Zero Harm PreStart and Risk Control Form

Information

Document No.
Audit Title
Conducted on
Pre-Start Meeting Conducted By:
Signature
Client / Site
Location
Nearest Hospital
Scope or Works for Shift:
Personnel
First Aid Officers

High Risk Tasks (mark applicable for shift):

Excavation/Trenching
Hot Work
Working at Heights
Confined Spaces
Working near Overhead Services
Electrical Work
Working near Traffic
Working in the vicinity of Mobile Plant
Operation of Powered Plant or Equipment
Working in Isolation
Hazardous Manual Handling
Asbestos Removal
Working within Rail Corridor
Handling/Transporting Hazardous Substances and Dangerous Goods
Isolation Testing and Tagging
Working near or over Water
Crane Operation and Rigging
Rail Crossings Utilised
Other

Requirements

Are controls on place to ensure personnel working in the vicinity of mobile plant and public vehicles are safe? ie. Restricted Access, Barriers, Exclusion Zones, Traffic Control, (Rail) Track Protection, etc... REMEMBER THE MINIMUM EXCLUSION ZONES AROUND MOBILE PLANT
Is reversing on site kept to a minimum and has a designated spotter been assigned?
Is there adequate protection around Open Pitts / Trenches, Excavation etc?
Have all services been identified (Overhead and Underground)? For the identification of Underground services, has a DIAL BEFORE YOU DIG been undertaken?
Have appropriate spoil (excess material) dumpsites been identified?
For all high risk tasks identified above, has a SWMS been developed and a permit completed (where applicable)?
Do all personnel understand the requirement of SWMS in use and signed off?
Is all equipment fit for purpose and in good working condition? (incl. completion of Pre-Start Checks) IF NOT, HAS IT BEEN REMOVED, ISOLATED / TAGGED OUT?
Are all plant operators or trades inside licensed, competent and fit for work? Have you verified documents that are required on the Authority to Work Permit (for contractors)?
Are all personnel including contractors wearing the appropriate PPE for the job?
Are Emergency procedures in place and equipment available.
Are any adverse weather conditions predicted for the shift? ie. High temperatures / humidity, storms, flood warnings, etc.. (also consider Total Fire Ban Days / Fire Danger Periods)
RAIL SPECIFIC Has the Rail Safe working Pre-work brief been presented to the personnel on site? Are all controls checked
Worksite Diagram (Zone of Understanding)

Hazards / Non-Conformances

Item 1
Initial Rating
Controls / Actions Apply Hierarchy of Controls 1.Elimination, 2. Substitution, 3. Engineering, 4. Administrative, 5. PPE
Residual Rating
Item 2
Initial Rating
Controls / Actions Apply Hierarchy of Controls 1.Elimination, 2. Substitution, 3. Engineering, 4. Administrative, 5. PPE
Residual Rating
Item 3
Initial Rating
Controls / Actions Apply Hierarchy of Controls 1.Elimination, 2. Substitution, 3. Engineering, 4. Administrative, 5. PPE
Residual Rating
Item 4
Initial Rating
Controls / Actions Apply Hierarchy of Controls 1.Elimination, 2. Substitution, 3. Engineering, 4. Administrative, 5. PPE
Residual Rating
Item 5
Initial Rating
Controls / Actions Apply Hierarchy of Controls 1.Elimination, 2. Substitution, 3. Engineering, 4. Administrative, 5. PPE
Residual Rating
Item 6
Initial Rating
Controls / Actions Apply Hierarchy of Controls 1.Elimination, 2. Substitution, 3. Engineering, 4. Administrative, 5. PPE
Residual Rating
Item 7
Initial Rating
Controls / Actions Apply Hierarchy of Controls 1.Elimination, 2. Substitution, 3. Engineering, 4. Administrative, 5. PPE
Residual Rating
Item 8
Initial Rating
Controls / Actions Apply Hierarchy of Controls 1.Elimination, 2. Substitution, 3. Engineering, 4. Administrative, 5. PPE
Residual Rating
Item 9
Initial Rating
Controls / Actions Apply Hierarchy of Controls 1.Elimination, 2. Substitution, 3. Engineering, 4. Administrative, 5. PPE
Residual Rating
Item 10
Initial Rating
Controls / Actions Apply Hierarchy of Controls 1.Elimination, 2. Substitution, 3. Engineering, 4. Administrative, 5. PPE
Residual Rating
Signature
Other Items to be discussed at the Pre-Start Meeting
List Relevant SWMS in use for Shift

Pre-Start Meeting Attendees

By signing this risk assessment, your are confirming that you are fit for duty and not adversely affected by fatigue, drugs or alcohol.
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Use of this Form (Zero Harm STAR Start Guidance)

This for is used as a general HAZARD IDENTIFIACTION AND RISK ASSESSEMENT tool for any worksite and is used in conjunction with Safe a Work Method Statements (SWMS). It I'd also ICRC to record the pre-start meeting.
It must be used:
• Before starting work each day on a work site.
• Following any change to a worksite which may affect health, safety or the environment.
• For Mobile work sites, this form is to be completed for the first job/activity, and any subsequent risks are to be considered, documented, reviewed and controlled for all other jobs during the shift.

Step 1: Site Walk Around

• Review the site prior to the start of work. Enter work site details and complete the checklist on Page 1 .
• Note any hazards identified and any controls needed from Page 1 checklist on Page 2.
• The WORKSITE DIAGRAM can be used as a short-term works Vehicle Movement Plan (VMP) and/or to communicate fencing, barriers, temporary warning signs, roads, rail tracks etc.. It may also be used to define the exclusion zones, evacuation points, spotters, vehicle turning bays, etc..

Step 2: Risk Assessment and Controls

• Assess hazards identified an determine appropriate controls. Use the Risk Assessment Matrix below when assessing hazards.
• For high-risk tasks, list the SWMS in use for the shift.
• Ensure that site personnel are consulted when formulating controls for hazards identified.
• List any other items to be discussed in Page 2.
• Apply the Hierarchy of Controls.

Step 3: Pre-Start Meeting / Communication

• Conduct a Pre-Start Meeting and communicate the hazards and. Introns to site personnel prior to starting work. Also discuss any other items listed on Page 2.
• Record details of who was briefed/attended the Pre-Start meeting on Page 2.