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Scope of Works
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Photo of site overview
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Permit to Work?
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Permit Number:
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***IMPORTANT***
Unless specifically identified in the permit no work on RF/Antenna/Mast/Tower/Feeders is allowed!
Where an RF Hazard is present NOP 4027 must be followed in all circumstances!
Site Information
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Is the site access information correct and up to date?
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Please insert correct site access information.
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Does the Land Owner(LO) have specific H&S induction process or special requirements for safe access to site?
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Has required process or induction been completed?
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Please provide details of induction or process.
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Please provide photo evidence of completion of induction.
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Stop work until LO requirements is fulfilled.
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Additional Site hazards to be added to site information? (4x4 access only, special key instructions, not suitable for MEWP or Crane etc.)
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please describe additional site hazards
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Is there a track, gravel, driveway, etc. to site? (other than normal registered road)
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Please provide details of any hazardous or areas that require any maintenance.NOTE - Please be clear if the issue is actually Hazardous or just needs some upkeep maintenance. If it actually Hazardous does the site require caution or a complete lock-down?
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Please provide photos of any hazards or areas requiring maintenance.
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Is there safe parking while working on the site?
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Picture of site layout displaying parking concern.
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List all site keys for this site you used.
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Is the area around site free of hazards?
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Does the area around the site require any maintenance? Weeds, Fences, Rubbish, etc.
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Please describe to best of your knowledge what maintenance is required.
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Does the shelter/Cabinet require maintenance or repair?
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Please describe to best of your knowledge what maintenance is required.
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Are steps and ramps in good condition with a firmly fixed handrail if steps above 1m?
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please photograph area
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Site safety signage?
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New Site signage pictures
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Interior of shelter or building clean, tidy, free from - water damage, slip and trip hazards? Any overhead hazards?
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please describe.
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Site access & additional site hazard photos.(Photo of road leading to site + any other access info)
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Vertical Fall Arrest Systems
- Railok
- Latchway
- Non-Climbable tower
- Rooftop
- None
- Other
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Photo of either Railok,Latchway, Non-Climbable or Rooftop safety systems.
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All contractors (including sub-contractors) have been provided with information relating to health and safety for the work they are undertaking?
Safety Gear
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Personal Protective Equipment/Safety Gear appropriate to the task is in being worn and is in good condition?
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PPE inspected before use?
Competency
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Principal Contractor Network Requirements
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2 Degrees
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Vodafone Sites
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Spark Sites - PTN & PTP Training
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Other
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Workers on roofs with proprietary anchor systems in place have completed US23229 and have a copy of their current certification on site?
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Workers on communication towers, poles and roofs have completed US 23229, 15757 and 17025 and have a copy of their current certificate on site?
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Are all persons on site competent and trained to undertake the tasks on site?
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Work should cease until persons competent to undertake the required tasks are on site. An incident report should also be sent to the relevant Principal Contractor
Emergency planning and equipment
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Is the site able to call for emergency assistance - Fire, Police Ambulance?
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Are appropriate Fire Extinguishers and First Aid kits on site?
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Emergency assembly point identified?
Environmental
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All site areas are kept tidy with litter removed from site appropriately?
General
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Have all visitors signed the visitor log and are hazards, risks and controls discussed with visitors prior to entering the site??
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Is the work site (including footpaths and roadways) clear and free from debris, rubbish and obstructions?
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Are slip and trip hazards being adequately managed?
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Is lighting adequate for carrying out tasks and and/or safe access?
Section 2.0 Access to Roofs, Brittle Roofs and RF
Roof Access
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Are persons on site working on the roof of a building?
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An assessment has been made of any internal ladders used to gain access to the roof to ensure they are structurally sound?
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Handrails are in place for ladders if required?
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Ladders extends 1 metre above the landing platform?
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Portable ladders meet AS/NZS 1892?
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Portable ladders are secured at the top and the bottom?
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If access to the roof is via an internal crawl space this should be considered a restricted space and a safe work method planned. (This must include a standby person who does not enter the restricted space).
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If work is being undertaken in a restricted space has a safe work method statement been established and implemented?
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Work should cease until a safe work procedures are in place
Brittle Roofs (Skylights, Asbestos Roofs, Openings, Roofs in Poor Condition)
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Is the roof surface brittle, in poor condition or has skylights?
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An assessment of the roof has been made to ensure it is strong enough to support the work activities being carried out. (Asbestos roofs are the majority of brittle roofs).
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Has the roof been inspected internally (if possible) to ensure it is sound?
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Has an competent person undertaken this assessment?
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Are areas such as skylights, roof openings designated as no go zones and barricaded off or covered if required?
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Are walkways with guardrails provided when work on fragile roofs cannot be avoided?
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If walkways are not provided is a fall arrest system being used?
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Work on the roof must stop until safe work methods are in place.
RF
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Are there RF hazards on site?
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RF warning signs are in place at access points?
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Are persons trained/competent/certified in RF Awareness
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Are appropriate RF monitors available and being used?
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Are RF monitors calibrated?
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Spark RF Shutdown Procedure NOP 4027 has been followed?
Section 3.0 - Equipment used for Working at Heights on Towers, Poles and Roofs
Machinery for working at Heights on Towers, Roofs and Structures
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MEWP, Crane, Scaffold or Guardrails being used on Site?
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Move to the next section
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Are workers on the ground wearing appropriate PPE e.g. Safety Helmets, Safety Boots, High Viz Vests and Eye Protection?
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Have exclusion zones been implemented and sufficient for the tasks being carried out?
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Assess any of the following equipment on site
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Mobile Elevated Work Platfrom
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Has the operator carried out a carried out a pre start inspection of the MEWP that includes functional and visual tests (required each day)?
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Is the MEWP clearly marked with the rated lifting capacity
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Weight of lift?
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Essential operating and maintenance instructions permanently displayed or stored in a conspicuous place on the MEWP?
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Is the six monthly inspection certificate displayed?
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Operator is trained and competent (US 23966 v1) and the corresponding unit for the type of MEWP being used?
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Hazards associated with power lines are appropriately controlled (no closer than 6.4 metres, or between 4 - 6.4 metres with appropriate controls in place. No work can be carried out within 4 metres of a power line without the written consent of line owner and this consent must remain on site at all times?
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Weather conditions are suitable for using the MEWP?
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Are harnesses, lanyard and attachment points available to all workers undertaking tasks from the MEWP?
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Is the MEWP set up on firm and level ground?
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Crane
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Is the plan and information provided by the crane supplier signed and accepted by the contractor on site?
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Is the crane set up on firm, level ground with barriers in place?
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Safe working distances are maintained from overhead power lines?
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No persons are standing under suspended loads?
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Tag lines are used where there could be load spin?
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The load does not exceed the lifting capacity of the crane
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Lifting capacity of the crane
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Weight of lift
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Clear lines of communication exist between the dogman/persons in bucket and the crane operator?
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Weather conditions suitable for the use of a crane?
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Scaffold or Mobile Scaffold
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Are the surface conditions suitable for scaffold access and stability - e.g level and safe to work on?
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Is there a health and safety management plan on site that clearly identifies those responsible for implementing control measures for the scaffold?
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Are site specific hazards e.g proximity to power lines and control measures included in the Safe Work Method Statement or JSA?
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The scaffold was erected, altered or dismantled by a person(s) who have been trained and have suitable experience with the type of scaffold being used?
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Are the wheels locked and turned out on mobile scaffolds?
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If a portion of the scaffold is above 5 metres above the ground the following conditions must be met
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The person assembling, altering or dismantling the scaffold have a certificate of competence
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Scaffold inspection card/register (Safety Tag) clearly visible in place by the access ladder and checked weekly?
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Notification has been sent to WorkSafe NZ
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Edge protection provided where a person could fall 2 or more metres
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Scaffold protected from passing vehicles or plant
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Ladders are secured top and bottom.
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Ladder extended 900-1000 mm above the landing platform.
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Planks are in good condition, 3 planks minimum and butted and secured.
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Edge Protection?
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Designed and constructed to by a competent person?
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Positioned appropriately?
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Will barriers and guard rails be regularly inspected
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Includes a toe board or mesh infill to prevent tools, materials and debris falling from the roof?
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Not used on a roof with greater than 35 degree slope (In this instance a MEWP, or Fall Restraint/Arrest system must be used)
Section 4.0 - Fall Restraint and Fall Arrest
Rope Access
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Is the approved double lanyard climbing method being used on Spark Towers?
Fall restraint and fall arrest systems
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Are fall restraint or fall arrest systems being used on site?
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Move to the next section
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All personnel trained and certified for working at height?
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Has the rigger undertaken a visual inspection of the structure, pole etc prior to work commencing?
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Is each person familiar with the work plan?
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Are personnel attached at all times while working at height?
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Has a drop zone been implemented and sufficient for the tasks being carried out?
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Is all equipment secure to prevent a fall from height?
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Does each member of the team have the required PPE?
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Two certified rescue climbers are on site at all times?
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Notification has been sent to WorkSafe NZ of the work?
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Has a SWMS or JSA been prepared for height work on site?
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Are there established safe access pathways to the anchor points?
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Is a certified fall restraint system available for use?
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If using a fall arrest system are suitable certified anchor points being used?
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Date anchor points certified to?
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Certified load?
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If certified anchor points are not available a Temporary Anchor Point Permit must be completed and a copy held on site
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The temporary anchor point permit has been signed by a competent rigger?
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Rope access work must cease until the permit is completed
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The temporary anchor point permit has been signed by the rescue climber?
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Rope access work must cease until the permit is completed
Section 5.0 - Other Safety Critical Risks
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For this assessment the following applies
Safe -
At Risk -
Fail -
Pedestrian and Public Safety
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Are members of the public/pedestrians passing the site?
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Is a spotter required on site?
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Is safe pedestrian access maintained on site at all times?
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Work vehicles are parked safely?
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Pedestrian and public safety
Electrical Safety
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Is electrical (230 v and over) work being undertaken on site?
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Procedures are in place for ensuring electrical equipment is de-energised before electrical work is carried out and methods in place to ensure that it cannot <br>be inadvertently re-energised (isolation, tagging and lockout)?
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Persons conducting work on electrical equipment are appropriately trained, registered and hold a practising license for the type of work being undertaken?
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Proven to be de-energised before work commences?
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Only ladders constructed of timber or fibreglass are to be used for work on or near electrical apparatus?
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All electrical equipment, extension leads and portable power tools are in good condition and regularly inspected, tested and tagged?
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Undertaken a CPR course (within the last 12 months) and Basic First Aid course (within the last 2 years)?
Live electrical work
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Is live electrical work being undertaken on site?
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A risk assessment and safe work method statement has been prepared before any live work is undertaken?
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When working on or near live electrical apparatus the following Safety Gear (PPE) is being worn
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Clothing covers the body from neck to wrist to ankle, (cotton)
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Sleeves rolled down and shirts tucked into trousers (protecting against entanglement and arc flash)
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Non metallic fasteners (or fasteners are protected by a layer of the same material as that of the garment)?
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Suitable eye protection?
Traffic Management
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Is the worksite in the road corridor or subject to frequent vehicle movements?
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Copy of the traffic management plan signed by the contractor and maintained on site?
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Traffic management setup is correct and according to the TMP?
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STMS contact number listed?
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Is there an escape route for the traffic controller?
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Comes and barriers in good condition?
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After hours TMP in place if necessary?
Section 6.0 - Health and Safety Summary
Spark Asset Management
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Have you installed, replaced, upgraded or alter any of the following assets?( drop down list- more than one asset can be selected.)
- Containers, Portacoms, Cabinets, Huts or Buildings (aka Shelters)
- Fall Protection - anchor points, latchway, rail lock or static line
- Antenna installation
- Tracks, Fences or Gates
- Power lines, power meters, transformer or generator connections.
- DC Plant, rectifiers or Batteries
- Inverters, DC-DC converters, UPS's or Controllers
- Air Conditioning, Fans or Filters
- Network equipment
- Other
- None of the above
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Select asset.
- Track
- Fence
- Gates
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Decommissioned,Upgraded, Altered or Relocated <br>
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Surface?
- Dirt
- Gravel
- Metal
- Grass
- Sealed
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Total Lenght (m)
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Access:
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Date:
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Decommissioned, Upgraded, Altered or Relocated
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Date:
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Decommissioned, Upgraded, Altered or Relocated
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Manufacturer?
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Date:
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Please select:
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Use of building?
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Location of Assets in building?
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please select:
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Manufacturer?
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Model?
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Date:
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Asset ID?
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Antenna installed -
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Is the tower-
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Tower, Mast, Light pole type-
- Tubular Tower
- Lattice Tower
- Stayed Mast
- Monopole Mast
- Tilt Over Mast
- Lamppost
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Tower, Mast, Light pole owner-
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Date:
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Is antenna on building
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Building owner?
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Date:
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Fall protection-
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Please select-
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Date:
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Anchor point/s is -
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Location-
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Date:
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Please select-
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New, Decommissioned,<br>Upgraded, Altered or Relocated? <br>
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Type-
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Length (m)?
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Date?
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New, Decommissioned,<br>Upgraded, Altered or Relocated?
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ICP?
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Meter Number?
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Owner?
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Location?
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Date?
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New, Decommissioned,<br>Upgraded, Altered or Relocated?
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Owner?
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Capacity (kVA)?
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Location?
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Date?
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New, Decommissioned,<br>Upgraded, Altered or Relocated?
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Model?
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Location?
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Date?
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DC Plant-
- DC Rack (one entry for each DC rack)
- Rectifiers (one entry per DC rack)
- Battery Strings (one entry per DC system)
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New, Decommissioned,<br>Upgraded, Altered or Relocated?
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Model?
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Asset ID of shelter?
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Manufacturer?
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Number of Rectifiers?
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Battery Model?
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Number of battery in strings?
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Date?
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UPS's, Inverters, DC-DC converters or Controllers
- UPS
- Inverter
- DC-DC Converter
- Controller
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New, Decommissioned, Upgraded, Altered or Relocated?
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Model?
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Asset ID of Shelter?
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Manufacturer?
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Air Conditioning, Fans or Filters-
- Air Conditioning
- Fan Standalone
- Filter Standalone
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Air Conditioning -
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Outdoor unit model?
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Indoor unit Model?
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Asset ID of Shelter?
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Outdoor unit manufacturer?
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Outdoor unit model?
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Outdoor unit Capacity?
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Indoor unit Manufacturer?
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Indoor unit model?
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Indoor unit capacity?
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Refrigerant?
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Number of filters?
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Filter Type?
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Asset ID of shelter?
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Date:
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Fan is
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Function?
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Type?
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Asset ID of shelter?
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Function?
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Type?
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Asset ID of shelter?
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Manufacturer?
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Model?
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Filter is?
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Function?
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Type?
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Asset ID of Shelter?
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Function?
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Type?
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Filter material?
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Depth(mm) x Width(mm) x Height(mm)
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Frame Material
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Asset ID of Shelter?
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Date?
Agreement
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Are any other hazards present on site, list below
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Are these hazards and risks being appropriately controlled?
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Were any unsafe work practices observed at the time of the assessment
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Please describe the unsafe practice observed below
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Required corrective actions
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Agreed date for completion of corrective actions
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Assessor
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- Spark
- Connect 8
- Skycomms
- Broadspectrum
- Downers
- Other
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Site representative
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- Spark
- Connect 8
- Skycomms
- Broadspectrum
- Downers
- Other
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Additional people
Person