Title Page
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Project Number/Site Location
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Conducted on
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Prepared by
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Task description
- GIS data collection
- General (detail/boundary) survey
- SUI mapping
- Laser scanning/Reality capture
- Investigation
- Drone/RPA
Pre-Task Checklist
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Do I have the correct: • Access to property • Service delivery support • Information • BYDA(DBYD)
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Think about: ·People/Systems affected ·Safe access/exits ·Nearby equipment or tasks ·Task set up ·Environmental impact ·Alternate method
Page 1
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Can I strain or over exert myself (Lifting, twisting, pulling or reaching)?
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Use appropriate tools and manual handling techniques. If opening covers that are heavy or that are unable to be slid open organise service delivery assistance.
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Can I slip or trip (Wet surface, obstacles, uneven surfaces, steps up/down)?
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Appropriate footwear. Assess ground conditions. Avoid slippery and unstable surfaces if possible. Use paths if possible. 3 points of contact when climbing steep steps or on steep terrain.<br>
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Can I damage any equipment?
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Assess risk to equipment. Are there alternatives? If working in public or busy areas, use one instrument at a time.
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Can I be caught in, on or between any equipment, tools or objects?
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Stop work. JSEA required.
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Could there be any uncontrolled movement (vehicle, mobile plant, equipment)?
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Suitable PPE (e.g., high vis, foot protection, long sleeves and trousers, gloves, safety glasses), Maintain situational awareness. Comply with any traffic controls.
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Can I come into contact with traffic?
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Do the traffic conditions meet the criteria in AGTTM-05 4.2 or 4.3 (Working in gaps between traffic), or 5.1/TW TM Proc01 (Work outside traffic lane), or TW 5E (Frequently changing work area outside traffic lane).
- AGTTM05 - 4.2 (Working in gaps in traffic)
- AGTTM05 - 4.3 (Short term works in traffic)
- AGTTM05 - 5.1/TMP 01 (Low impact works off travelled path)
- TW TMP 5A (Frequently Changing work area outside of traffic lane)
- No
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Shadow vehicle as per TW TMP 5A
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Is traffic management arranged?
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By whom?
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T1-5 signs to be placed 45m up from work area. Check every 2 hours. Log traffic plan.
Part 2
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Can I come into contact with something that may harm me (heat, fumes, electricity, gas, stored energy, traffic, hydraulics)?
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Are you using the hydraulic lifter. If so follow Survey SWMS.
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Stop work. JSEA required.
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Do I need to enter a confined space?
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Stop work. Organise access with Service Delivery. Requires multiple trained personnel and JSEA.
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Can I fall from a height or a live edge with no barriers (Not maintenance holes)?
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Stop work. JSEA required. Organise access with service delivery or revise work method.
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Are you surveying/inspecting maintenance holes or similar pits?
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Follow SWMS. Laser scan holes deeper than ~1.3m to avoid crossing live edge. Watch footing and minimise work near live edge. Hole must be barricaded or actively attended at all times. Follow confined space gas test procedure (crack/check) if holes suspected of containing gases (long residence times/slow flows).
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Could something fall on me or strike me (lifting operations, work overhead)?
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Stop work. JSEA required.
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Do I need to identify an exit path in case of emergency?
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Stop work. JSEA required
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Does anything need to be isolated (pump, valve, switch, equipment)?
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Stop work. JSEA required. Liaise with other teams.
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Do I have work mates or contractors I need to inform of the risk of my task?
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Stop work. JSEA required. Liaise with other teams.
Part 3 - Environmental hazards
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Am I working in adverse weather conditions (wind, heat, cold, lightning)?
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Use appropriate PPE. If windy, check for potential falling branches and avoid working in potential fall zones. If lightning, stop work and wait.
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Can I get sunburnt?
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Sunblock, hat, long sleeves/pants
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Am I working on a treatment plant or other similar complex site
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Are there any hazardous areas (e.g., digesters)?
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Identify hazardous areas, or ensure none within your work area.
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Is there a chlorine store on site?
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Identify chlorine storage, or ensure none within your work area.
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Any other chemicals to be aware of?
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Identify chemicals, or ensure none within your work area.
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Is there a likelihood of wildlife - snakes, insects?
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Appropriate PPE - foot protection, gloves, long sleeves/pants
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Am I working in an area of high bushfire risk?
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Have you checked for any nearby fires - http://www.fire.tas.gov.au/Show?pageId=colCurrentBushfires
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Am I working near or on water?
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Life jacket as per Survey SWMS. Spotter required if exiting water likely to be difficult.
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Stop work. JSEA required.