Visionstream Start Card 2018

• Date:

  Date

• Name:

• Location/Task:
  Address

• SHEWMS Reference:

Stop and Think through the task

• Contact supervisor if red box is ticked

• Have I signed and do I understand the SHEWMS for this task?

  Yes

  No

  N/A

• Contact supervisor

• Is there a change to a procedure, process or design?

  Yes

  No

  N/A

• Contact supervisor

• Do I have the required permits and approvals?

  Yes

  No

  N/A

• Contact supervisor

• Am I trained, competent and authorised to complete this task?

  Yes

  No

  N/A

• Contact supervisor

• Am I wearing the correct PPE for the task?

  Yes

  No

  N/A

• Contact supervisor

• Are tools and equipment in good working order, tested/tagged and safe to use?

  Yes

  No

  N/A

• Contact supervisor

• Have I signed onto the Pre-start/JSEA Meeting form today and have I been briefed on the task?

  Yes

  No

  N/A

• Contact supervisor

• Do I have a clear plan in mind to complete this task safely?

  Yes

  No

  N/A

• Contact supervisor

Task readiness

• Contact supervisor if red box is ticked

• Am I fit to perform this task (aware, rested, alert and physically able)?

  Yes

  No

  N/A

• Contact supervisor

• Am I under the influence of drugs or alcohol?

  Yes

  No

  N/A

• Contact supervisor

• Do I need additional help with the task?

  Yes

  No

  N/A

• Contact supervisor

• Do I understand the directions given by my supervisor?

  Yes

  No

  N/A

• Contact supervisor

• Is my immediate work area neat and tidy (clear access and egress)?

  Yes

  No

  N/A

• Contact supervisor

• I have response plans in place for a potential emergency?

  Yes

  No

  N/A

• Contact supervisor

• Am I able to effectively implement the risk control measures identified in the SHEWMS and JSEA?

  Yes

  No

  N/A

• Contact supervisor

• Are there any other safety or environmental hazards associated with this task that are not covered in the SHEWMS and/or Pre-start/JSEA Form

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Stop work and contact your supervisor.

Hazard Identification

• Hazard:

• Control:

• Risk Rating:

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

  Yes

  No

  N/A

• Stop work and contact your supervisor.