Title Page

  • Pit Name:

  • Conducted on

  • Prepared by

  • Location
  • Supervisor / Team Leader:

1. Emergency Management

  • o Exits identified

  • list additional risk control measures

  • o Exit paths and equipment unobstructed

  • list additional risk control measures

  • o Evacuation plan in place, communicated and understood.

  • list additional risk control measures

  • o Fire extinguishers available.

  • list additional risk control measures

2. House keeping

  • o o Pollution (e.g. oil waste, scrap steel, etc.)

  • list additional risk control measures

  • o Adequate disposal/collection

  • list additional risk control measures

  • o Bunding/storage of container area

  • list additional risk control measures

  • o Other

  • list additional risk control measures

3. Paths and storage areas

  • o Demarcation in place as required

  • list additional risk control measures

  • o Work area not cluttered or obstructed

  • list additional risk control measures

  • o Access to emergency equipment and exits clear of obstruction

  • list additional risk control measures

4. Plant and yard

  • o No redundant plant

  • list additional risk control measures

  • o No redundant material

  • list additional risk control measures

  • o Tidy

  • list additional risk control measures

5. Waste removal system

  • o Enough bins

  • list additional risk control measures

  • o Adequate removal/emptied

  • list additional risk control measures

  • o Other

  • list additional risk control measures

6. High voltage power lines

  • o Identified by signs on all approach roads

  • list additional risk control measures

  • o Material not stock-piled under power lines

  • list additional risk control measures

7. Machine guarding

  • o Machines comply with appropriate standards

  • list additional risk control measures

  • o Guards in place

  • list additional risk control measures

  • o All nip points guarded

  • list additional risk control measures

  • o Not loose, broken, or inadequate

  • list additional risk control measures

8. Lock-out system and usage

  • o Written procedure

  • list additional risk control measures

  • o Covers all sources of energy

  • list additional risk control measures

  • o Switches lockable

  • list additional risk control measures

  • o Tags/locks available

  • list additional risk control measures

9. Switches, isolators, valves & controls

  • o Labelled

  • list additional risk control measures

  • o No labels missing

  • list additional risk control measures

  • o Emergency stop buttons red

  • list additional risk control measures

10. Lifting gear and machinery

  • o Identified and on register

  • list additional risk control measures

  • o No defective items

  • list additional risk control measures

  • o Safe working load marked

  • list additional risk control measures

  • o Safety latches in place

  • list additional risk control measures

  • o Regular inspections

  • list additional risk control measures

11. Chemicals and substances

  • o Chemical register

  • list additional risk control measures

  • o Manifest and emergency plan

  • list additional risk control measures

  • o Products labelled

  • list additional risk control measures

  • o SDS sheets

  • list additional risk control measures

  • o Stored appropriately, bunding & containment

  • list additional risk control measures

  • o Segregation distances

  • list additional risk control measures

12. Condition of vehicles/plant

  • o Daily check/documentation (pre-starts)

  • list additional risk control measures

  • o No defective items – maintenance system okay

  • list additional risk control measures

  • o Operator competent – documented training

  • list additional risk control measures

  • o Isolated when unattended

  • list additional risk control measures

  • o Seat belts

  • list additional risk control measures

  • o Critical safety items (steering, brakes, loss of power – regularly checked)

  • list additional risk control measures

  • o ROPs, FOPs, TOPs

  • list additional risk control measures

  • o Overhead guards where applicable

  • list additional risk control measures

  • o Guardrails on all platforms

  • list additional risk control measures

  • o Three points of contact available on all access systems

  • list additional risk control measures

  • o Fire extinguisher and/or suppression system

  • list additional risk control measures

  • o Potential for contact with overhead structures

  • list additional risk control measures

  • o Flashing light/reversing alarm

  • list additional risk control measures

  • o Maintenance records

  • list additional risk control measures

13. Hand tools condition and storage

  • o Routine check

  • list additional risk control measures

  • o No damaged or defective tools

  • list additional risk control measures

  • o No sharp edges, mushroomed ends

  • list additional risk control measures

  • o No split handles

  • list additional risk control measures

  • o Stored correctly

  • list additional risk control measures

  • o Clean of oil & grease

  • list additional risk control measures

14. Noise

  • o Areas identified where excessive noise levels exist (noise monitoring conducted)

  • list additional risk control measures

  • o Operators not being exposed to levels above national standards

  • list additional risk control measures

  • o Operators are isolated from noise (cabins)

  • list additional risk control measures

  • o Hearing protection worn

  • list additional risk control measures

  • o Signs installed for PPE requirements

  • list additional risk control measures

  • o PPE worn correctly

  • list additional risk control measures

15. Dust

  • o Mineralogy of material being mined is known (petrographic analysis)

  • list additional risk control measures

  • o Dust generation has been considered in all tasks (activities)

  • list additional risk control measures

  • o Operators are isolated from dust sources (cabins)

  • list additional risk control measures

  • o Sprays and chute cover installed

  • list additional risk control measures

  • o Dust masks worn

  • list additional risk control measures

  • o Signs installed for PPE requirements

  • list additional risk control measures

  • o PPE worn correctly

  • list additional risk control measures

16. Ergonomics

  • o Body posture

  • list additional risk control measures

  • o No lifting and twisting

  • list additional risk control measures

  • o Standard colour coding

  • list additional risk control measures

  • o Accessibility (switches, levers, ladders)

  • list additional risk control measures

  • o Adequate lighting

  • list additional risk control measures

  • o Seats/chair/workstations condition

  • list additional risk control measures

  • o Ladders approx. 70-degree angle

  • list additional risk control measures

  • o Walkway width is adequate

  • list additional risk control measures

17. Ultraviolet (UV) and ionizing radiation

  • o Provision of shade covers or canopies

  • list additional risk control measures

  • o Work performed outside of peak UV exposure times

  • list additional risk control measures

  • o Barriers are in place for welding tasks

  • list additional risk control measures

  • o Long sleeve clothing worn

  • list additional risk control measures

  • o Sunscreen and hats provided to workers

  • list additional risk control measures

  • o Signs installed for PPE requirements

  • list additional risk control measures

  • o PPE worn correctly

  • list additional risk control measures

18. Vibration

  • o Seat design considered in plant

  • list additional risk control measures

  • o Low vibration tools for maintenance selected

  • list additional risk control measures

  • o Road surfaces maintained

  • list additional risk control measures

  • o Anti-vibration gloves selected

  • list additional risk control measures

19. Fitness for work <br>Fatigue<br>

  • o People working shifts 8 hrs. or less

  • list additional risk control measures

  • o Pre- shift travelling distances are considered

  • list additional risk control measures

  • o Fatigue discussed with supervisors

  • list additional risk control measures

  • o Breaks are regular and available

  • list additional risk control measures

  • o Climate and operating conditions are considered in work demands

  • list additional risk control measures

Drugs and alcohol (D&A)

  • o D&A banned from site

  • list additional risk control measures

  • o D&A policy exists

  • list additional risk control measures

  • o D&A education is included in induction

  • list additional risk control measures

  • o D&A testing on site

  • list additional risk control measures

  • o Supervisors empowered to act

  • list additional risk control measures

  • o Prescription medication is declared when used

  • list additional risk control measures

20. Head protection

  • o Area identified – sign

  • list additional risk control measures

  • o Hard hats provided

  • list additional risk control measures

  • o Being worn

  • list additional risk control measures

21. Footwear

  • o Provided

  • list additional risk control measures

  • o Correct for task

  • list additional risk control measures

  • o Being worn

  • list additional risk control measures

22. Protective clothing

  • o Suitable clothing for task

  • list additional risk control measures

  • o Provided and maintained

  • list additional risk control measures

23. Eye and face protection

  • o Area identified – signs

  • list additional risk control measures

  • o Equipment provided

  • list additional risk control measures

  • o Worn correctly

  • list additional risk control measures

  • o Prescription glasses to standard

  • list additional risk control measures

24. Other PPE

  • o Safety harness & lanyards

  • list additional risk control measures

  • o Hand protection (gloves etc.)

  • list additional risk control measures

  • o Respiratory equipment

  • list additional risk control measures

  • o Sun protection, sunscreen

  • list additional risk control measures

  • o Sun hat or attachment

  • list additional risk control measures

  • o Insect repellent

  • list additional risk control measures

  • o Welding PPE

  • list additional risk control measures

25. Signs posted

  • o Appropriate signs displayed

  • list additional risk control measures

  • o To standard requirements

  • list additional risk control measures

  • o Visible and correctly located

  • list additional risk control measures

  • o Good condition

  • list additional risk control measures

26. Noticeboards and displays

  • o Conspicuous position

  • list additional risk control measures

  • o Up to date

  • list additional risk control measures

27. Warning signs

  • o No unauthorised entry

  • list additional risk control measures

  • o Procedure in case of fire

  • list additional risk control measures

  • o Procedure in case of electric shock

  • list additional risk control measures

28. Extinguishing equipment

  • o Adequate number provided

  • list additional risk control measures

  • o Correct types for fire risks i.e. hydrants and fire extinguishers, sprinkler systems, foam equipment, fire station etc.

  • list additional risk control measures

29. Fire equipment locations

  • o Location accessible

  • list additional risk control measures

  • o Signs and demarcated areas

  • list additional risk control measures

  • o Signs indicated type of equipment

  • list additional risk control measures

  • o Signs to standard

  • list additional risk control measures

  • o No equipment obstructed

  • list additional risk control measures

30. Maintenance of equipment

  • o All equipment on register

  • list additional risk control measures

  • o Inspection/service to standard

  • list additional risk control measures

  • o Tags/seals in place

  • list additional risk control measures

  • o Condition good

  • list additional risk control measures

31. Fire fighting

  • o Adequate workers trained

  • list additional risk control measures

  • o Available number of people on all shifts

  • list additional risk control measures

  • o Training and competency records

  • list additional risk control measures

32. Road condition

  • o Wide enough for vehicles

  • list additional risk control measures

  • o Adequate passing areas

  • list additional risk control measures

  • o Graded surface, no spillage, potholes

  • list additional risk control measures

  • o Camber 2–3%

  • list additional risk control measures

33. Signs

  • o Access to site adequately sign posted

  • list additional risk control measures

  • o Mining/open pit hazard identified

  • list additional risk control measures

  • o Speed limits

  • list additional risk control measures

Others

  • 1. Any other hazards not identified in table above?

  • 1

  • 2

  • 2

  • 3

Completed By

  • Supervisor Name

  • (Signature)

  • (Date)

  • Inspection Completed By

  • Signature

  • Finding Reported To

  • Date:

Controls Implemented

  • Controls Implemented ?

  • By Whom

  • Date

  • Review Date

  • Controls Implemented ?

  • By Whom

  • Date

  • Review Date

  • Controls Implemented ?

  • By Whom

  • Date

  • Review Date

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.