Zero Harm Management / Supervisor Inspection

• Client / Site

• Location
  Address

• Conducted on

  Date

• Prepared by

• Supervisor inspection

• DA-ZH-FM116.2

PEOPLE

• 1. Persons wearing correct PPE

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 2. Persons engaged in regular safety discussion (pre-start meetings/ toolbox talks)

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 3. Persons properly inducted, including adequate site-specific induction

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 4. Persons can describe site hazards, evacuation and first aid procedures

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 5. Persons can describe course of action if a hazard is identified or job/task is unsafe

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 6. Contractors authorised to work on site (i.e. Authority to Work Permit)

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

PLANT & VEHICLES

• 1. Plant subject to regular inspection (documented) - Daily Plant Check Sheets for Mobile Plant

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 2. Plant is fit for purpose, including adequate maintenance, cleaning, guarding, and warning systems (e.g. reversing alarms, flashing lights etc)

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 3. Operators properly trained, licensed and competent

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 4. Traffic Management Plan in place (documented) – Controls in place as per plan

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 5. Reversing kept to an absolute minimum and spotters used correctly

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 6. Persons on foot maintain a safe distance from moving vehicles and plant

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 7. Safe speed maintained (brisk walking pace when around persons on foot)

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 8. Safe area established for onsite cleaning of plant & vehicles

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

PROCESS & HOUSEKEEPING

• 1. Site risks identified, controlled and regularly reviewed (documented evidence)

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 2. Safe Work Method Statements (SWMS) and MSDSs available on site and kept up-to-date

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 3. Unsafe plant/equipment tagged out

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 4. Isolation, lock-out and tag-out applied during maintenance and repairs

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 5. Electrical equipment tagged, tested and fit for purpose

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 6. Emergency equipment available and serviced (e.g. fire, first aid & spill equipment)

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 7. Manual handling adequately controlled (e.g. lifting aids, techniques, job rotation etc)

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 8. Overhead and underground services identified and controlled

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 9. Chemicals and Dangerous Goods correctly used, labelled and stored

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 10. Permits issued for Hot Work, Confined Space Entry and Excavation/Trenching

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 11. General housekeeping maintained to an acceptable standard

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 12. Worksite amenities adequate (e.g. drinking water, toilets, shelter etc)

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

ENVIRONMENT

• 1. Adequate collection and disposal of waste

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 2. Noise levels reduced as far as possible

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 3. Prevention of spills/leaks (e.g. bunding of drums, tanks and wash bay facilities)

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• 4. Impacts on native vegetation, wildlife habitat and aboriginal heritage minimised

  Safe

  At Risk

  N/A

• Has the risk been controlled?

  Yes

  No

  N/A

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

SAFE BEHAVIOURAL OBSERVATIONS & UNSAFE CONDITIONS

• 1. BEHAVIOUR (Choose one)

  Select People Overhead and Underground Services Personal Protective Equipment Isolation, Energy Sources, Guarding Manual Handling Plant & Equipment Plant & Pedestrian Interface Environmental Work Practices Housekeeping Fall Protection Traffic Managment Other:

  • People
  • Overhead and Underground Services
  • Personal Protective Equipment
  • Isolation, Energy Sources, Guarding
  • Manual Handling
  • Plant & Equipment
  • Plant & Pedestrian Interface
  • Environmental
  • Work Practices
  • Housekeeping
  • Fall Protection
  • Traffic Managment
  • Other:

• DETAILS

  Safe

  At Risk

  N/A

• COMMENTS

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• Has the risk been controlled?

  Yes

  No

  N/A

• 2. BEHAVIOUR (Choose one)

  Select People Overhead and Underground Services Personal Protective Equipment Isolation, Energy Sources, Guarding Manual Handling Plant & Equipment Plant & Pedestrian Interface Environmental Work Practices Housekeeping Fall Protection Traffic Managment Other:

  • People
  • Overhead and Underground Services
  • Personal Protective Equipment
  • Isolation, Energy Sources, Guarding
  • Manual Handling
  • Plant & Equipment
  • Plant & Pedestrian Interface
  • Environmental
  • Work Practices
  • Housekeeping
  • Fall Protection
  • Traffic Managment
  • Other:

• DETAILS

  Safe

  At Risk

  N/A

• COMMENTS

• Select Elimination Substitution Isolation Engineering Administration PPE

  • Elimination
  • Substitution
  • Isolation
  • Engineering
  • Administration
  • PPE

• Action taken / Lessons learned

• Has the risk been controlled?

  Yes

  No

  N/A

ASSESS THE RISK

• What would a reasonably foreseeable outcome be if an incident occurred?

• Consequence

  1 Low

  2 Minor

  3 Moderate

  4 Major

  5 Catastrophic

• Likelyhood

  A Almost Certain

  B Likely

  C Possible

  D Unlikely

  E Rare

• Risk Rating

  Low

  Medium

  High

  Extreme

CONTROL THE RISK

• Has the hazard been controlled?

  Yes

  No

  N/A

• Further action required / Learning shared:

ACTIONS:

• Name of person reporting this event:

  Sign

• Enter Position

  Select Project Manager Project Superintendent Safety Manager Safety Advisor Engineer Supervisor Leading Hand Employee Contractor

  • Project Manager
  • Project Superintendent
  • Safety Manager
  • Safety Advisor
  • Engineer
  • Supervisor
  • Leading Hand
  • Employee
  • Contractor

• Please complete section below and highlight any additional observations and actions

• Please add photo if required

  Media

• Please sketch diagram if required

  Drawing

APPROVAL / MANAGEMENT REVIEW

• Manager to review & approve, or send for further investigation:

  Approved

  Further Action required

• Additional actions and Learnings shared

• Management Approval:

  Sign

• Distribution: (1) Project Manager (2) ZH Administrator (3) Zero Harm Advisor