USI M2 Pre-Work Assessment

• Team Completing Pre-work

• Document No.

• Conducted on

  Date

• By signing this document the above employees agree to having taken part in the Toolbox talk and agree that the checklist items have been completed as indicated

• Are you performing work on the M2 as this form is form the M2 only?

  Yes

  No

• Carry on using this form

• Please discard this form and use a regular form

Pre-Work Information

• A toolbox talk is required at the start of each new shift. Please ask these questions and carry out these Pre-work checks on your team and equipment and record with checks applicable aspects as required. Comments can be placed in the box at the bottom of the screen if there are any issues

• Does the work party have all SWMS required for the shift?

• Work permits present?

• Enter permit number

• is the Site Safety Management Plan (SSMP) with the work party?

• Confirm all workers have current ID cards?

• Do all workers have their drivers licenses and WorkCover licenses with them?

• Are all workers inducted to the sites they will be working on during the shift?

• Are all required MSDS's and a hazardous substances register present?

• Is there at least one functioning mobile phone in the team?

• Are all power tools and electrical leads tested and tagged and in date?

• Is there a fully stocked first aid kit with the team?

• Name of designated first aid qualified team member (must be trained and/or certified)?

• If required, has the EWP logbook been completed?

• If required, do abseil team members have their logbook with them?

• Is a ROL (Road Occupancy Licence) required?

• Has the M2 Control Office been notified that you are on site?

• Comments

Toolbox talk topics of discussion

• 
  (Thought points to consider - weather conditions, workers notes, safety issues, aspects specific to job being performed during the day)

• Toolbox topic 1

• Toolbox topic 2

• Toolbox topic 3

• Toolbox topic 4

• Toolbox topic 5

Equipment Checks

• It is the daily responsibility of all workers to check all items prior to use and answer the following questions about their PPE and other equipment when asked by their supervisor. If any item is found to be defective it is to be withdrawn from service and replaced prior to any work commencing

• Which ladders are you using?

• Are all ladders free from major dents and crack?

• Are all ladders safe to use?

• Harnesses being used? (Record whether abseil or full body)

• Are all team members harnesses free of rips, tears, burns, fraying edges and chemical spills?

• Are all karabiners free of cracks, bends or dents?

• Are all slings free of rips, tears, fraying ends, burns or chemical spills?

• Are all attachments like yokes on your harnesses?

• All harnesses are subject to 3 monthly inspections and recorded, it is the installers responsibility to visually check all safety gear (harnesses and attachments) prior to all work activity

PPE - all workers must check they have the following items present with them and that they are in serviceable condition

• Do all staff have a hi-vis vest in an approved colour and style?

• Are all staff wearing steel capped boots (lace up for Rail Sites)?

• Is sunscreen available?

• Do all staff have their harness with double yolks and lanyards?

• Do all workers have their hard hat?

• Is PPE gear clean and tidy?

Fatigue management - team leaders are to ask all workers the following questions before starting work. If any worker/s answer NO then they cannot commence work USI has a zero tolerance policy towards drugs and alcohol at work

• Have all workers had a minimum 10 hour break between shifts?

• Are all workers free from any drugs or alcohol in their system?

• Are all workers alert, fit and able to work and free from fatigue?

Sign off

• Team Leader

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