Take 5 - Parks

• Document No.

• Audit Title

• Location
  Address

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Yes

  No

  N/A

Safe Work Procedures

• SWP - Blower - Petrol operated

  Yes

  No

  N/A

• SWP - Chainsaw operation

  Yes

  No

  N/A

• SWP - Recovery strap

  Yes

  No

  N/A

• SWP - Agivator Tractor Operator

  Yes

  No

  N/A

• SWP - Angle Grinder

  Yes

  No

  N/A

• SWP - Auger - Petrol Operated

  Yes

  No

  N/A

• SWP - Brush - Cutter petrol operated

  Yes

  No

  N/A

• SWP - Cordless Drill

  Yes

  No

  N/A

• SWP - Drive and Manoeuvre Trailers

  Yes

  No

  N/A

• SWP - edger

  Yes

  No

  N/A

• SWP - Electric drill

  Yes

  No

  N/A

• SWP - Flail Deck Mower (Tractor mounted)

  Yes

  No

  N/A

• SWP - Hedge Trimmer

  Yes

  No

  N/A

• SWP - Mig Welder

  Yes

  No

  N/A

• SWP - Mowing Deck (wings) Tractor Mounted

  Yes

  No

  N/A

• SWP - Push Mower

  Yes

  No

  N/A

• SWP - Push Mower

  Yes

  No

  N/A

• SWP -Ride on Mower

  Yes

  No

  N/A

• SWP - Spray Unit Tractor Mounted

  Yes

  No

  N/A

• SWP - Tractor

  Yes

  No

  N/A

• SWP - Collection of Water Samples

  Yes

  No

  N/A

• SWP - Compound Mitre Saw

  Yes

  No

  N/A

• SWP - Fuel Handling

  Yes

  No

  N/A

• SWP - Garden Bed Maintenance

  Yes

  No

  N/A

• SWP - Garden Bed Mulching

  Yes

  No

  N/A

• SWP - Garden Bed Planting

  Yes

  No

  N/A

• SWP - Parkland land grass Verge Mowing

  Yes

  No

  N/A

• SWP - picking up sharps

  Yes

  No

  N/A

• SWP - Working Near Water bodies

  Yes

  No

  N/A

Work Method Statements

• WMS - Fuel handling

  Yes

  No

  N/A

• WMS - Implementation of Traffic Control

  Yes

  No

  N/A

• WMS - Loading and Unloading Plant Trailer

  Yes

  No

  N/A

• WMS - Loading and Unloading Trucks and Utilities

  Yes

  No

  N/A

• WMS - Pesticide Application In Parklands (small volume)

  Yes

  No

  N/A

• WMS - Pesticide Application in Parklands and Sportsfields (Large Volume)

  Yes

  No

  N/A

• WMS - Playground and Infrastructure Inspection and Minor Repairs

  Yes

  No

  N/A

• WMS -Playground Mulch Repair and Replacement

  Yes

  No

  N/A

• WMS - Roadside Mowing

  Yes

  No

  N/A

• WMS - Sports field Mowing

  Yes

  No

  N/A

• WMS - Truck Driving

  Yes

  No

  N/A

• WMS - Changing Implements on Plant

  Yes

  No

  N/A

• WMS - chainsaw operation

  Yes

  No

  N/A

• WMS - Polesaw Operator

  Yes

  No

  N/A

• WMS - Collection of water samples

  Yes

  No

  N/A

• WMS - Garden Bed Maintenance

  Yes

  No

  N/A

• WMS - Garden bed Mulching

  Yes

  No

  N/A

• WMS - Garden Bed Mulching

  Yes

  No

  N/A

• WMS -Chemical Handling (Pesticide)

  Yes

  No

  N/A

• WMS - Garden Bed Planting

  Yes

  No

  N/A

• WMS - Refueling at Depot

  Yes

  No

  N/A

• WMS - Parklands and Grass Verge Mowing

  Yes

  No

  N/A

• WMS - Mowing Activities During Fire Danger Periods

  Yes

  No

  N/A

• WMS - Working near water bodies

  Yes

  No

  N/A

Hazard / Condition

• Site access / agrees poor

  Safe

  At Risk

  N/A

• Signs / lamp posts

  Safe

  At Risk

  N/A

• Scaffold secure

  Safe

  At Risk

  N/A

• Overhead power lines

  Safe

  At Risk

  N/A

• Other electrical hazards

  Safe

  At Risk

  N/A

• Underground services

  Safe

  At Risk

  N/A

• Exposed Reo

  Safe

  At Risk

  N/A

• Environment (ie noise, dust, fumes)

  Safe

  At Risk

  N/A

• Others working above / below

  Safe

  At Risk

  N/A

• Falling objects possible.

  Safe

  At Risk

  N/A

• Warning notices required.

  Yes

  No

  N/A

• No go zones in area.

  Safe

  At Risk

  N/A

• Exclusion zone not set up

  Yes

  No

  N/A

• Pits / trenches

  Safe

  At Risk

  N/A

• Ground and support conditions poor.

  Safe

  At Risk

  N/A

• Not consulted with other work groups in area.

  Safe

  At Risk

  N/A

• Demolition work nearby.

  Safe

  At Risk

  N/A

• Working on / in / near water

  Safe

  At Risk

  N/A

• Inadequate traffic / pedestrian control

  Safe

  At Risk

  N/A

Other - anything that is not listed above.

Personal Protective Equipment

• Breathing equipement

  Yes

  No

  N/A

• Eye protection

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• High vis

  Yes

  No

  N/A

• Hard hat

  Yes

  No

  N/A

• Harness

  Yes

  No

  N/A

• Long long

  Yes

  No

  N/A

• Face shield

  Yes

  No

  N/A

• Protective boots

  Yes

  No

  N/A

• Sun hat

  Yes

  No

  N/A