SRG Short Form JSA (Hoists)

• Site conducted

  Select

• Conducted on:

  Date

• Client:

• Site:

• HMS Contract # (5 Digit):

• Hoist Number:

BEFORE YOU START - Think about your safety

• I have read and understood the Work Instruction and Assessment

  Yes

  No

• I am fit for work, trained and competent to carry out required tasks

  Yes

  No

• I am wearing the correct PPE

  Yes

  No

• I have the required permits, certificates and / or authorisation to start this task

  Yes

  No

• if any of the ticked boxes are RED, see your Supervisor/Leading Hand

WORK AREA - is the work area safe to operate in ?

• Is there a risk of injury to people or damage to property

  Yes

  No

• What actions have been undertaken to eliminate or reduce the risk?

• Are there other work groups in my work area

  Yes

  No

• What actions have been undertaken to eliminate or reduce the risk?

• Are ground conditions suitable for safe completion of tasks?

  Yes

  No

• What actions have been taken to make good ?

• Are there any overhead hazards that will impact of works (electrical or otherwise)?

  Yes

  No

• What actions have been taken to eliminate the hazard?

• Can the works be undertaken safely in accordance with relevant Australian Standards and manufacturers instructions?

  Yes

  No

• If you have any questions or concerns regarding the works to be undertaken and associated conditions, consult with your supervisor to resolve before proceeding

• Completed By:

  Sign