Take the Time - 3T - SHE

• Job

• Location
  Address

• Date

  Date

• Brickworks Employee Name

• Builder

• Prepared by

• INSTRUCTIONS:
  -------------------------------------
  1. Provide the appropriate response in recognition of: - if it is safe proceed. -if the site is inaccessible or unsafe complete the JSEA provided & DO NOT enter
  2. Add photos and notes by clicking on the paperclip icon.
  3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
  4. Complete audit by providing digital signature.
  5. Share your report by exporting as PDF, Word, Excel or Web Link.
  
  **Carry out a visual inspection of the site you are accessing and consider the points below BEFORE entering a site Refer: WHS-SOP-SaM-07.012 and WHS Frm-JSEA-07.002**
  

SITE SAFETY CHECK

• Which is appropriate?

  New Site

  Revisiting Site

  During the Visit

• Can you sign in safely?

  Safe

  Unsafe

  N/A

• Is a site escort required and available?

  Safe

  Unsafe

  N/A

• Do you have their contact number?

  Safe

  Unsafe

  N/A

• Who?

• Mobile Number

• Have you permission to access site if no-one is available?

  Safe

  Unsafe

  N/A

• By Whom?

• Are any ground obstacles avoidable? Observe trenches, debris, excavations, gates, guard dogs, etc.

  Safe

  Unsafe

  N/A

• Are any overhead activities occurring in your vicinity? Observe power lines, double storey buildings, trees, roofing structure, plumbing / downpipes, etc.

  Safe

  Unsafe

  N/A

• Are activities in your vicinity conducted safely? To your best knowledge- roofing, use of equipment, consider water, gas, chemicals, tools, etc.

  Safe

  Unsafe

  N/A

• Respect 3 metre mobile plant exclusion zone? Observe forklifts or any mobile plant

  Safe

  Unsafe

  N/A

• All scaffolding/structures appear compliant and safe? Observe any balustrades, stairs, scaffolding, etc.

  Safe

  Unsafe

  N/A

• Are there controls in place for my actions affecting others? Incorrect parking, not announcing visit, incorrect handling of Hazardous Chemicals, etc.

  Safe

  Unsafe

  N/A

• Are there controls in place for persons' actions affecting me? Is there an access point, register to sign in/out, barricades, signage, etc

  Safe

  Unsafe

  N/A

• Appropriate PPE gear worn? Are you wearing PPE for designated areas? Do not enter otherwise.

  Safe

  Unsafe

  N/A

• Are the Evacuation Points and First Aid clearly identified?

  Safe

  Unsafe

  N/A

• Do you have your GIT card (AKA General Construction or white card) with you? Do not enter otherwise.

  Safe

  Unsafe

  N/A

• If the site is deemed unsafe to enter and cannot be rectified immediately - a formal JSEA is to be completed

  Safe

  Unsafe

  N/A

COMPLETION

• Brickworks Employee Name and Signature

  Sign

• Builder

  Sign