SWMS/JSEA - City of Melbourne

• Site conducted

  Select

Programmed Safe Work Essentials - Every Job, Every Time

• When working for Programmed, you are expected to apply these safe work essentials EVERY JOB, EVERY TIME:
  • Present fit for work – not impaired by alcohol or other drugs, fatigue or pre-existing injuries.
  • Assess & discuss work related risks before starting work.
  • Re-assess the risks when there is a change to the task.
  • Confirm that all team members are competent & hold the correct licence or are supervised by a qualified person.
  • Ensure that suitable PPE is worn.
  • Verify that all tools & equipment used is in good working order & used as intended.
  • Identify line of fire hazards & take action to prevent being in harm’s way.
  • Use lifting aids & adopt practices such as team lifts & task rotation to minimise hazardous tasks.
  • Stop & report any unsafe work or condition.

• Date

  Date
• Location
  Address

• Job Number: WA

• Works being completed

• Person responsible for completing & ensuring compliance with SWMS / JSEA

• By signing this, you confirm all hazards will be identified and controls will be put in place and the persons listed on this document will be informed of the hazards and controls.

  Sign

Required Personal Protective Equipment

• Required Personal Protective Equipment

  Select Head protection Eye protection Hearing protection Foot protection Hand protection Safety Harness Respirator Sun Smart (hat, sunscreen etc) Other

  • Head protection
  • Eye protection
  • Hearing protection
  • Foot protection
  • Hand protection
  • Safety Harness
  • Respirator
  • Sun Smart (hat, sunscreen etc)
  • Other

• Please state other PPE used

Work Permits

• Are specific work permit(s) required?

  Yes

  No

• Permit types required?

  Select Confined Space Work at Heights Isolation/Energisation Hot Works Excavation/Trenching Other

  • Confined Space
  • Work at Heights
  • Isolation/Energisation
  • Hot Works
  • Excavation/Trenching
  • Other

• Type

Working at Heights

• • That I consider all options to eliminate the need to perform work at height.
  • Height access equipment is checked before use & operated only by certified & competent personnel.
  • Fall barriers, restraints & arrest devices, anchor points are set up & used.
  • Rescue plans are understood & accessible.
  • Tools & equipment are secured.
  • Drop zones are identified & barricaded.
  • That I do not exit equipment at heights unless risk assessed, approved & additional fall prevention measures are in place.

Isolating Energy Sources

• • Energy have been identified, isolated & deenergized before starting works.
  • All isolations have been proven (test for dead), tagged & controlled.
  • My personal lock & / or tag has been applied.
  • I never remove another person’s lock or tag without authorisation of a line manager.
  

Driving and Mobile Plant

• • A pre-start inspection is conducted on mobile plant & identified defects are reported & rectified prior to use.
  • The vehicle & equipment are in a safe working condition.
  • Loads are secure & restrained & within capacity limits.
  • My seatbelt is fastened.
  • Vehicle / mobile plant & pedestrian interaction risks are considered, & defined control implemented.
  • Driving is safe & within road & speed rules.
  • Mobile phone & other devices are never handled.

Working Around Asbestos & Silica

• • Check site registers for presence of asbestos.
  • Ensure all asbestos removal works are undertaken by licensed contractor.
  • Treat suspicious material as hazardous where the material cannot be determined as asbestos or silica.
  • Consider silica risk prior to commencing dust generating works such as grinding, cutting or break in work.
  • Adopt work methods that minimize the generation of silica dust, such as wet cutting, local exhaust ventilation & tools with vacuum extraction.
  • Wear the required protective & respiratory equipment.
  • Ensure any residual silica dusts are not dry swept, rather vacuumed thoroughly with a correctly rated vacuum.

Lifting & Loading

• • A lift plan is completed according to procedure.
  • Pedestrians & lifting movements are assessed & exclusion zones are implemented.
  • Pick up & lay down locations clear.
  • Tag lines are used to assist in guiding loads.
  • I never climb onto or work under a suspended load.
  • Lifting equipment & devices are inspected& deemed suitable before use.
  • Network operator rules are followed when lifting around or near overhead power lines.

Excavation & Trenching

• • All underground services & hazards are identified, located & if necessary, isolated.
  • Traffic & pedestrian movement is controlled.
  • Access is restricted to authorised personnel only.
  • The site has been safely sloped, benched, shored or shielded before allowing access.
  • A spotter is present for all mechanical excavations.
  • Monitor ground conditions & stormwater drainage.

Demolition Works

• • Demolition methods are confirmed by a competent person.
  • All services have been disconnected.
  • Hazardous materials assessments have been completed.
  • Asbestos & other hazardous materials are removed by a licensed contractor.
  • Demolition work involving structural removal is approved by a structural engineer.
  • Exclusion zones are established.

Working in Confined Spaces

• • A risk assessment, permit & rescue plan for entry is completed.
  • Energy sources & engulfment risks have been positively isolated.
  • Regular atmospheric testing is conducted.
  • That a dedicated confined space spotter is constantly on watch.
  • Only approved equipment is used.

Hazards

• Hazards

  Select Work at Heights (less than 2 metres) Hazardous Substances Lifting & Loading Interacting with public Young/inexperienced Workers Interacting with other Contractors Driving & Mobile Plant Working around Asbestos & Silica (not removal or lilely disturbance) Hot Works Hazardous Manual Tasks Isolating energy sources Demolition Works Excavation & Trenching (Less than 1.5 metres) Environmental Fitness for Work Biological Hazardous Atmospheres Psychosocial Other

  • Work at Heights (less than 2 metres)
  • Hazardous Substances
  • Lifting & Loading
  • Interacting with public
  • Young/inexperienced Workers
  • Interacting with other Contractors
  • Driving & Mobile Plant
  • Working around Asbestos & Silica (not removal or lilely disturbance)
  • Hot Works
  • Hazardous Manual Tasks
  • Isolating energy sources
  • Demolition Works
  • Excavation & Trenching (Less than 1.5 metres)
  • Environmental
  • Fitness for Work
  • Biological
  • Hazardous Atmospheres
  • Psychosocial
  • Other

• Working at Heights hazards

  Select Fall from height causing serious injury/death Unsecure work zones Dropped objects Faulty Equipment Other

  • Fall from height causing serious injury/death
  • Unsecure work zones
  • Dropped objects
  • Faulty Equipment
  • Other

• Other hazards

• Controls

• Work at Heights control measures

  Select Harness/Equipment precheck Use of harness & lanyard systems Use of ladder clamps Tie off ladder Use EWP Edge protection systems Ladders all footed & secured Barricading & signage in place Equipment is inspected & tagged Anchors inspected & compliant Scaffold & plant inspected before use Rescue plan & training in place Workers trained & competent Other

  • Harness/Equipment precheck
  • Use of harness & lanyard systems
  • Use of ladder clamps
  • Tie off ladder
  • Use EWP
  • Edge protection systems
  • Ladders all footed & secured
  • Barricading & signage in place
  • Equipment is inspected & tagged
  • Anchors inspected & compliant
  • Scaffold & plant inspected before use
  • Rescue plan & training in place
  • Workers trained & competent
  • Other

• Other controls

• Lifting & Loading hazards

  Select Dropped loads Crane tip over Unsecure work zone Overhead powerlines Other

  • Dropped loads
  • Crane tip over
  • Unsecure work zone
  • Overhead powerlines
  • Other

• Other hazards

• Controls

• Lifting & Loading control measures

  Select Scheduled inspections and tagging of all gear Pre-start inspection of plant Licensed operators Barricading & signage in place Loads secured correctly Lift plans used where required Spotter used Other

  • Scheduled inspections and tagging of all gear
  • Pre-start inspection of plant
  • Licensed operators
  • Barricading & signage in place
  • Loads secured correctly
  • Lift plans used where required
  • Spotter used
  • Other

• Please state other controls

• Excavation & Trenching hazards (less than 1.5 metres)

  Select Collapse of trench or pit Fall from heights Risk of flooding Contact with unknown energy source Other

  • Collapse of trench or pit
  • Fall from heights
  • Risk of flooding
  • Contact with unknown energy source
  • Other

• Other hazards

• Controls

• Excavation & Trenching controls

  Select Underground scanning Dial Before You Dig Restricted access to work area Shoring, benching and stepping of trenches over 1.5m Soldier sets Ladder access Spotter used for trench works Barriers Other

  • Underground scanning
  • Dial Before You Dig
  • Restricted access to work area
  • Shoring, benching and stepping of trenches over 1.5m
  • Soldier sets
  • Ladder access
  • Spotter used for trench works
  • Barriers
  • Other

• Please state other controls

• Working around Asbestos & Silica hazards

  Select Loose fibres or dust Unsecure or broken sheeting No asbestos register on site Other

  • Loose fibres or dust
  • Unsecure or broken sheeting
  • No asbestos register on site
  • Other

• Other hazards

• Controls

• Working around Asbestos controls

  Select A/C Control Plan Up to date asbestos register A/C double bagged Dust suppression and removal WorkCover Removal Notifications No pressure washer for asbestos Isolated work area Correct PPE available Other

  • A/C Control Plan
  • Up to date asbestos register
  • A/C double bagged
  • Dust suppression and removal
  • WorkCover Removal Notifications
  • No pressure washer for asbestos
  • Isolated work area
  • Correct PPE available
  • Other

• Please state other controls

• Environmental hazards

  Select Contaminated rivers, drains & soil Poor waste management Excessive noise for workers & public Adverse - extreme weather Other

  • Contaminated rivers, drains & soil
  • Poor waste management
  • Excessive noise for workers & public
  • Adverse - extreme weather
  • Other

• Other hazards

• Controls

• Environmental controls

  Select All waste is controlled and removed from site or disposed of correctly Prescribed waste managed correctly Noise management systems in place Weather included in job planning Other

  • All waste is controlled and removed from site or disposed of correctly
  • Prescribed waste managed correctly
  • Noise management systems in place
  • Weather included in job planning
  • Other

• Please state other controls

• Interacting with other Contractors hazards

  Select Work impacting on other contractors Other contractors impacting on your work Interaction with plant Unsecure work zones Other

  • Work impacting on other contractors
  • Other contractors impacting on your work
  • Interaction with plant
  • Unsecure work zones
  • Other

• Other hazards

• Controls

• Interacting with other Contractors - controls

  Select Combined pre-start meetings Agreement on workflows Identification of contacts Site walks with contractor leads Other

  • Combined pre-start meetings
  • Agreement on workflows
  • Identification of contacts
  • Site walks with contractor leads
  • Other

• Other controls

• Hazardous Manual Tasks hazards

  Select Repetitive movements Heavy physical work tasks Awkward sustained postures Insufficient space for task Other

  • Repetitive movements
  • Heavy physical work tasks
  • Awkward sustained postures
  • Insufficient space for task
  • Other

• Other hazards

• Controls

• Hazardous Manual Tasks controls

  Select Correct lifting techniques used Warm up & stretch & M/H training Task rotation between workers Team lifts for heavier loads The use of trolleys and carts for goods Other

  • Correct lifting techniques used
  • Warm up & stretch & M/H training
  • Task rotation between workers
  • Team lifts for heavier loads
  • The use of trolleys and carts for goods
  • Other

• Other controls

• Hazardous Substances hazards

  Select Electrocution Chemical burns and skin irritation Fire & explosion Spills & contamination Asbestos Other

  • Electrocution
  • Chemical burns and skin irritation
  • Fire & explosion
  • Spills & contamination
  • Asbestos
  • Other

• Other hazards

• Controls

• Hazardous Substances controls

  Select Provision of training Spill kits available at work location Correct PPE available Emergency equipment available SDS available at worksite Other

  • Provision of training
  • Spill kits available at work location
  • Correct PPE available
  • Emergency equipment available
  • SDS available at worksite
  • Other

• Other controls

• Young/inexperienced Workers hazards

  Select Lack of experience Undeveloped skills Inadequate training Other

  • Lack of experience
  • Undeveloped skills
  • Inadequate training
  • Other

• Other Hazards

• Controls

  Yes

  No

• Young Workers controls

  Select Mentor & coach provided to worker Training plan in place & started Close supervision Buddy system in place Instruction in the use of tools Other

  • Mentor & coach provided to worker
  • Training plan in place & started
  • Close supervision
  • Buddy system in place
  • Instruction in the use of tools
  • Other

• Please state other controls

• Biological hazards

  Select Used syringes Unclean work areas Waste left lying around Ill workers presenting for work Working with animals Other

  • Used syringes
  • Unclean work areas
  • Waste left lying around
  • Ill workers presenting for work
  • Working with animals
  • Other

• Other hazards

• Controls

• Biological controls

  Select Good housekeeping practices in place Use of tools to eliminate risk of needlestick Wearing of correct PPE Good personal hygiene practiced Thorough cleaning practices in place Good waste management in place Other

  • Good housekeeping practices in place
  • Use of tools to eliminate risk of needlestick
  • Wearing of correct PPE
  • Good personal hygiene practiced
  • Thorough cleaning practices in place
  • Good waste management in place
  • Other

• Other controls

• Psychosocial hazards

  Select Bullying & Harassment Stress & Fatigue Social stigma Violence Other

  • Bullying & Harassment
  • Stress & Fatigue
  • Social stigma
  • Violence
  • Other

• Other hazards

• Controls

• Psychosocial controls

  Select Promote awareness Inform workers of resources Intervene & support Provide recovery & return to work Other

  • Promote awareness
  • Inform workers of resources
  • Intervene & support
  • Provide recovery & return to work
  • Other

• Please state other controls

• Hazardous Atmospheres hazards

  Select Fire & explosion Ignition sources Other

  • Fire & explosion
  • Ignition sources
  • Other

• Other hazards

• Controls

• Hazardous Atmospheres controls

  Select Risk assessment & permits in place Atmospheric testing Fire control systems available Trained personnel Isolations Other

  • Risk assessment & permits in place
  • Atmospheric testing
  • Fire control systems available
  • Trained personnel
  • Isolations
  • Other

• Please state other controls

• Hot Works hazards

  Select Serious injury/death Minor injuries Fire & explosion Property damage Other

  • Serious injury/death
  • Minor injuries
  • Fire & explosion
  • Property damage
  • Other

• Other hazards

• Controls

• Hot Works controls

  Select Emergency equipment Correct PPE used for task Effective work planning Other

  • Emergency equipment
  • Correct PPE used for task
  • Effective work planning
  • Other

• Please state other controls

• Fitness for Work hazards

  Select Fatigue & illness Drugs & alcohol Other

  • Fatigue & illness
  • Drugs & alcohol
  • Other

• Other hazards

• Controls

• Fitness for Work controls

  Select Good eating & sleeping patterns Zero tolerance for D&A at work Report all issues to supervisor Other

  • Good eating & sleeping patterns
  • Zero tolerance for D&A at work
  • Report all issues to supervisor
  • Other

• Please state other controls

• Other Hazard/s

• Controls

• Driving & Mobile Plant Hazards

  Select Defective Plant/Vehicle Vehicle accident Pedestrians Road Rules breach Other

  • Defective Plant/Vehicle
  • Vehicle accident
  • Pedestrians
  • Road Rules breach
  • Other

• Other Hazard

• Controls

• Driving & Mobile Plant Controls

  Select A pre-start inspection is conducted Secure Loads and restrain within capacity limits Seatbelt is fastened Vehicle/mobile plant &pedestrian interaction are considered, defined controls implemented Driving is safe & within road& speed rules Mobile Phone, not to be handled. Hands free to be used. Other

  • A pre-start inspection is conducted
  • Secure Loads and restrain within capacity limits
  • Seatbelt is fastened
  • Vehicle/mobile plant &pedestrian interaction are considered, defined controls implemented
  • Driving is safe & within road& speed rules
  • Mobile Phone, not to be handled. Hands free to be used.
  • Other

• Other Controls

• Isolating Energy Sources Hazards

  Select Electrocution Chemical burns and skin irritation Fire & explosion Spills & contamination Asbestos Other

  • Electrocution
  • Chemical burns and skin irritation
  • Fire & explosion
  • Spills & contamination
  • Asbestos
  • Other

• Other Hazards

• Controls

• Isolating Energy Sources Controls

  Select Lock Out Tag Out (LOTO) in place Work area cleared of hazards Permit Spotter Workers advised of Isolations in place Test for dead and verify Assessments include arc flash hazards Rescue plan & training in place Verify isolation when done by client All other isolations verified AVDD Monitoring of staff Review Asbestos Register Barricade/sign work area Supplementary lighting Other

  • Lock Out Tag Out (LOTO) in place
  • Work area cleared of hazards
  • Permit
  • Spotter
  • Workers advised of Isolations in place
  • Test for dead and verify
  • Assessments include arc flash hazards
  • Rescue plan & training in place
  • Verify isolation when done by client
  • All other isolations verified
  • AVDD
  • Monitoring of staff
  • Review Asbestos Register
  • Barricade/sign work area
  • Supplementary lighting
  • Other

• Other controls

• Demolition Works Hazards

  Select Falling objects Collapse of structure Damage to property Other

  • Falling objects
  • Collapse of structure
  • Damage to property
  • Other

• Demolition Works Controls

  Select Demolition methods are confirmed by a competent person All services have been dosconnected Hazardous materials assessments have been completed Asbestos & other hazardous materials are removed by a licensed contractor Demolition work involving structural removal is approved by a structural engineer Exclusion zones are established Other

  • Demolition methods are confirmed by a competent person
  • All services have been dosconnected
  • Hazardous materials assessments have been completed
  • Asbestos & other hazardous materials are removed by a licensed contractor
  • Demolition work involving structural removal is approved by a structural engineer
  • Exclusion zones are established
  • Other

• Other controls

• Other Hazard

• Other Controls

• Interacting with Public hazards

  Select Public in workspace Aggressive people Theft

  • Public in workspace
  • Aggressive people
  • Theft

• Interacting with public controls

  Select Barricade area Spotter Signage Protect tooling/equipment Remove high value &/or hazardous goods from view

  • Barricade area
  • Spotter
  • Signage
  • Protect tooling/equipment
  • Remove high value &/or hazardous goods from view

High Risk Construction Work

• Are you completing any of the following:

  Select No High Risk Construction Work Where there is a risk of a person falling more than 2 metres On or near energised electrical installations or services Working in a ceiling or roof cavity At workplaces where there is any movement of powered mobile plant High Pressure jetting Industrial Rope Access Swing Stage Use Involving a confined space In an area that may have contaminated or flammable atmosphere On or adjacent to roadways or railways used by road or rail traffic Involving removal or likely disturbance of asbestos Underground Services Involving a trench or shaft if the excavated depth is more than 1.5 metres Involving demolition In an area where there are artificial extremes of temperature On or near pressurised gas distribution mains or piping On or near chemical, fuel or refrigerant lines Structural alterations requiring temporary support to prevent collapse Involving a tunnel In, over or adjacent to water or other liquids where there is a risk of drowning

  • No High Risk Construction Work
  • Where there is a risk of a person falling more than 2 metres
  • On or near energised electrical installations or services
  • Working in a ceiling or roof cavity
  • At workplaces where there is any movement of powered mobile plant
  • High Pressure jetting
  • Industrial Rope Access
  • Swing Stage Use
  • Involving a confined space
  • In an area that may have contaminated or flammable atmosphere
  • On or adjacent to roadways or railways used by road or rail traffic
  • Involving removal or likely disturbance of asbestos
  • Underground Services
  • Involving a trench or shaft if the excavated depth is more than 1.5 metres
  • Involving demolition
  • In an area where there are artificial extremes of temperature
  • On or near pressurised gas distribution mains or piping
  • On or near chemical, fuel or refrigerant lines
  • Structural alterations requiring temporary support to prevent collapse
  • Involving a tunnel
  • In, over or adjacent to water or other liquids where there is a risk of drowning

Where there is a risk of a person falling more than 2 metres

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Fall from heights Falling tools/objects Non compliant equipment &/or anchors Incorrect erection of equipment Unauthorised use/entry Weather Other

  • Fall from heights
  • Falling tools/objects
  • Non compliant equipment &/or anchors
  • Incorrect erection of equipment
  • Unauthorised use/entry
  • Weather
  • Other

• Other Hazard

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Harness/Equipment precheck Use of harness & lanyard systems Use of ladder clamps Tie off ladder Use EWP Edge protection systems Ladders all footed & secured Barricading & signage in place Equipment is inspected & tagged Anchors inspected & compliant Scaffold & plant inspected before use Rescue plan & training in place Workers trained & competent Other

  • Harness/Equipment precheck
  • Use of harness & lanyard systems
  • Use of ladder clamps
  • Tie off ladder
  • Use EWP
  • Edge protection systems
  • Ladders all footed & secured
  • Barricading & signage in place
  • Equipment is inspected & tagged
  • Anchors inspected & compliant
  • Scaffold & plant inspected before use
  • Rescue plan & training in place
  • Workers trained & competent
  • Other

• Other control measures

On or near energised electrical installations or services

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Work on or near live electrical circuits Death, arc flash events Isolation not in place Unlicensed/inexperienced workers Overhead Power Lines Unsafe work area Asbestos present Unauthorised access Other

  • Work on or near live electrical circuits
  • Death, arc flash events
  • Isolation not in place
  • Unlicensed/inexperienced workers
  • Overhead Power Lines
  • Unsafe work area
  • Asbestos present
  • Unauthorised access
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Lock Out Tag Out (LOTO) in place Work area cleared of hazards Permit Spotter Workers advised of Isolations in place Test for dead and verify Assessments include arc flash hazards Rescue plan & training in place Verify isolation when done by client All other isolations verified AVDD Monitoring of staff Review Asbestos Register Barricade/sign work area Supplementary lighting Other

  • Lock Out Tag Out (LOTO) in place
  • Work area cleared of hazards
  • Permit
  • Spotter
  • Workers advised of Isolations in place
  • Test for dead and verify
  • Assessments include arc flash hazards
  • Rescue plan & training in place
  • Verify isolation when done by client
  • All other isolations verified
  • AVDD
  • Monitoring of staff
  • Review Asbestos Register
  • Barricade/sign work area
  • Supplementary lighting
  • Other

• Other Control measures

Involving a confined space

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Contaminated atmospheres Engulfment & hazardous substances Fire & explosion Other

  • Contaminated atmospheres
  • Engulfment & hazardous substances
  • Fire & explosion
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Entry permit system in place Rescue equipment & training Atmospheric testing & monitoring Safe access & egress Isolation of energy sources Communication with workers Stand-by / spotter person Rescue Plan in place Worksite controlled Natural or Mechanical venting Other

  • Entry permit system in place
  • Rescue equipment & training
  • Atmospheric testing & monitoring
  • Safe access & egress
  • Isolation of energy sources
  • Communication with workers
  • Stand-by / spotter person
  • Rescue Plan in place
  • Worksite controlled
  • Natural or Mechanical venting
  • Other

• Other Control measures

• Is entry required?

  Yes

  No

• Controls implemented for non entry

  Select No body parts will enter space Fall hazards controlled Continual atmospheric monitoring Atmospheric hazards controlled Appropriate signage utilised Worksite controlled Hazard communicated to people in vicinity Other

  • No body parts will enter space
  • Fall hazards controlled
  • Continual atmospheric monitoring
  • Atmospheric hazards controlled
  • Appropriate signage utilised
  • Worksite controlled
  • Hazard communicated to people in vicinity
  • Other

• Other control

• Please complete Confined Space Entry Permit in iAuditor before entry.

  

Involving removal or likely disturbance of asbestos

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Loose fibres or dust Unsecure or broken sheeting No asbestos register on site Other

  • Loose fibres or dust
  • Unsecure or broken sheeting
  • No asbestos register on site
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select A/C Control Plan Up to date asbestos register A/C double bagged Dust suppression and removal WorkCover Removal Notifications No pressure washer for asbestos Isolated work area Correct PPE available Other

  • A/C Control Plan
  • Up to date asbestos register
  • A/C double bagged
  • Dust suppression and removal
  • WorkCover Removal Notifications
  • No pressure washer for asbestos
  • Isolated work area
  • Correct PPE available
  • Other

• Other Control measures

On or adjacent to roadways or railways used by road or rail traffic

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Site situated on blind turn or where visibility is poor Site situated adjacent to high volume traffic Site situated adjacent to high speed traffic Site situated adjacent to busy public areas Site situated adjacent to trains Other

  • Site situated on blind turn or where visibility is poor
  • Site situated adjacent to high volume traffic
  • Site situated adjacent to high speed traffic
  • Site situated adjacent to busy public areas
  • Site situated adjacent to trains
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Road closure Lane closure adjacent to work area or traffic diversions Speed reduction Use of safety barriers Use of vehicle mounted attenuators Use of warning signs Use of electronic Variable Message Signs High visibility clothing for all workers Various other measures Other

  • Road closure
  • Lane closure adjacent to work area or traffic diversions
  • Speed reduction
  • Use of safety barriers
  • Use of vehicle mounted attenuators
  • Use of warning signs
  • Use of electronic Variable Message Signs
  • High visibility clothing for all workers
  • Various other measures
  • Other

• Other Control measures

At workplaces where there is any movement or use of powered mobile plant

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Roll-over Overhead services Underground cavities Other vehicles and plant Inexperienced/unqualified workers Equipment faulty Weather Objects dropped from height Fall from elevated plant Suspension trauma Pedestrians/other workers in vicinity Other

  • Roll-over
  • Overhead services
  • Underground cavities
  • Other vehicles and plant
  • Inexperienced/unqualified workers
  • Equipment faulty
  • Weather
  • Objects dropped from height
  • Fall from elevated plant
  • Suspension trauma
  • Pedestrians/other workers in vicinity
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Pedestrian warning signs Site barricade Workers qualified to use plant Spotter Complete log book/pre start Rescue Plan Harness used No work within 6.4m of power lines. No work within 10m of power towers. EWP moved in lowered position PPE Tool contained/tied off Don't operate if in thunderstorm/high winds or other extreme weather Other

  • Pedestrian warning signs
  • Site barricade
  • Workers qualified to use plant
  • Spotter
  • Complete log book/pre start
  • Rescue Plan
  • Harness used
  • No work within 6.4m of power lines. No work within 10m of power towers.
  • EWP moved in lowered position
  • PPE
  • Tool contained/tied off
  • Don't operate if in thunderstorm/high winds or other extreme weather
  • Other

• Other Control measures

In an area that may have contaminated, hazardous or flammable atmosphere

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Fire & explosion Ignition sources Other

  • Fire & explosion
  • Ignition sources
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Risk assessment & permits in place Atmospheric testing Fire control systems available Trained personnel Isolations Other

  • Risk assessment & permits in place
  • Atmospheric testing
  • Fire control systems available
  • Trained personnel
  • Isolations
  • Other

• Other Control measures

In an area where there are artificial extremes of temperature

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Fatigue Loss of co-ordination Impaired decision making Heat stress/hypothermia Sunburn Other

  • Fatigue
  • Loss of co-ordination
  • Impaired decision making
  • Heat stress/hypothermia
  • Sunburn
  • Other

• Other Hazards

  Yes

  No

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Drinking water is available. Appropriate PPE is available. Maximum personnel exposure periods can be observed. Work-rest and job rotation to minimise exposure. Other

  • Drinking water is available.
  • Appropriate PPE is available.
  • Maximum personnel exposure periods can be observed.
  • Work-rest and job rotation to minimise exposure.
  • Other

• Other Control measures

  Yes

  No

Involving Removal or Likely Disturbance of Asbestos

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Loose fibres or dust Unsecure or broken sheeting No asbestos register on site Other

  • Loose fibres or dust
  • Unsecure or broken sheeting
  • No asbestos register on site
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Check Site Registers for presence of Asbestos Ensure all asbestos removal works are undertaken by licensed contractor Trerat suspicious material as hazardous where the material cannot be determined as asbestos or silica Consider silica risk prior to commencing dust generating, cutting or break in work Adopt work methods that minimise the generation of silica dust, such as wet cutting, local exhaust cventilation and tools with vacuum extraction Wear the required protective and respiratory equipment Ensure any residual silica dust are not dry swept, rather vacuumed thoroughly with a correctly ratedvacuum Dust suppression & removal No pressure washer for asbestos Isolated work area Correct PPE available and worn Other

  • Check Site Registers for presence of Asbestos
  • Ensure all asbestos removal works are undertaken by licensed contractor
  • Trerat suspicious material as hazardous where the material cannot be determined as asbestos or silica
  • Consider silica risk prior to commencing dust generating, cutting or break in work
  • Adopt work methods that minimise the generation of silica dust, such as wet cutting, local exhaust cventilation and tools with vacuum extraction
  • Wear the required protective and respiratory equipment
  • Ensure any residual silica dust are not dry swept, rather vacuumed thoroughly with a correctly ratedvacuum
  • Dust suppression & removal
  • No pressure washer for asbestos
  • Isolated work area
  • Correct PPE available and worn
  • Other

• Other Controls

Involving Demolition

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Unstable structures Hazardous dusts Risk of collapse during demolition Other

  • Unstable structures
  • Hazardous dusts
  • Risk of collapse during demolition
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Hazardous materials identified Effective job planning in place Workers exclusion zones in place Interaction of plant & people managed Good housekeeping practices in place Other

  • Hazardous materials identified
  • Effective job planning in place
  • Workers exclusion zones in place
  • Interaction of plant & people managed
  • Good housekeeping practices in place
  • Other

• Other Control measures

Involving a tunnel

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Confined spaces with build-up of gas and fumes High water and mud inflow Falls from height Loss of lighting Noise Fire or explosion, flammable gases and vapours Falling objects Dust Other

  • Confined spaces with build-up of gas and fumes
  • High water and mud inflow
  • Falls from height
  • Loss of lighting
  • Noise
  • Fire or explosion, flammable gases and vapours
  • Falling objects
  • Dust
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select PPE Supplemental lighting Fatigue management Barricading Signage Entry Permit system in place Other

  • PPE
  • Supplemental lighting
  • Fatigue management
  • Barricading
  • Signage
  • Entry Permit system in place
  • Other

• Other Control measures

In, over or adjacent to water or other liquids where there is a risk of drowning

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Drowning Loss of equipment Other

  • Drowning
  • Loss of equipment
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Personal flotation devices used/available Rescue plans & equipment in place Effective work planning Spotter Barricades Other

  • Personal flotation devices used/available
  • Rescue plans & equipment in place
  • Effective work planning
  • Spotter
  • Barricades
  • Other

• Other Control measures

Structural alterations requiring temporary support to prevent collapse

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Falling objects Collapse of structure Damage to property Other

  • Falling objects
  • Collapse of structure
  • Damage to property
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select PPE Exclusion zones if required Other

  • PPE
  • Exclusion zones if required
  • Other

• Other Control measures

On or near chemical, fuel or refrigerant lines

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Fire Explosion Rupture Other

  • Fire
  • Explosion
  • Rupture
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Isolation Service Authority contacted before works commence Hot Works Permit Mechanical ventilation Firefighting equipment PPE Other

  • Isolation
  • Service Authority contacted before works commence
  • Hot Works Permit
  • Mechanical ventilation
  • Firefighting equipment
  • PPE
  • Other

• Other Control measures

Involving a trench or shaft if the excavated depth is more than 1.5 metres

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Collapse of trench or pit Fall from heights Risk of flooding Contact with unknown energy source Other

  • Collapse of trench or pit
  • Fall from heights
  • Risk of flooding
  • Contact with unknown energy source
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Underground scanning Dial Before You Dig Restricted access to work area Shoring, benching and stepping of trenches over 1.5m Soldier sets Ladder access Spotter used for trench works Barriers Other

  • Underground scanning
  • Dial Before You Dig
  • Restricted access to work area
  • Shoring, benching and stepping of trenches over 1.5m
  • Soldier sets
  • Ladder access
  • Spotter used for trench works
  • Barriers
  • Other

• Other Control measures

High Pressure Water Jetting (HPWJ)

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Being struck by a water jet Use of Class A HPWJ Unauthorised people coming into area Injuries caused by malfunctioning or out of control equipment Eye or face injuries from flying debris Inexperienced operator Other

  • Being struck by a water jet
  • Use of Class A HPWJ
  • Unauthorised people coming into area
  • Injuries caused by malfunctioning or out of control equipment
  • Eye or face injuries from flying debris
  • Inexperienced operator
  • Other

• Other Hazards

• Do you have a ticket to operate Class A jetter?

  Yes

  No

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select SWMS/JSEA/SoPs/Medical Advice Card HPWJ PPE Using a leader hose Using tiger tails to protect HP hose Having access to sewer plans & DBYD Barriers to define work area Displaying HPWJ warning signs onsite Trained HPWJ Operators Guidance from experienced operator Other

  • SWMS/JSEA/SoPs/Medical Advice Card
  • HPWJ PPE
  • Using a leader hose
  • Using tiger tails to protect HP hose
  • Having access to sewer plans & DBYD
  • Barriers to define work area
  • Displaying HPWJ warning signs onsite
  • Trained HPWJ Operators
  • Guidance from experienced operator
  • Other

• Other Control measures

Underground Services

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Within 1 metre of tree Within 1 to 3 metres of tree Electricity Gas Water Telecommunications High pressure gas or oil Other

  • Within 1 metre of tree
  • Within 1 to 3 metres of tree
  • Electricity
  • Gas
  • Water
  • Telecommunications
  • High pressure gas or oil
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select All services marked DBYD Permit Hand dig Hydro excavation Consultation with Local Authority Tree Officer Other

  • All services marked
  • DBYD
  • Permit
  • Hand dig
  • Hydro excavation
  • Consultation with Local Authority Tree Officer
  • Other

• Other Control measures

Working in a Ceiling Space or Roof Cavity

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Fall from heights or through ceiling Weather Hazardous substances Electrocution Items dropped from height Emergency Response Inadequate Supervision Insects/Spiders/Vermin Other

  • Fall from heights or through ceiling
  • Weather
  • Hazardous substances
  • Electrocution
  • Items dropped from height
  • Emergency Response
  • Inadequate Supervision
  • Insects/Spiders/Vermin
  • Other

• Other Hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Working in ceiling/roof cavity with more than 1 staff member (Mandatory requirement) Buddy up system No access to areas with uncontrolled fall hazards Wear appropriate PPE Ensure access/egress is safe Establish a rescue/recovery process Review Asbestos Register All voids, fall hazards, electrical hazards are controlled Continuous monitoring of staff Ladder tied off/footed LOTO procedure Adequate lighting in space Use toolbelts Other

  • Working in ceiling/roof cavity with more than 1 staff member (Mandatory requirement)
  • Buddy up system
  • No access to areas with uncontrolled fall hazards
  • Wear appropriate PPE
  • Ensure access/egress is safe
  • Establish a rescue/recovery process
  • Review Asbestos Register
  • All voids, fall hazards, electrical hazards are controlled
  • Continuous monitoring of staff
  • Ladder tied off/footed
  • LOTO procedure
  • Adequate lighting in space
  • Use toolbelts
  • Other

• Other control measures

Industrial Rope Access

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Inadequate trained staff Other site trades Weather Cuts, abrasions, hand injuries Ultraviolet (eye, skin) Public Falling tools, material, objects Emergency situation Inadequate/incorrect anchors Fragile/damaged roof structure Weather Damaged/faulty equipment Fall from heights

  • Inadequate trained staff
  • Other site trades
  • Weather
  • Cuts, abrasions, hand injuries
  • Ultraviolet (eye, skin)
  • Public
  • Falling tools, material, objects
  • Emergency situation
  • Inadequate/incorrect anchors
  • Fragile/damaged roof structure
  • Weather
  • Damaged/faulty equipment
  • Fall from heights

• Other hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Minimum Industrial Rope Access (Level 1 Basic Site) (must be supervised by at least Industrial Rope Access level 2 operator) Qualified in Industrial Abseiling Twin Rope system by recognised body Toolbox/communication with other trades Adequate water on site First Aid kit on site Equipment and surfaces inspected Appropriate gloves (minimum Level 3 cut resistant) to be worn PPE Setup barricades, tape, signs. Set up exclusion zones

  • Minimum Industrial Rope Access (Level 1 Basic Site) (must be supervised by at least Industrial Rope Access level 2 operator) Qualified in Industrial Abseiling Twin Rope system by recognised body
  • Toolbox/communication with other trades
  • Adequate water on site
  • First Aid kit on site
  • Equipment and surfaces inspected
  • Appropriate gloves (minimum Level 3 cut resistant) to be worn
  • PPE
  • Setup barricades, tape, signs.
  • Set up exclusion zones

• Other controls

Swing Stage Use

• HAZARDS - How could anyone be injured doing this task, what could go wrong?

  Select Fall from heights Falling tools/objects Non compliant equipment &/or anchors Incorrect erection of equipment Unauthorised use/entry Weather Other

  • Fall from heights
  • Falling tools/objects
  • Non compliant equipment &/or anchors
  • Incorrect erection of equipment
  • Unauthorised use/entry
  • Weather
  • Other

• Other hazards

• IDENTIFY THE CONTROL MEASURES - What do we need to do to protect ourselves or anyone else?

  Select Drop zone: barricades, bollards, warning tape, signage used Equipment must comply with AS1576.4 and be supplied with clear instructions about the safe configurations for erection and the intended uses and load combinations Erected by a qualified and experience person. Adequate PPE should be present in the swing stage and correctly used Harnesses used Appropriate communication systems include persons being in sight of the swing stage at all times at a distance from which hand signals, whistles or bells can be used effectively. Radio communication An authorised person should directly operate hoists Unattended cradles should be left so that unauthorised persons cannot access them and so that wind cannot affect the equipment in a way that will cause damage to adjacent structures or equipment. Other

  • Drop zone: barricades, bollards, warning tape, signage used
  • Equipment must comply with AS1576.4 and be supplied with clear instructions about the safe configurations for erection and the intended uses and load combinations
  • Erected by a qualified and experience person.
  • Adequate PPE should be present in the swing stage and correctly used
  • Harnesses used
  • Appropriate communication systems include persons being in sight of the swing stage at all times at a distance from which hand signals, whistles or bells can be used effectively. Radio communication
  • An authorised person should directly operate hoists
  • Unattended cradles should be left so that unauthorised persons cannot access them and so that wind cannot affect the equipment in a way that will cause damage to adjacent structures or equipment.
  • Other

• Other controls

TASK STEPS

• TASK STEPS - Identify ALL steps in order of activity

Site Personnel (additional to person completing JSEA/SWMS)

• I have reviewed this SWMS/JSEA & agree with all job steps, hazards & control measures that will be implemented including daily review.

  Sign