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WUSI RISK ASSESSMENT V03102013
WUSI RISK ASSESSMENT V03102013
Western USI

WUSI RISK ASSESSMENT V03102013

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Free WUSI RISK ASSESSMENT V03102013 Checklist

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Information

  • Client / Site

  • Conducted on

  • SITE ADDRESS AND AMBULANCE PICK UP POINT

  • NAMES OF WORKERS USED FOR THIS TASK

    • Mitch Batterham
    • Mike CRAGG
    • Jack Wagner
    • Adam Hooper
    • Garratt Hall
    • Andrew Hooper
    • Leon Reed
    • Matt Dobson
    • Matt Turner
    • David Sims
    • Allan Hall

  • Names of workers not mentioned above

  • NAME OF SUPERVISOR / LEADING HAND FOR THIS TASK

    • Mitch Batterham
    • Mike CRAGG
    • Jack Wagner
    • Adam Hooper
    • Garratt Hall
    • Andrew Hooper
    • Leon Reed
    • Matt Dobson
    • Matt Turner
    • David Sims
    • Allan Hall

  • NAME OF PERSON FILLING OUT THIS FORM

    • Mitch Batterham
    • Mike CRAGG
    • Jack Wagner
    • Adam Hooper
    • Garratt Hall
    • Andrew Hooper
    • Leon Reed
    • Matt Dobson
    • Matt Turner
    • David Sims
    • Allan Hall

  • CHOOSE OPTION FOR TASK BEING CARRIED OUT.

  • ARE THERE ANY HAZARDS FOR REVIEW

  • ON A SCALE OF 1 - 10 (1 being no risk) RATE HAZARD HERE

  • For hazards rated 5 or above choose best option and insert photo

  • Enter photos of hazard here

SITE ASSESSMENT

  • TO BE COMPLETED FOR ALL WORK ON OUTDOOR ADVERTISING STRUCTURES. IF MORE THAN ONE SKIN IS TO BE INSTALLED AT A PARTICULAR SITE PLEASE TICK BOX HERE

  • HAS EVERYONE READ, SIGNED AND UNDERSTOOD THE SWMS FOR THIS TASK

    • YES
    • NO

  • CONSULT, READ AND SIGN SWMS IMMEDIATELY

  • IS WEATHER SUITABLE FOR SAFE INSTALLATION?

  • CAN USING EXTRA INSTALLERS ELIMINATE RISK

  • IF ANSWER IS NO CHOOSE MOST SUITABLE OPTION

  • DO YOU CONSIDER THE WORKPLACE IS SAFE TO WORK ON AND FROM

  • IF RESPONSE IS NO DO NOT INSTALL

  • INSERT PHOTO HERE

  • CAN SKIN BE TRANSPORTED TO SITE SAFELY

  • DO NOT INSTALL

  • IS THERE SAFE PARKING AND ACCESS TO SITE?

  • IF RESPONSE IS NO DO NOT INSTALL

  • INSERT PHOTO OF ACCESS HAZARD HERE

  • HAS THE WORKSITE BEEN CORDONED OFF CORRECTLY (where applicable)

  • CORDONE OFF WORKSITE BEFORE BEGINNING WORK

  • IS THE SITE COMPLETELY FREE FROM ELECTRICAL HAZARDS?

  • IF ANSWER IS NO CHOOSE BEST OPTION TO ELIMINATE RISK

  • INSERT ELECTRICAL HAZARD PHOTO HERE

  • HAS THE AMBULANCE PICKUP POINT BEEN IDENTIFIED TO ALL WORKERS

  • IDENTIFY AMBULANCE PICK UP POINT AND NOTIFY ALL WORKERS

FOR WORK WITH EWP

  • IS EWP OPERATOR LICENSED AND COMPETENT?

  • IF ANSWER IS NO DO NOT INSTALL AND REPORT TO MANAGEMENT

  • HAS EWP BEEN ASSESSED AND DEEMED SUITABLE FOR TASK?

  • IF ANSWER IS NO DO NOT INSTALL AND REPORT TO MANAGEMENT

  • IS EWP SETUP ON FIRM LEVEL GROUND?

  • IF ANSWER IS NO CHOOSE BEST OPTION

  • HAS EWP LOGBOOK BEEN FILLED OUT?

  • FILL OUT LOGBOOK IMMEDIATELY

  • ARE ALL EWP WORKERS WEARING SUITABLE HARNESSES / LANYARDS?

  • ALL EWP WORKERS MUST WEAR HARNESSES. IF THERE ARE NO HARNESSES ON SITE INSTALL MUST BE CANCELLED

FOR WORK WITH LADDERS

  • CAN YOU PLACE LADDER ON EVEN GROUND

  • CAN USE OF A LADDER LEVELLER ELIMINATE RISK

  • IF RESPONSE SELECTED IS NO STOP WORK IMMEDIATELY AND CONTACT MANAGEMENT

  • DO ALL WORKERS USE HARNESSES OR FALL PROTECTION DEVICES?

  • IF RESPONSE IS NO CHOOSE BEST OPTION TO EXPLAIN WHY FALL PROTECTION / HARNESSES ARE NOT USED

  • IF NONE CHOSEN ABOVE PLEASE EXPLAIN WHY FALL PROTECTION / HARNESSES ARE NOT USED

  • ARE THERE PERMANENT LADDER LOCKS, ANCHOR HOOKS OR STATIC LINES ON THE STRUCTURE?

  • IF ANSWER IS NO PLEASE CHOOSE THE SAFEST OPTION

  • CAN YOU MAINTAIN THREE POINTS OF ATTACHMENT AT ALL TIMES

  • IF THE ANSWER IS NO DO NOT INSTALL AND REPORT TO MANAGEMENT

FOR WORK ON RAILWAYS

  • DO ALL WORKERS HAVE TRACK ACCREDITATION?

  • IS AN EXEMPTION IN PLACE FOR UNACCREDITED WORKER?

  • IF UNACCREDITED WORKER DOES NOT HAVE A CURRENT EXEMPTION THEY MUST NOT ENTER RAIL RESERVE

  • IS WPW15 PRESENT AND BOOKED ONTO TRACK

  • IF ANSWER IS NO DO NOT ENTER RAIL RESERVE

FOR ABSEIL INSTALLS

  • HAVE ALL ABSEIL ANCHOR POINTS BEEN ASSESSED AS SUITABLE?

  • IF ANSWER IS NO DO NOT INSTALL AND REPORT TO MANAGEMENT

  • HAVE ALL ROPES BEEN ASSESSED AS SUITABLE?

  • IF ANSWER IS NO DO NOT INSTALL AND REPORT TO MANAGEMENT

  • HAVE ALL HARNESSES AND ATTACHMENTS BEEN ASSESSED AS SUITABLE?

  • CHECK SUITABILITY OF ALL GEAR IMMEDIATELY

  • ARE ALL ABSEILERS FULLY TRAINED AND ASSESSED BY MANAGEMENT AS COMPETENT?

  • IF ANSWER IS NO DO NOT INSTALL

INSTALLER SIGN OFF

  • ALL INSTALLERS MUST ENTER PHOTO BELOW IN LIEU OF SIGNATURE ONCE RISK ASSESSMENT AND SWMS HAVE BEEN CONSULTED

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WUSI RISK ASSESSMENT V03102013
Western USI

WUSI RISK ASSESSMENT V03102013

Use this Template
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.

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