Title Page
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Site conducted
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Document No.
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Reported by:
- Dayle Osgood
- Dean Aitken
- Wayne McGillen
- Ben Earnshaw
- Andrew Walker
- Glen Simpson
- Malcolm Mott
- Rory Aroa
- Ben Buckley
- Steve Christensen
- Other - Please list below
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Date and Time:
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Job Location
- Carding
- Spinning
- Dye House
- Blending
- Winding
- Twisting
- Finishing
- Services
- Despatch
- Admin
- External
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Task?
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Add media
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Can you be struck or injured while performing the task?
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Can you be caught in, on, or between anything?
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Can you strain yourself while performing the task?
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Can you slip or trip on anything while performing the task?
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Can you fall from any height where you can be injured?
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Am i exposed to:
- Excessive noise?
- Hazardous substances?
- Extremes of temperatures (hot/cold)?
- Vibration/Radiation?
- Gas/Fumes/Dust?
- Mobile Plant, equipment or vehicles?
- Working with a suspended load?
- Manual Handling/Repetitive tasks?
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Can you injure a fellow employee, contractor or visitor?
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Can equipment damage occur?
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Can environmental harm occur while performing the task?
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Is anyone working above or below?
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Are all energy sources isolated and locked out?
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Does machinery have guarding and interlocks in place?
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Am I trained and competent to perform the task?
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Are all tools in safe working condition and right for the task?
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Have all hazards been identified and controlled?
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FOR ANY RED ANSWERS YOU MUST LIST THE RISK AND THE CONTROL METHOD UTILISED. IF ANY RISKS ARE SIGNIFICANT (MODERATE OR HIGHER) ON THE RISK MATRIX ABOVE A JSA WILL BE REQUIRED IF IN ANY DOUBT ASK YOUR SUPERVISOR BEFORE COMMENCING THE TASK
