TransACT Mr Fluffy Pre-Start

• Date

  Date

• TOW No.

• Location
  Address

• Completed By:

• Contact No.

• Emergency Evacuation Point:

• Nearest Medical Facility/ Hospital:

Daily Pre-Start Form

• Workers are competent to carry out all tasks scheduled for the day, particularly competencies related to traffic management, operation of plant and equipment, and asbestos management?

  Yes

  No

• If NO, do not proceed until confirming all crew are trained and competent

• Do you have take 5 booklets available?

  Yes

  No

• If NO, issue Take 5 booklet/s before proceeding

• Is the house listed on the Mr Fluffy register?

  No

  Yes

• If YES, DO NOT PROCEED and contact your Supervisor

• Was the house built before 1980?

  No

  Yes

• If YES, DO NOT PROCEED and contact your supervisor

• Is the home owner aware of the presence of Mr Fluffy insulation in the house?

  No

  Yes

• If YES, DO NOT PROCEED and contact your Supervisor

Site Specific PPE

• Hard Hat

• Hearing Protection

• Safety Gloves

• Safety Boots

• Hi-Vis Vest

• Safety Glasses

• Respirator

• Safety Overalls

• Other PPE?

  Yes

  No

Comments:

• NOTE: If there is any doubt that the house may be a Mr Fluffy house, assume it is not safe to proceed until an Occupational Hygienist issues a clearance certificate

• Has the house been identified as a Mr Fluffy house?

  No

  Yes

• If YES, time to contact your Supervisor:

• Followup action:

• Add signature

  Sign