Tasman Power Entanglement & Crushing CCC

• Site conducted

• Date & Time

  Date

• Task

• Work Area

• Prepared by

• Is a procedure for use of mechanical blocks (e.g. belt clamps, jacks, stands etc) being followed?<br>

  Yes

  No

  N/A

• Are mechanical blocks appropriate for the task and safe for use? i.e. in good condition, tagged, rated, with compliance/certification plates<br>

  Yes

  No

  N/A

Isolation and Verification of Zero Energy

• Have you followed an approved isolation procedure?

  Yes

  No

  N/A

• Have you placed your personal lock onto the correct isolation point?<br>

  Yes

  No

  N/A

• For unisolated work (including testing and fault finding), are you following an approved procedure?

  Yes

  No

  N/A

• Have all energy sources been identified, isolated and checked for zero energy? E.g. process flows, mechanical, stored, residual,<br>hydraulic, pneumatic, chemical, electrical.

  Yes

  No

  N/A

Guards, Barriers and Barricades

• Are guards, barriers and barricades appropriate, in place and secure?<br>

  Yes

  No

  N/A

• Can you locate and easily access emergency stops, pull wires and dead man switches?

  Yes

  No

  N/A

• Where guards, barriers and barricades have been removed, does the work plan include their reinstallment?<br>

  Yes

  No

  N/A

Guards, Barriers and Barricades

• Are controls in place for any unguarded moving equipment? E.g. maintaining safe distance, spotter, hard barricading, restricted access etc

  Yes

  No

  N/A

Handling Requirements

• Are you and your clothing (including PPE) safe from entanglement with rotating/moving equipment?<br>

  Yes

  No

  N/A