TSAT - WST JSA & INSPECTION FORM - v1.3.2

• Audit Title

• Document Number

SWMS Applicable

• SWMS Applicable

  Select SWMS/001 Minor Electrical Shock SWMS/003 HV/LV Contact SWMS/004 Electrical Inspection SWMS/005 Working at Heights

  • SWMS/001 Minor Electrical Shock
  • SWMS/003 HV/LV Contact
  • SWMS/004 Electrical Inspection
  • SWMS/005 Working at Heights

General Hazard(s) Identified (Tick if applicable)

• Working with live equipment

• Access to metering impeded

• Access to switchboard impeded

• Manual handling

• Trips, slips & falls ( heights )

• Traffic Hazard assessment

• Non restrained animals

• Inclement weather

• Sharp objects (eg. Syringes)

• Restricted (site) access

• Public area clearances

• Confined space

• Parking congestion

• Dangerous/hazardous materials

• Limits of approach

• Falls from holes

• Hard hat site or area

• Not safe with single man

• Customer acting in a threatening or dangerous manner

• Unsafe worksite or area

General Hazard Control Measures

• Visual inspection

• Clear access obtained

• Reflective safety vest

• Full PPE in serviceable condition

• Eye and hearing protection

• LV safety gloves

• Safety helmet

• Safety harness or belt

• Spotlight or torch

• Ladder and/or LV sticks

• Traffic management - signs, cones

• Signs/labels/tags/barriers

• Housekeeping

• First aid kit

• Fire extinguisher

• Syringe disposal container

Live Works Hazard(s) Identified (tick if applicable)

• Working with and in the vicinity of live electrical apparatus

• Metal meter box

• Incomplete testing

• Incorrect test results

• Alternate generator supply

• Back feed

• Reverse polarity

• Damaged assets

• Electrocution

Live Works Hazard Control Measures

• Isolate supply

• Appropriate clearance

• LV mats

• Tags, labels and barriers

• Control physical movements

• Full PPE in serviceable condition

• LV safety gloves

• Eye protection

• Insulated tools

• Visual inspection

• Test equipment certified

Environmental Hazard(s) Identified (tick if applicable)

• Asbestos

• Weeds, erosion

• Vehicle used -grass fires, emissions

• Oil & fluid spills

• Flora, water & minerals

• RF antenna

Environmental Hazard Control Measures

• Asbestos - isolate and report

• Wash car, take alternate route

• Maintain 100 mm clearance

• Location of fire prevention equipment

• Site evacuation plan and emergency process

• Hazardous substance procedure

Working From Heights

• Fall from heights greater than 2 meters or over 2 meters near edge

• Do not rely on existing brackets

Roof Pitch

• 0-20

• 20-30

• 30 and Above

Ground Surface

• Hard

• Soft

• Sloping

• Flat

Working from Heights Hazard Controls (Hierarchy)

• 1st - Complete Task on Ground

• 2nd - EWP or Guarding/Scaffold

• 3rd - Restraint System

• 4th - Double Lanyard

• 5th - Extension Ladder with Outriggers

• 6th - Step ladder

• 7th - Gutter Bracket

• 8th - Roof Brackets x3 Harness Points

• 9th - 75mm Roofing Screws required min 2 per bracket

• 10th - Observer / Temporary Barrier (eg. Signs, witches hats, barricade tape)

Additional Hazard(s) identified

• Comments

Additional Hazard Control Measures

• Comments

Additional Comments / Notes

• Comments

Mandatory Section - Signature Required

• The risk assessment has been completed in accordance with the appropriate Safe Work Method Statement (SWMS), and all mandatory tests have been performed in accordance with TSA procedures
  
  By signing this form you acknowledge that you understand the Work Instructions and are authorised to carry out this work

• Signature

  Sign

• Signature

  Sign