FormsOnce per job:Risk Assessment ToolSWMS Inspection ToolSite Housekeeping & First Aid InformationOngoing:Weekly Toolbox Talk RecordJSA Pre-Start RecordPer Incident:Hazard ReportHazard Response Plant Hazard Identification & Risk Assessment Name of person completing this form: * Zac Ozolins Sean Millar other Name if listed as other above: Date completing this form: * MM DD YYYY Plant details: * Model: Serial Number: State/Territory Registration #: Asset Number Location of Plant: * Mobile Main P6 Yard other Scope of use: * Plant checklist: * Check the box if answering yes. Leave blank if no. Is the plant designed to perform the work outlined in the scope? Has the plant been modified from the original condition? Is the plant in good working condition? Is the plant capable of creating a hazardous condition due to any of the following: Check the box if answering yes. Leave blank if no. Explosion Exhaust Pressure Load Loss Malfunction Fire Dust Electrical Fragmentation Vibration Noise Heat Generation Instability Does the plant have ergonomic considerations for the operator relating to: Check the box if answering yes. Leave blank if no. Physical Noise Lighting Guarding Warning Devices Control Operation Communication Visibility Vibration Design Is the plant serviced and maintained according to the manufacturers’ specification? yes no Are servicing records kept for this particular item of plant? yes no Does the plant create a risk of contact with: Check the box if answering yes. Leave blank if no. Overhead Power Lines Underground Cables Other Hazards Inadvertent operation Does the plant: Check the box if answering yes. Leave blank if no. Have Lifting attachments appropriate for the load Specified Safe Working Limits Require PPE for its Safe Use Have safe Access and Egress Conditions Have Sufficient Work Instructions Have an Adequate Communication System Require any special guarding Is the Plant Appropriately Located in the Workplace Design Check the box if answering yes. Leave blank if no. yes no unsure Thank you!
