Information

  • Site conducted

  • This document is to assist you audit the task ahead along with the site conditions to ensure your and our customers safety by delivering a safe service.

    If there are factors inhibiting compliance or risking the safety of yourself or that of others, PAUSE the job and seek advice from your supervisor.

    On completion please ensure this is emailed to your supervisor.

    Thank you for your co-operation

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  • Technician Name

  • Date and Time Audit Commenced

  • Customer Company Name

  • Machine Serial Number

  • Take a photo of the serial plate

  • Hour meter reading

  • Site Address
  • Additional Technician Name

  • Brief Description of the Task Being Assessed

Pre Job Assessment

  • Life saving behaviours relevant to this task

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  • LSB - I Position.jpg
  • LSB - I Wear.jpg
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  • Does this site require a log in and or induction?

  • Have you reported in and signed in at site office or met with onsite contact?

  • Does the site have specific Site Safety rules such as emergency procedures, lock out tag out or working at height? or site specific induction requirements?

  • Have you been inducted with their site specific requirements?

  • Pause the job and complete the required induction

Covid-19 Questions

  • If you are unsure about any Covid responses please call your manager for advice on how to proceed

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  • Do you have the following required Covid-19 protection?<br><br>Sanitiser<br>Facemask<br>Gloves

  • Does this task require the use of three way communication?

  • Do you have a control plan in accordance with three way communication?

  • Does this task require working alone?

  • Do you have a control plan in accordance with the working alone policy?

  • Pause the job, contact your manager

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  • Are there ground condition hazards in the work area?

  • Have you eliminated them?

  • Are there overhead risks in your work area?

  • If the following overhead risks have been identified in your work area:<br><br>Electricity<br>Structures<br>Wind speed higher than12.5m/s - if no wind meter available please check Willy Weather app<br>https://apps.apple.com/au/app/weather-by-willyweather/id592978502?ign-mpt=uo%3D4<br> <br><br>Has the risk been eliminated by moving the machine to another area?

  • Is there potential interaction from the following?<br><br><br>Pedestrians<br>Vehicles<br>Mobile plant

  • If the following potential interactions are present<br><br>Pedestrians<br>Vehicles<br>Mobile plant<br><br>Have you eliminated them with a plan?

  • Pause the job

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General Task

  • Life saving behaviours relevant to this task

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  • LSB - I Check.jpg
  • LSB - I Position.jpg
  • Are you equipped with the correct PPE for this task?

  • PAUSE the Job

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  • Do you have all necessary tools/equipment to complete the task?

  • PAUSE the Job

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  • Is there sufficient natural or artificial light to complete the task?

  • Pause the job. Move machine to another location with sufficient lightings.

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  • Are there any potential environmental risks? eg Lightning, Hail?

  • Have you eliminated your risk from the environment impact

  • Is there risk of exposure to disrupted or airborne asbestos?

  • Pause the job

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  • Is there a risk for potential ignition of flammable vapours?

  • Pause the job

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  • Are any power tools to be used for this task?

  • Are they in safe good condition with their guarding intact?

  • Pause the job

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  • Is a multi meter required for this task?

  • Have you:<br>1. Visually inspected the unit, leads and probes for damage?<br>2. Tested the leads for continuity (resistance)?

  • Is the use of hazardous substances required for this task?

  • Do you have access to the most recent copy of the Safety Data Sheet for those chemicals?

  • Does this task require use of fluids?

  • Do you have suitable spill containment for the task?

Lifting

  • Life saving behaviours relevant to this task

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  • Link to current lift plans - https://sharepoint.terex.com/segments/awp/arc/Revision%20Control/Health%2C%20Safety%20%26%20Environment/Terex%20Genie%20SIF%20Roadmaps/SIF%201%20Rigging/Genie%20Lift%20Plans

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  • Is lifting required for this task?

  • Do you have a lift plan? You can check for current plans here<br>Link to current lift plans - https://sharepoint.terex.com/segments/awp/arc/Revision%20Control/Health%2C%20Safety%20%26%20Environment/Terex%20Genie%20SIF%20Roadmaps/SIF%201%20Rigging/Genie%20Lift%20Plans

  • Are you or other personnel involved in the task suitably qualified to operate any of the crane/equipment in use?

  • Is all lifting equipment certified and in the correct test period?

  • PAUSE the Job

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  • PAUSE the Job

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  • PAUSE the Job

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  • WARNING - If you are not able to ensure your own safety through any of the above questions, PAUSE the job, ASSESS and RESOLVE the issue with the customer. If this is not possible then escalate this to your relevant supervisor/manager.

Working at Height

  • Life saving behaviours relevant to this task

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  • Is working at height required for this task?

  • Is the portable working at height kit required for this task?

  • Do you have the kit with you?

  • Is all working at height equipment certified and in correct test period?

  • Do you have a working at height plan?

  • PAUSE the Job

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  • Are all personnel protected from falling objects?

  • PAUSE the Job

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  • Have I PAUSED and asked for help from my supervisor if a condition is not safe or I cannot take these actions. If a near miss occurs, I report it immediately!

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Hazardous Energy Control Risk Assessment

  • What type of hazardous energy are present with this job?

  • Are you able to control or eliminate this Hydraulic pressure energy hazard?

  • Reason

  • Are you able to control or eliminate this Electrical shock hazard?

  • Reason

  • Are you able to control or eliminate this Gravitational energy hazard?

  • Reason

  • Are you able to control or eliminate this Noise/Vibration energy hazard?

  • Reason

  • Are you able to control or eliminate this Thermal energy hazard?

  • Reason

  • Are you able to control or eliminate this Chemicals energy hazard?

  • Reason

  • Please specify hazard

  • Are you able to control or eliminate this identified energy hazard?

  • Reason

Machine operation after repair

  • Does your task require you to operate the machine once repairs are completed?

  • Have you completed a function test?

  • Pause the job - complete the function test

Inspection and repair completion

  • Time Completed

  • Which country are you operating in?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.