Compliance

Work Health & Safety

Get familiar with all Gore Earthmoving safety requirements. Complete JSA’s, SWMS and Take 5’s here.  Also, report an Incident or a Hazard here.

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Use these charts and matrix to identify Risk, define Control Measures and determine Hazards…

Risk Assessment:

Hierarchy of Controls

Hazard Groups

You must complete a JSA before starting a job.

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What job does this JSA relate to?
Where is this job located?
Enter the date this JSA relates to.
List the workers involved in this Job Safety Analysis. Separate each name with a comma.

Job Tasks

1. List Each Job Step.
2. Identify Any Hazards Associated With Each Step.
3 Assess the Risk of Those Hazards.
4. Define Control Measures to Eliminate or Reduce That Risk.

Job Step 1

Job Step 2

Job Step 3

Summarise this job step

Job Step 4

Job Step 5

Identify any possible hazards associated with this job step
Clear Signature
Supervisor, leading hand or the initiator of this JSA to sign.

You must complete and sign a SWMS for any High Risk Construction Work.

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Project and Task Identification

Initiators of SWMSs are responsible for consulting all persons in charge of the work and personnel involved in the execution of the task for input into the SWMS.
Other persons may be consulted for technical advice or to review the SWMS to see that the proposed measures are effective and workable.
The task is to be broken up into steps. For each step hazards are identified.
For each of the hazards the risk factor is assessed and control measures are identified to reduce the hazard.
All involved in the task must review and sign this SWMS form.

SWMS Sign Off

Your signature below indicates that you have been consulted in the development of the SWMS and you accept and will implement the requirements of the SWMS and it's control measures

Worker's Names

Date Signed

Signatures

Clear Signature
Clear Signature
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Clear Signature

Hazard Analysis, Control and Legislation Worksheet

First, identify and assess the risks by using the matrix below. Then decide the best way to control them by applying the Hierarchy of Controls below.

Task # 1

Task # 2

Task # 3

Task # 4

Task # 5

You must complete a Take 5 before starting work.

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Name

1. STOP! Think through the task

1. Am I clear on what the task is?

2. Do I have the skills, training, licences and permits for the job?

3. Have I checked the JSA/SWMS for the job?

4. Is all equipment and tools in good order?

5. Do I have the required PPEs for the job?

IF YOU ANSWERED NO TO ANY ITEM, STOP! SEE YOUR SUPERVISOR! FURTHER ACTION IS REQUIRED!

2. Look For Hazards - Use the Hazard Group Chart below:

1. BIOLOGICAL - bacteria, viruses, insects, birds, animals, humans...

2. CHEMICAL - hazardous materials or chemicals...

3. ERGONOMIC - excursion, unnatural or repetitive movement, poor posture, physical stress...

4. PHYSICAL - radiation, magnetic fields, pressure extremes, noise, light, slips & trips, falling, collision...

4. PSYCHO-SOCIAL - cultural, social, stress, violence, bullying, violence...

4. CLIMATIC - natural environmental, climatic condition i.e. weather..

3. Assess Hazard Risk - Use the Risk Matrix below:

1. Is the Risk Rating Moderate, High or Severe?

IF YES, STOP! SEE YOUR SUPERVISOR! FURTHER ACTION IS REQUIRED!

4. Make the Hazards Safe- Use the Hierarchy of Controls Chart below:

1. Have I eliminated the hazards or reduced the risk?

2. Can I complete the task safely?

IF NO, STOP! SEE YOUR SUPERVISOR! FURTHER ACTION IS REQUIRED!
Clear Signature
Your signature affirms that you have accurately completed this take 5 and that you will abide by the information you have entered.

Complete a Hazard / Incident report when identifying a hazard or when involved in an incident.

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Date / Time of Incident or Hazard
When did the incident occur or when was the hazard identified?
What was the Nature of the Hazard / Incident?
Select one or more factors that summarise the nature of the incident / hazard
What Factors Contributed to the Hazard / Incident
Select one or more factors that contributed to this incident / hazard
Clear Signature
Please sign the report stating that, to the best of your knowledge, the facts are as you have reported.
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