Visionstream istart Card

• Name

• Date

  Date

• Location/Task

• Address
  Address

Focus on critical risks

• 1. Am I working with electricity?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• 2. Is there a risk I could fall from one level to another?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• 3. Am I working around live services?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• 4. Am I completing excavation works or working in excavations or trenches greater than 1.5m?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• 5. Am I working near live traffic?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• 6. Am I working in and around an area of operating mobile plant?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• 7. Am I working in a remote or isolated location?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• 8. Am I performing heavy lifting using a crane or other mechanical lifting device?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• 9. Could I be exposed to asbestos?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• 10. Am I working in a confined space?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• 11. Am I working on or near hazardous energies?

  Yes

  No

  N/A

• SHEWMS Ref: Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's content and signed in.

• Identify your hazards (including critical risks above), assess your risk and note your controls.

Hazard

• Specify hazard

• Controls

• Risk Rating

Completion

• Additional comments

• Have I achieved an acceptable risk rating and do I feel safe?

  Yes

  No

• Stop work and contact your supervisor.

• Sign off

  Sign