VUL-PLN-043-REG1-CMR

• Contractor Company

• Date

  Date

• Site conducted

  Select

CMR Primary Contact Information

• In this section, the Contractor needs to complete:
  • Primary contact information
  • Description of the Scope of Works
  • Insurance information

• Vulcan Mine Contractor Manager (As per the Management Structure)

• Email address

• Phone

• Vulcan Mine Contractor Owner (The Company representative who requested the services)

• Email

• Phone

• Contracting Company Contractor Manager (Contracting Company Owner/Managing Director/Operations Manager)

• Email

• Phone

• Contracting Company Authorised Administrative Representative

• Email

• Phone

Contracting Company Primary Details

• ABN

• Address
  Address

• Phone

• Fax

• Website

Scope of Works

• If you have provided a Scope of Works to the Contract Owner, please include the document name within the brief description.

• Provide a brief Description of the work being conducted on the Vulcan Mine

• Proposed Start Date

  Date

• Proposed End Date

  Date

• Proposed Shifts

  Day

  Night

  Both

• Provide any licences required to complete the Scope of Works

  Media

Company Org Structure

• Provide the proposed org structure for the Scope of Works

  Media

undefined

• Category 1 Contractor
  
  Contractor to work under the Mine’s SHMS with integrated safety procedures to conduct the scope of works to ensure there is only 1 approved SHMS for the site.
  The integrated safety procedures MUST be approved by the SSE.
  All elements of the site SHMS are applicable to these persons, including inductions, medicals, refresher training, and attendance at pre-start and toolbox meetings when on site, etc.
  
  Category 2 Contractor
  
  Contractor to work under site Mine's SHMS.
  All elements of the site SHMS are applicable to these persons, including inductions, medicals, refresher training, and attendance at pre-start and toolbox meetings when on site, etc.
  
  Category 3 Contractor
  
  Office based, escorted in work area at all times or offsite Contractor. Accompanied or supervised by a nominated site representative at all times.
  Mainly office based / consultative scope of works.
  Visitor / Consultant - visitor induction No ‘hands-on’ work
  

• Select the Contractor Catergory Type

  Category 1

  Category 2

  Category 3

Contractor Integration Plan (CIP)

• The purpose of this section is to describe the integration and accountabilities for Health, Safety, Environmental and Training between Vulcan Mine Management (Vulcan or the Company), and all wholly owned and operated subsidiaries, including Vulcan Mine Management at the Mine, and the Contractor, for the duration of the contracted services.
  All contractors at the the Mine Site shall use the SHMS systems and procedures. However, it is acknowledged that some tasks may not be covered by the systems and procedures. In these cases, the contractor shall submit the required procedures to the Contractor Manager for review and must be approved by the the Mine Site SSE to be integrated into the SHMS and before any work can begin on site.(e.g., Drilling).
  In all cases the Standard Operating Procedures (SOP's) required by Regulation must apply.
  All Category 1 contractors will need to complete and comply with the CIP if the Contractor is required to integrate safety documentation into the SHMS to ensure there is only 1 approved SHMS for the the Mine.
  The SSE must approve the Contractor’s safety documentation to be integrated into the SHMS.
  Part 1. Provide a list of safety documentation for integration into the the Mine SHMS
  Part 2. SSE Approval
  Part 3. Contractor Acknowledgment

• Provide copies of the safety documentation for integration into the Mine's SHMS

  Yes

  No

• CONTRACTOR ACKNOWLEDGMENT Policy & Commitment Vulcan and the Contractor are aligned in their commitment to Health, Safety, Environment and Training leadership which supports an injury free workplace through the elimination of workplace injury and illness. Both Vulcan and the Contractor are committed to supporting a safety culture that empowers all personnel to ‘Stop the Job’ if they believe the activity or situation could result in personal injury or environmental or asset damage.

  Sign

• CONTRACTOR LEGISLATIVE OBLIGATIONS The Contractor has specific obligations defined by the QLD Coal Mining Safety and Health Act (s43 – s47). By developing and implementing this SHMS Contractor Integration Plan, both Vulcan and the Contractor are working towards discharging their respective obligations under the QLD Coal Mining Safety and Health Act.

  Sign

Preliminary Risk Assessment

• A Preliminary Risk Assessment (PRA) is required to be completed by the Contracting Company to determine an acceptable level of risk.
  Based on the answers to the below Critical Risk, if you answer YES, a Hazard Control Study is required in accordance with VUL-SOP-049-Risk Management. The controls included in the Hazard Control Study must be in place prior to the commencement of work. Relevant Significant Risk Standards are to be used as the primary source of control measures that must be implemented to control risk. A representative from all work areas involved in the work task must be consulted and provide feedback into the development of the PRA

Critical Risks

• The general requirements of completing the Scope of Works have been considered and activities that are classified as a Critical Risk have been identified.

• Cutting, Drilling or Excavating near a concealed service (Entering a trench more than 1.5 metres deep).

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Entering a Confined Space.

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Erecting and Installing of Fixed Plant

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Work on or adjacent to a road or railway.

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Exposure to excess noise, vibration, excess lead, silica.

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Excessive air emissions, ground contamination due to work processes

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Prescribed Activity (Demolition or removal of asbestos)

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Lifting Operations - Tilt-up or Pre-Cast Construction Work

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Use of Light Vehicles

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Fluid above and below atmospheric pressure (Fluid Power Systems)

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Working at Heights - Potential to fall from a height greater than 1.8m

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Hot Works that produces fire / heat / sparks / fumes

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Working near a body of water or other liquid

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Isolation and Tagging - Work that requires the isolation of hazardous energy

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Lifting Operations - Lifting using a mechanical lifting device.

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Operation of mobile Plant and equipment

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Using hazardous substances

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Guarding - Working beside rotating equipment

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Use of high pressure equipment

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Require access to high or low voltage electrical equipment

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

Safety & Health Management Plan (SHMP)

• Yes

  No

• The purpose of this plan is to describe how the Safety and Health Management Plan will be implemented and to ensure there is only one Safety Health Management System (SHMS) for the Mine and to be approved by the the Mine Site Senior Executive (SSE).
  As the accountable representative of the Contractor, we will ensure we understand and discharge our obligations under the QLD Coal Mining Safety and Health Act as relevant to our activities and the service we are providing to the the Mine:

• Obligations of persons generally – S39 of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of contractors – S43 if the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of designers, manufacturers, importers and suppliers of plant etc. for use at coal mines – S44 of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of designers, constructors and erectors of earthworks – S45A of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of manufacturers, importers and suppliers of substances for use at a coal mine – S46 of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• The Contractor agrees to not commence any works on site until this Safety Management Plan is approved by the Contract Owner, Contractor Manager, and the SSE

  Understood

  N/A

• The Contractor will not commence any works on site until all coal mine workers have been:<br>a. Fully inducted in the site SHMS to the extent of our activities<br>b. Have been provided relevant training and instruction about the hazards and risk at the mine associated with our work activities

  Understood

  N/A

• The Contractor agrees to comply with all directions issued by a Supervisor regarding health, safety, training, or environmental matters

  Understood

  N/A

• The Contractor agrees to report and communicate all hazards, issues, and concerns to the Contractor Owner.

  Understood

  N/A

Preliminary Risk Assessment

• A Preliminary Risk Assessment (PRA) is required to be completed by the Contracting Company to determine an acceptable level of risk.
  Based on the answers to the below Critical Risk, if you answer YES, a Hazard Control Study is required in accordance with VUL-SOP-049-Risk Management. The controls included in the Hazard Control Study must be in place prior to the commencement of work. Relevant Significant Risk Standards are to be used as the primary source of control measures that must be implemented to control risk. A representative from all work areas involved in the work task must be consulted and provide feedback into the development of the PRA

Critical Risks

• The general requirements of completing the Scope of Works have been considered and activities that are classified as a Critical Risk have been identified.

• Cutting, Drilling or Excavating near a concealed service (Entering a trench more than 1.5 metres deep).

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Entering a Confined Space.

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Erecting and Installing of Fixed Plant

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Work on or adjacent to a road or railway.

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Exposure to excess noise, vibration, excess lead, silica.

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Excessive air emissions, ground contamination due to work processes

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Prescribed Activity (Demolition or removal of asbestos)

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Lifting Operations - Tilt-up or Pre-Cast Construction Work

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Use of Light Vehicles

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Fluid above and below atmospheric pressure (Fluid Power Systems)

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Working at Heights - Potential to fall from a height greater than 1.8m

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Hot Works that produces fire / heat / sparks / fumes

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Working near a body of water or other liquid

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Isolation and Tagging - Work that requires the isolation of hazardous energy

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Lifting Operations - Lifting using a mechanical lifting device.

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Operation of mobile Plant and equipment

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Using hazardous substances

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Guarding - Working beside rotating equipment

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Use of high pressure equipment

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

• Require access to high or low voltage electrical equipment

  Yes

  No

Hazard Control Study

• Critical Risks

• Measures to Control Critical Risk

Risk Rating

• Please review the Vulcan Mine Risk Matrix to determine the Risk Rating for each Hazard Control Stuf

• Consequence

  Level 1 - Insignificant

  Level 2 - Minor

  Level 3 - Moderate

  Level 4 - Major

  Level 5 Catastrophic

• Likelihood

  A - Extremely Likely

  B - Very Likely

  C - Likely

  D - Unlikely

  E - Rarely

• Rating

  (E) - Extreme Risk

  (H) - High Risk

  (M) - Medium Risk

  (L) - Low Risk

Safety & Health Management Plan

• The purpose of this plan is to describe how the Safety and Health Management Plan will be implemented and to ensure there is only one Safety Health Management System (SHMS) for the Mine and to be approved by the the Mine Site Senior Executive (SSE).
  As the accountable representative of the Contractor, we will ensure we understand and discharge our obligations under the QLD Coal Mining Safety and Health Act as relevant to our activities and the service we are providing to the the Mine:

• Obligations of persons generally – S39 of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of contractors – S43 if the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of designers, manufacturers, importers and suppliers of plant etc. for use at coal mines – S44 of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of designers, constructors and erectors of earthworks – S45A of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of manufactures, importers and suppliers of substances for use at a coal mine – S46 of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• The Contractor agrees to not commence any works on site until this Safety Management Plan is approved by the Contract Owner, Contractor Manager, and the SSE

  Understood

  N/A

• The Contractor will not commence any works on site until all coal mine workers have been:<br>a. Fully inducted in the site SHMS to the extent of our activities<br>b. Have been provided relevant training and instruction about the hazards and risk at the mine associated with our work activities

  Understood

  N/A

• The Contractor agrees to comply with all directions issued by a Supervisor regarding health, safety, training, or environmental matters

  Understood

  N/A

• The Contractor agrees to report and communicate all hazards, issues, and concerns to the Contractor Owner.

  Understood

  N/A

Safety & Health Management Plan

• The purpose of this plan is to describe how the Safety and Health Management Plan will be implemented and to ensure there is only one Safety Health Management System (SHMS) for the Mine and to be approved by the the Mine Site Senior Executive (SSE).
  As the accountable representative of the Contractor, we will ensure we understand and discharge our obligations under the QLD Coal Mining Safety and Health Act as relevant to our activities and the service we are providing to the the Mine:

• Obligations of persons generally – S39 of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of contractors – S43 if the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of designers, manufacturers, importers and suppliers of plant etc. for use at coal mines – S44 of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of designers, constructors and erectors of earthworks – S45A of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• Obligations of manufactures, importers and suppliers of substances for use at a coal mine – S46 of the QLD Coal Mining Safety and Health Act

  Understood

  N/A

• The Contractor agrees to not commence any works on site until this Safety Management Plan is approved by the Contract Owner, Contractor Manager, and the SSE

  Understood

  N/A

• The Contractor will not commence any works on site until all coal mine workers have been:<br>a. Fully inducted in the site SHMS to the extent of our activities<br>b. Have been provided relevant training and instruction about the hazards and risk at the mine associated with our work activities

  Understood

  N/A

• The Contractor agrees to comply with all directions issued by a Supervisor regarding health, safety, training, or environmental matters

  Understood

  N/A

• The Contractor agrees to report and communicate all hazards, issues, and concerns to the Contractor Owner.

  Understood

  N/A

Workers Compensation and Employer's Liability Insurance

• Workers Compensation and Employer's Liability Insurance Held

  Yes

  No

• Insurer

• Limit of Cover

• Policy Number & Certificate

• Workers Compensation and Employer's Liability Insurance Policy Expiry Date

  Date

Public and Product Liability Insurance

• Public and Product Liability Insurance Held

  Yes

  No

• Insurer

• Limit of Cover

• Note: Minimum amount of public liability insurance is $20m unless written exemption is made by the COO

  Understood

  N/A

• Policy Number & Certificate

• Public and Product Liability Insurance Policy Expiry Date

  Date

Equipment Insurance

• Third Party Motor Vehicle Insurance Held

  Yes

  No

• Insurer

• Limit of Cover

• Policy Number & Certificate

• Third Party Motor Vehicle Insurance Policy Expiry Date

  Date

• Heavy Machinery & Mobile Plant Insurance (Owned)

  Yes

  No

• Insurer

• Limit of Cover

• Policy Number & Certificate

• Heavy Machinery & Mobile Plant Insurance (Owned) Expiry Date

  Date

• Heavy Machinery & Mobile Plant Insurance (Hired)

  Yes

  No

• Insurer

• Limit of Cover

• Policy Number & Certificate

• Heavy Machinery & Mobile Plant Insurance (Hired) Expiry Date

  Date

Construction Plant Insurance

• Construction Plant Insurance Held

  Yes

  No

• Insurer

• Limit of Cover

• Policy Number & Certificate

• Construction Plant Insurance Policy Expiry Date

  Date

Professional Indemnity Insurance

• Professional Indemnity Insurance Held

  Yes

  No

• Insurer

• Limit of Cover

• Policy Number & Certificate

• Professional Indemnity Insurance Policy Expiry Date

  Date

Contractor Company Onboarding

• Prior to Contractors commencing work at the Vulcan Mine, the Contracting company must create and maintain a Site Approve account. Instructions are provided https://pages.qwilr.com/SiteApprove-Quick-Start-Guide-xW2uorBCQSiB
  
  1. Create a free personal account
  2. Create your company page
  3. Send your Company Page Profile number to your Contract Owner.
  4. The Contract Owner will invite you to the required Project.
  5. Accept the invitation to the Project.
  

• Has a Company Page been created in Site Approve

  Yes

  No

• Please provide your Company Page Profile Number

Employee Inductions

• Prior to Contractor’s commencing work at the the Mine, the Contract Owner shall ensure the Contracting Companies’ CMW’s are inducted in accordance with VUL-FRM-07-10-Contractor Induction

• Have all employees completed their induction and onboarding requirements

  Yes

  No

• Provide number of Employees

• Provide Training Needs Analysis (TNA) in excel format to Contract Owner and Contract Manager via email

  Yes

  No

Sub Contractors

• Please provide a list of Sub Contractors the Contracting company will engage to conduct the Scope of Works.
  All Sub Contractors will be treated as Contractors as per VUL-PLN-043-Contractor Management and will be required to complete their own VUL-PLN-043-REG1-CMR and submit for approval to contract to the Vulcan Mine.

Sub Contractor Details

• Company Name

• Company Contact Information (Name, Email, Phone)

Equipment Compliance

• Please provide a list of Assets, including all Plant and Equipment being requested to be brought to the Vulcan Mine to conduct works as per the Scope of Works.
  Please keep using the 'green plus' to add all equipment

Equipment

• Type

  Light Vehicle

  Medium Vehicle

  Heavy Vehicles

  Ancillary

• Asset ID/Call Sign

• VIN

• Rego

• Does the Asset have a completed Vulcan Mine equipment compliance inspection form

  Yes

  No

Contractor Execution

• I hereby declare the information provided is complete in all respects, correct and true to the best of my knowledge and belief. I hereby agree this declaration shall form part of the basis of the contract.

  Sign

Authority to Mobilise

• The Authority to Mobilise section MUST be completed by Vulcan Mine Representatives

• Contractor CMW's onboarding requirements completed as per VUL-PLN-082-Training Plan

  Yes

  No

• I have reviewed the Contractor CMW's onboarding requirements and confirm they are accurate and approve mobilisation to site

  Sign

• Contractor Equipment onboarding requirements completed as per VUL-MOP-071-Equipment Compliance

  Yes

  No

• I have reviewed the Contractor equipment onboarding requirements and confirm they are accurate and approve mobilisation to site

  Sign

• Contractor Chemicals as per VUL-SOP-056-Hazardous Substances

  Yes

  No

• I have reviewed the Contactors chemical requirements and confirm they are accurate and approve mobilisation to Site

  Sign

Execution (Vulcan Mine)

• To approve the scope of work for mobilisation to commence work required, each party is to be satisfied with the information provided and a thorough pre-mobilisation meeting has occurred (if required) and adequate controls are in place to manage the Health, Safety, Environment and Community Risks associated with this work.
  This completed form and its associated relevant appendices must be completed before work is commenced.

• Contract Owner Approval

  Yes

  No

• Contract Owner Signature

  Sign

• Provide reasons for not approving

• Contractor Manager Approval

  Yes

  No

• Contract Manager Signature

  Sign

• Provide reasons for not approving

• SSE Approval

  Yes

  No

• SSE Signature

  Sign

• Provide reasons for not approving

• CMR Amendments can only be completed by the Contractor Manager to ensure the CMR is a live document. All Amendments are to be listed below.

CMR Amendments

• Amendment Date

  Date

• Amendment Details

• Amendment Approval

  Sign