WORKPLACE INSPECTION

• Site conducted

  Girgarre

  Bears Lagoon

• Conducted on

  Date

• Prepared by

  Select Antonio Deus De Villiers Beukes Scott Kirby Paula Pereira Andre Hatting Marissa Ritcher

  • Antonio Deus
  • De Villiers Beukes
  • Scott Kirby
  • Paula Pereira
  • Andre Hatting
  • Marissa Ritcher

• Signature

  Sign

• HSR Consulted

  Yes

  No

  N/A

• HSR Name

• Signature

  Sign

• Employee Consulted

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Employee’s name

• Signature

  Sign

• Location

HOUSEKEEPING

• Work areas clean (including removal of off-cuts, dwarf and grinding dust)?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Work areas free of clutter?

  Yes

  No

  N/A

• Work areas free from slips & trip hazards?

  Yes

  No

  N/A

• All equipment stored correctly?

  Yes

  No

  N/A

MACHINERY AND ELECTRICAL

• Machinery adequately guarded & operated safely?

  Yes

  No

  N/A

• Mobile plant Pre-Start checks completed?

  Yes

  No

  N/A

• Emergency stops appropriately placed & clearly identified?

  Yes

  No

  N/A

• Electrical equipment (sockets, leads, switches) in good condition & leads have current test tags?

  Yes

  No

  N/A

• Electrical cabinets locked?

  Yes

  No

  N/A

CHEMICAL

• SDSs available?

  Yes

  No

  N/A

• Containers clearly labeled?

  Yes

  No

  N/A

• Chemicals correctly stored?

  Yes

  No

  N/A

• Correct PPE available for chemical using?

  Yes

  No

  N/A

• Storage area clear of empty containers?

  Yes

  No

  N/A

• Spill kit available & clearly marked?

  Yes

  No

  N/A

LADDERS

• Ladders & temporary work platforms in good condition?

  Yes

  No

  N/A

PERSONAL PROTECTION

• Appropriate PPE being worn by employees for task being performed?

  Yes

  No

  N/A

• Signage unobscured & in good condition?

  Yes

  No

  N/A

• First Aid Kit available & well stocked?

  Yes

  No

  N/A

MATERIAL STORAGE

• Stacked material stable & not exceeding maximum heights?

  Yes

  No

  N/A

• Material stored appropriately?

  Yes

  No

  N/A

• Racking in good condition & safe work limits?

  Yes

  No

  N/A

EMERGENCY CONTROL

• Date fire equipment last tested & tagged? (up to date)

  Yes

  No

  N/A

• Clear access to the fire equipment?

  Yes

  No

  N/A

• Are exit signs placed above doors?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Is there an Evacuation Map in shed?

  Select Yes No N/A

  • Yes
  • No
  • N/A

OTHER HAZARDS

• Any other hazards to report not identified previously?

  Select Yes No

  • Yes
  • No

Maintenance

• Has the maintenance requested been completed (please check Maintenance Request Book)?

  Select Yes No N/A

  • Yes
  • No
  • N/A