Traffic Lights NSW P/L - Hazard Identification and Risk Assessment

• Risk Assessment site number

• Conducted on

  Date

• Prepared by

• Location
  Address

1. Utilities and Permits & Pre Start

• Are TCS plans on site?

  Yes

  No

  N/A

• Searches on site? Dial before you dig.

  Yes

  No

  N/A

• Is the permit to excavate on site if required?

  Yes

  No

  N/A

• Have utilities been identified?

  Yes

  No

  N/A

• Potholing required?

  Yes

  No

  N/A

• Have the relevant authorities been notified?

  Yes

  No

  N/A

2. Plant and Equipment

• Unsafe or damaged plant/equipment? (including missing or damaged guards)

  Safe

  At Risk

  N/A

• Pre-start check list to be completed?

  Safe

  At Risk

  N/A

• Plant/equipment in good condition?

  Safe

  At Risk

  N/A

• Lack of safe work instructions?

  Safe

  At Risk

  N/A

• Lack of training in safe operation, clean-up and maintenance?

  Safe

  At Risk

  N/A

• Trained operators?

  Safe

  At Risk

  N/A

3. Lifting Equipment

• Loads lifted over persons, close proximity to obstacles incl. overhead power lines?

  Safe

  At Risk

  N/A

• Lack of maintenance and inspection?

  Safe

  At Risk

  N/A

• SWL information displayed?

  Safe

  At Risk

  N/A

• Unsafe or damaged lifting equipment, including ropes, slings, chains, hooks?

  Safe

  At Risk

  N/A

• Trained operators?

  Safe

  At Risk

  N/A

4. Hazardous Chemical (including fuel and oil)

• Are chemicals/fuel correctly labeled?

  Safe

  At Risk

  N/A

• Spill kits on site?

  Safe

  At Risk

  N/A

• Materials Safety Data Sheets not accessible on site?

  Safe

  At Risk

  N/A

• 8.7. Insufficient ventilation?

  Safe

  At Risk

  N/A

• 8.8. Insufficient, or incorrect, PPE?

  Safe

  At Risk

  N/A

5. Emergency Response

• Lack of, or no emergency plans for site?

  Safe

  At Risk

  N/A

• Location of utility providers phone numbers known.

  Safe

  At Risk

  N/A

• Lack of, or inadequate first aid kits aid equipment for site?

  Safe

  At Risk

  N/A

• Insufficient access to formally trained First Aiders for all shifts?

  Safe

  At Risk

  N/A

6. Traffic Management

• TMC notified of implementation of ROL?

  Safe

  At Risk

  N/A

• Adequate TMP and VMP on site?

  Safe

  At Risk

  N/A

• Correct clearances from traffic adhered to?

  Safe

  At Risk

  N/A

• Are staff and contractors crossing the road in a safe manner?

  Safe

  At Risk

  N/A

• Has provisions been made for predestions?

  Safe

  At Risk

  N/A

• Lack of training in TMP for all persons on site? <br>(contractors and visitors)

  Safe

  At Risk

  N/A

• Inadequate controls for TMP? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)

  Safe

  At Risk

  N/A

7. Personal Protective Equipment (PPE)

• Lack of, or inadequate PPE (including sun protection)

  Safe

  At Risk

  N/A

• Lack of PPE to be reported. Inspect, replace and monitor PPE?

  Safe

  At Risk

  N/A

• Lack of training in safe use, clean-up and inspection of PPE?

  Safe

  At Risk

  N/A

• Are hard hats required?

  Yes

  No

  N/A

8. Work Environment

• Insufficient lighting?

  Safe

  At Risk

  N/A

• Lack of, or inadequate noise/ vibration control?

  Safe

  At Risk

  N/A

9. Manual Handling

• Are staff trained in correct lifting procedures?

  Yes

  No

  N/A

• Team lifts for heavy items.

  Yes

  No

  N/A

9.1 Ladders and Working at Heights

• Are ladders in good condition?

  Yes

  No

  N/A

• Is the correct ladder being used?

  Yes

  No

  N/A

9.2 Electrical Hazards

• Unsafe electrical leads? (damaged, out of test date or untested)

  Safe

  At Risk

  N/A

• Two competent staff on site when working live?

  Safe

  At Risk

  N/A

• Lack of RCD protection?

  Safe

  At Risk

  N/A

• Contact with underground assets?

  Safe

  At Risk

  N/A

• Contact with overhead electrical lines? Spotter in place?

  Safe

  At Risk

  N/A

9.3 Excavations

• Stock piles to be sandbagged at the end of the shift.

  Yes

  No

  N/A

• Are unattended hole and trenches covered and barricaded?

  Yes

  No

  N/A

• Silt and debris contained from waterways during heavy rain.

  Yes

  No

  N/A

• Access into deep excavations to be made safe via benching or shoring.

  Yes

  No

  N/A

10. Environmental Hazards

• Lack of/or inadequate Environmental Management plan (EMP)?

  Safe

  At Risk

  N/A

• Saw cutting run of to be contained.

  Safe

  At Risk

  N/A

• Has noise been considered for the local residents?

  Safe

  At Risk

  N/A

• Waste removed from site at end of shift?

  Safe

  At Risk

  N/A

• Fumes.

  Safe

  At Risk

  N/A

• Is the site free of trip hazards?

  Safe

  At Risk

  N/A

• Lack of/or inadequate, dust suppression system?

  Safe

  At Risk

  N/A

• Lack of/or inadequate systems to prevent contaminants entering stormwater drains?

  Safe

  At Risk

  N/A

11. Administrative Procedures

• Subcontractors inducted?

  Safe

  At Risk

  N/A

• Is Site Safety Plan adequate.

  Safe

  At Risk

  N/A

• Fatigue to be managed?

  Safe

  At Risk

  N/A

• Failure to obtain permits?

  Safe

  At Risk

  N/A

• Lack of, or inadequate, induction for workers, contractors, visitors?

  Safe

  At Risk

  N/A

• Lack or, or inadequate, supervisory arrangements?

  Safe

  At Risk

  N/A

• Lack of/or inadequate training, licenses, skills, experience?

  Safe

  At Risk

  N/A

• Lack of/or inadequate Safe Work Method Statements (SWMS) for high- risk work?

  Safe

  At Risk

  N/A

• Lack of/or inadequate incident notification procedures?

  Safe

  At Risk

  N/A

• Lack of, or inadequate, routine inspections, monitoring, audits?

  Safe

  At Risk

  N/A

12. Corrective Actions

• Enter any corrective actions that will/must be undertaken.

Sign Off

• RMS/Client representative

  Sign

• Audit conducted by

  Sign

• Angus

  Sign

• Andy

  Sign

• Mark

  Sign

• Pete

  Sign

• Lachlan

  Sign

• Blake

  Sign

• Leon

  Sign

• Dave

  Sign

• Damian

  Sign

• Erwin

  Sign

• Additional workers to sign on here.

Touch to add

• Sign & Name

  Sign

• Select from range