VISY HSE Minimum Standard - Powered Mobile Equipment & People Interaction Audit Protocol

• Site

• Area of the site audited

• Conducted on

  Date

• Audit completed by

• Manager /Supervisor in charge at the time of the audit

• instructions

• 1. The purpose of this audit is to review the position of the site against the Visy Minimum Standard - Powered Mobile Equipment & People Interaction ( Visy HSE System) * Assess effectiveness in implementation of the PME Minimum Standard * Identify if any areas of concern exist and whether the site has plans in place to address these * Review the sites understanding of the Minimum Standard * Provide constructive feedback to the site on on-going implementation of the Minimum Standard * through these audits and feedback it is aimed that PME safety is increased through physical improvement and awareness 2. In all cases the Auditor should obtain and verify questions by observation and inspection of records. 3. Gaps in the audit leading to actions should be documented, be reviewed by site management / HSE committee and a response documented. Where necessary enter actions requiring an investigation and response into Vault. 4. Opportunities for improvement identified in the audit should be documented where described and reviewed by the site for implementation. Improvements and actions to close gaps can be documented in the annual site HSE Plan. HSE Procedure 201

• How to complete this audit: Audit instructions : The audit consists of a series of questions under a set key requirement, each question lists required evidence that you as an auditor are required to verify and prove whether they exist. 1. Ask the questions or statements contained within the standard question column. These are lead or 'kick off' questions that may generate further questions on the same topic. 2. Use the required evidence as the basis for obtaining factual evidence to prove that question or statement. 3. If the question or statement can be proved by factual evidence or by other appropriate means then note the evidence within the available space. 4. Rate each section against the following scoring criteria: if the question or statement can be proved by factual evidence or by other appropriate means then check the YES box. If the question or statement is not or partially achieved, check the NO. 5. Opportunities for Improvement and corrective actions should be noted in the relevant boxes at the end of the audit.

• Instructions directly following the audit: 1. Communicate the identified areas for concerns and items not commenced, with the management team during the closing meeting. 2. Complete the audit report summary template. 3. Send a copy of completed audit protocol to the site key stakeholders as applicable. 4. Site to prioritise gaps and develop action plan to address. 5. Audit shall be signed by the site manager. 6. If the audited site scored poorly (under 50%), a re-audit must be arranged within 6 months.

Key Requirement 1: GENERAL

• Does the site have a traffic management plan in place? (Evidence of sites traffic management plan - this shall be more that just a map.

  Yes

  No

  N/A

• Evidence of any applicable site action plans with dates set that have not passed.

  Yes

  No

  N/A

Key Requirement 2: PHYSICAL BARRIER / SEPARATION

• Are there physical barriers in place for all designated pedestrian walkways that are in close proximity to where PME operate? (Physical barriers shall exist for ALL walkways)

  Yes

  No

  N/A

• Does the site have list or register of identified authorised devices?

  Yes

  No

  N/A

• There is no where on the site where PME can / do cross over designated pedestrian walkways? (Designated walkways cannot be crossed / entered by PME and shared walkways marked accordingly)

  Yes

  No

  N/A

• All gates that separate designated pedestrian walkways from PME operating areas have signage clearly warning of the PME hazards.

  Yes

  No

  N/A

• All gates / barriers and applicable separation equipment are in good working order. (All applicable separation equipment shall be fitted in place and fully operational as required).

  Yes

  No

  N/A

• Areas not currently compliant with above have been risk assessed and appropriate controls in place. (Controls in place are supported by documented evidence).

  Yes

  No

  N/A

• There are no unsafe practices being carried out at the site that place pedestrians on walkways at risk such as but not limited to:<br>(I) items placed on walkways<br>(Ii) pallets stacked more than two high next to walkways

  Yes

  No

  N/A

Key Requirement 3: UNLOADING / LOADING ZONES

• Does the site have designated unloading / loading areas that complies to the standard (including dimensional)<br>Note - they may actually exceed the standard, ie. physical separation between bays to minimise PME interaction<br>(i - Areas shall be either marked as solid RED or with red lines around outside and cross-hatched<br>ii - areas do not fully comply with all dimensions but a separate Risk Assessment has been carried out with full sign-off from at leastSite Manager, Despatch Manager, Safety Committee<br>iii - N/A - no unloading / loading areas exist and are not required for the business)

  Yes

  No

  N/A

• Any evidence of Despatch Unloading / Loading breaches occurring during the audit?<br>(N/A - no unloading / loading areas exist and are not required for business)

  Yes

  No

  N/A

• Have all applicable persons involved within the Unloading / Loading Areas been trained?<br>(View training records and induction records)

  Yes

  No

  N/A

• A full Risk Assessment has been carried out for the current Unloading / Loading Area?<br>(Sight signed off Risk Assessment with sign-offs from at least the Site Manager, Despatch Manager, Safety Committee representative<br>N/A - no unloading / loading areas exist and are not required for business)

  Yes

  No

  N/A

• A designated Driver Waiting Area exists (may require more than one, depending on number and location of Unloading / Loading Areas?<br>(Driver waiting areas exist; safe areas; easily accessible; <br>N/A - no unloading / loading areas exist and are not required for business)

  Yes

  No

  N/A

Key Requirement 4: UNDERSTANDING THE STANDARD

• Has the site communicated the Responsibilities & Key Aspects of the Minimum Standard for PME & People Interaction to the Operations / Site Manager?<br>(i - evidence of completion of training - Induction, and/ or Toolbox Talk and/ or Competency based as required)

  Yes

  No

  N/A

• Has the site communicated the Responsibilities & Key Aspects of the Minimum Standard for PME & People Interaction to the Warehouse Manager / Supervisor?<br>(i - evidence of completion of training - Induction, and/ or Toolbox Talk and/ or Competency based as required<br>ii - N/A - as there is no Despatch Manager/ Supervisor on site)

  Yes

  No

  N/A

• Has the site communicated the Responsibilities & Key Aspects of the Minimum Standard for PME & People Interaction to the Supervisor / Leading Hand?<br>(i - evidence of completion of training - Induction, and/ or Toolbox Talk and/ or Competency based as required<br>ii - N/A - as there is no Despatch Supervisor / Leading Hand on site)

  Yes

  No

  N/A

• Has the site communicated the Responsibilities & Key Aspects of the Minimum Standard for PME & People Interaction to all on site PME Operators?<br>(i - evidence of completion of training - Induction, and/ or Toolbox Talk and/ or Competency based as required)

  Yes

  No

  N/A

• Has the site communicated the Responsibilities & Key Aspects of the Minimum Standard for PME & People Interaction to all visiting Truck Drivers?<br>(i - evidence of completion of training through inductions to all visiting truck drivers as applicable - Note this may only include specifics of the standard as applicable to their key tasks whilst on site)

  Yes

  No

  N/A

• Has the site communicated the Responsibilities & Key Aspects of the Minimum Standard for PME & People Interaction to all employees, visitors and contractors?<br>(i - evidence of completion of training - Induction, and/ or Toolbox Talk and/ or Competency based as required)

  Yes

  No

  N/A

Key Requirement 5: AUTHORISED ACCESS AREA (AAA)

• Does the site have areas which are or should be AAA and marked / sign posted as such and are they sign posted/ suitably marked?<br>(i No AAA exist so none of the following are applicable:<br> - There is no interaction between PME & Pedestrians with blind spots<br>- Infrequent need for Pedestrian work tasks to be performed, so having pedestrians in that area is abnormal<br>ii Areas exist and are adequately signposted / communicated to all applicable stakeholders including employees, contractors and visitors - see Key Req 6 - Q3)

  Yes

  No

  N/A

• Does the site have specific rules, including procedures, signage and training for their AAA's)<br>(i No AAA's exist {see Q1 above}<br>ii Register of Authorised AAA persons exists and is readily available<br>iii Procedures exist for all AAA's on site<br>iv Additional controls such as but not limited to Flashing Beacons; Temporary Bollards; etc are used each time that an Authorised Person enters a AAA<br>v. The site can demonstrate that all applicable stakeholders on site have been trained in AAA)

  Yes

  No

  N/A

• Any evidence during the audit of pedestrians walking through AAA's - if Yes, then we're applicable site rules followed?<br>(i No pedestrians seen walking through the AAA's<br>Ii Pedestrians seen but all applicable site rules followed as listed in Q2 above were followed<br>iii no AAA's exist as per Q1 above)

  Yes

  No

  N/A

• Any evidence of other breaches taking place within a AAA such as but not limited to pedestrians using mobile phone; not wearing applicable PPE, etc<br>(i No breaches were spotted during the audit<br>ii No AAA's exist as per Q1 above)

  Yes

  No

  N/A

• Any evidence of the site not meeting AAA rules - Eg, walkways going through AAA's; doors opening into AAA's<br>i All rules as laid out within the standard are met<br>ii Walkways do go through AAA's but full Risk Assessments have been carried out with applicable controls put into place<br>iii N/A - No AAA's exist on site)

  Yes

  No

  N/A

Key Requirement 6: ENTRY SIGNAGE & CONTROLS

• Does the site have Speed Limit Signs throughout key areas of the site?<br>i. The speed signs shall be clear and easy to read (not damaged)<br>ii. E speed signs shall be consistent across the site with the same speed noted<br>iii. The speed signs shall be in all key areas of where PME (including visitors / truck drivers) operate

  Yes

  No

  N/A

• Does the site have warning signs for Pedestrians to indicate that PME are operating in all areas of the site?<br>I. All applicable gates / doorways, etc where pedestrians have to cross PME operational areas have applicable warning signage displayed<br>ii. All signage shall be clear and easy to read (not damaged)

  Yes

  No

  N/A

• Does the site have warning / cautionary signage and AAA ground marking (yellow / black hatching) at the entrances for all AAA's of the site?<br>I. The AAA signs shall be clear and easy to read (not damaged / worn away)<br>ii. The AAA signs shall be consistent across e site<br>iii. The AAA signs shall be at all possible entrances to any AAA zone (including both pedestrian & PME)<br>iv. Yellow & black hatching is at all entrances where practicable

  Yes

  No

  N/A

Key Requirement 7: AUDIT

• Has the site been internally audited within the last 12 months?<br>I. The site can show a signed off audit checklist from the past twelve months that has been carried out by either site management, supervisor or safety person<br>ii. If no audit has been carried out in the last 12 months, then the score shall be zero

  Yes

  No

  N/A

• Has the site been externally audited within the last 2 years?<br>I. The site can show a signed off audit checklist within the past two years that has been carried out by an external Visy Manager, HSE Professional or applicable auditor<br>ii. If no audit has been carried out within the last 2 years, then the score shall be zero

  Yes

  No

  N/A

Key Requirement 8: INCIDENTS & CODE of PRACTICE BREACHES

• Does the site use Vault (or other dedicated system) to report all incidents and breaches of Minimum Standard for PME & People Interaction?<br>I. The site shall have a dedicated system where all breaches of this standard are captured and recorded and acted upon

  Yes

  No

  N/A

• Has the site conducted a full investigation for all Major (level 7-8) and above incidents?<br>I. Completed investigations on Vault (or other dedicated system) for all Major (7-8) or High Risk level and above breaches - investigations shall have been completed<br>ii. Where a site has not had any such breaches, then add N/A and score a 1

  Yes

  No

  N/A

• Does the site have evidence of any updated documents from any Major (level 7-8) and above incidents?<br>I. All associated documents as noted in Vault (or other dedicated system) for all Major (level 7-8) or High Risk level have been issued with applicable stakeholders trained<br>ii. Where a site has not had any such breaches, then add N/A and score a 1

  Yes

  No

  N/A

Key Requirement 9: PME COMPETENCY and TRAINING

• Do all PME operators have applicable licenses as applicable for PME on site?<br>I. Records of licenses kept, including date of issue and renewal <br>ii. Referenced on the site training matrix

  Yes

  No

  N/A

• Do all PME operators have applicable on site training in specific tasks as related to the PME, Including but not limited to - unloading/ loading; moving product around the site (eg. Bales, paper reels, bins, etc)<br>I. Records of specific training on site for ALL PME related tasks<br>ii. Referenced on the site training matrix

  Yes

  No

  N/A

• Site Induction<br>I. Records of specific site induction for all PME operators on site<br>ii. Referenced on the site training matrix

  Yes

  No

  N/A

• Actions Resulting from the Audit

• Opportunities for Improvement

• Add signature

  Sign