Ventia - LEAD Form

• Conducted on

  Date

• Prepared by

• Project and work type

• Location
  Address

• Has a start card been completed correctly?

  Yes

  No

  N/A

• What was missing/incorrect?

• Are all workers wearing the appropriate PPE?

  Yes

  No

  N/A

• Comments

• Were the employees able to explain the major risks and hazards associated with the task being undertaken and the necessary controls that were in place?

  Yes

  No

  N/A

• Hazards

• Controls

• Are the controls effective in controlling the hazards

  Yes

  No

  N/A

• CRP's observed;

  Select Lifting Live traffic Isolated work Confined space Mobile plant Live services ACM Excavation Heights Electrical Hazardous energies

  • Lifting
  • Live traffic
  • Isolated work
  • Confined space
  • Mobile plant
  • Live services
  • ACM
  • Excavation
  • Heights
  • Electrical
  • Hazardous energies

Asbestos and ACM

• What additional PPE is being worn?

  Select N/A P2 Mask Coveralls Gumboots Safety Glasses Disposable Gloves Other

  • N/A
  • P2 Mask
  • Coveralls
  • Gumboots
  • Safety Glasses
  • Disposable Gloves
  • Other

• Have personnel conducted asbestos awareness training?

  Yes

  No

  N/A

• Are the workers aware of how to correctly dispose of ACM and their PPE?

  Yes

  No

  N/A

• Explain the workers understanding of the task and disposal.

Confined Space Work

• Has a rescue and permit been completed?

  Yes

  No

  N/A

• What type of rescue method has been selected and who is completing which role?

• Is continuous gas monitoring being completed?

  Yes

  No

  N/A

• Has equipment been inspected prior to use and when is the equipment due for inspection?

Electrical Safety

• Has all electrical equipment been inspected prior to use and test and tagged?

  Yes

  No

  N/A

• When is the equipment due to be reinspected for test and tag?

Managing Hazardous Energies

• Are any isolation's in place for the work?

  Yes

  No

  N/A

• Are all relevant permits and plans in place?

  Yes

  No

  N/A

• How have the hazardous energy sources been isolated?

• What training do workers completing the isolation have and is it current?

Trenching and Excavation

• If the excavation is over 1.5m deep - Are all side of the trench benched, battered or shored?

  Yes

  No

  N/A

• Comments

• Is there adequate warning signage and appropriate access/egress?

  Yes

  No

  N/A

• Comments

• Has a rescue plan been completed on the start card?

  Yes

  No

  N/A

• Comments

Working around live traffic

• Are road closures, detours, traffic control or traffic signage in place when working around live traffic?

  Yes

  No

  N/A

• Is traffic control self performed or externally provided?

  Self performed

  External provider

• Comments

• Take a photo of the signage or traffic control devices

  Media

• Do the implemented traffic management controls offer adequate protection to the workers and pedestrians?

  Yes

  No

  N/A

• Comments

Mobile plant

• Have plant and vehicle pre-starts been completed correctly?

  Yes

  No

  N/A

• Where there any faults or maintenance requirements noted in the pre-starts?

• How is site set up to achieve separation or maintain the exclusion zone between plant and personnel?

• Are flashing beacons and beepers installed and operational?

  Yes

  No

  N/A

• Is all plant secured correctly when being transported? Are all safety chains for buckets available?

  Yes

  No

  N/A

• Comments

Working around live services

• Are DBYD plans available on site?

  Yes

  No

  N/A

• Comments

• Have all services been located in vicinity of works?

  Yes

  No

  N/A

• How have services been located?

  Select Hand dig Vac truck Visual (Pits, trench etc) Electronic locator GPR Other N/A

  • Hand dig
  • Vac truck
  • Visual (Pits, trench etc)
  • Electronic locator
  • GPR
  • Other
  • N/A

• Comments

Emergency response

• Are all workers aware of where the muster point is?

  Yes

  No

  N/A

• Have the crew explain their understanding of the emergency procedure for these works.

• Who is the nominated first aider for the site?

• Are fire extinguishers and first aid kits present and in date?

  Yes

  No

  N/A

• First aid inspection date

• Fire extinguisher inspection date

Environmental

• What environmental hazards are present?

  Select Dust Noise Water Waste Asbestos Sediment Fuel/Chemicals Spoil Other N/A

  • Dust
  • Noise
  • Water
  • Waste
  • Asbestos
  • Sediment
  • Fuel/Chemicals
  • Spoil
  • Other
  • N/A

• What environmental controls are in place?

Contractor Management

• Are any contractors on site?

  Yes

  No

  N/A

• Are the contractors wearing the correct PPE?

  Yes

  No

  N/A

• Discuss PPE requirements with contractor.

• Are the contractors aware of the emergency procedure and muster point?

  Yes

  No

  N/A

• Have the contractors completed the Ventia induction?

  Yes

  No

  N/A

• Report name to SHEQ for induction and complete short term induction.
  https://ventia-my.sharepoint.com/:b:/g/personal/kurtis_carlyle_ventia_com_au/EX-YouWn0iRPrShGdbUtfakBw7O-aiA-JVOOXq3e1N4lMA?e=PYXwzo

• Contractor name?

• What hazards and controls were identified by the contractors?

Additional information

• Site photos

  Media
Personnel interviewed

• Add signature

  Sign

• Comments/Suggestions/Improvements/Innovations

• Person completing

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