Uploaded by Ray Anderson

site-assessment-form

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Site assessment
Instructions: Complete the site assessment prior to and during operations (as required). Record
information, acquire additional documents (from owner/manager) and take photos. Use in conjunction with
site information previously collected e.g. surveillance information. Form is relevant for any site.
Assessment details
Date of assessment
Date of previous assessment
Assessing team
- name & role
Site details
Case number
Owner/manager name & contact
Checklist of previously collected site information:
 mud map  surveillance data  google map or BioMap
Biosecurity plan in place? Y/N Biosecurity direction issued? Y/N Permits issued? Y/N
Assessment
Area of assessment
1.
Y/N/
NA
Record observations /evidence
Biosecurity
1.1 Does the site have existing biosecurity?


Procedures
Photos of signs/practices
1.2 For pests/diseases impacting human
health - were site personnel exposed?


Numbers, names, contact details &
vacc records for NSW Health
Tracing issues?
1.3 Is PPE satisfactory for personnel entering
the site?

Type, condition, quantity
1.4 Has a suitable decontamination
procedure been implemented for exiting the
site?
1.5 Has a gate been established? If no, mark
potential location(s) on the mud map.
1.6 Draw movements of vehicles & personnel
on site (on mud map)
1.7 Can the potential source areas be
Form – Site assessment v2
30 November 2018
Page 1 of 9
Site assessment
Area of assessment
Y/N/
NA
Record observations /evidence
isolated or access restricted?

Specify areas & method of
marking/restriction
 Minimum personnel for operations
e.g. animal welfare
1.8 Are there procedures to handle, store
&/or dispose of contaminated waste?
1.9 List details of wild animals that could be
vectors
1.10 List non-target animals that may have
access to the contaminated area?

Or refer to surveillance records
2.
Site access
2.1 Who has access to the site?

E.g. workers, family, public
2.2 Has access been restricted?


How
Potential in future
2.3 Are boundaries secure to prevent
movement of people/animals?
2.4 Are entry/exits signed, locked or
guarded?
2.5 Is unauthorised entry occurring?
2.6 Are entry points suitable for operations?



Gate set up
Decontamination
Vehicle & machinery movements
(size & load capacity)
2.7 Are there any other site access issues?
3.
Communication
3.1 List site contact numbers for liaison
Form – Site assessment v2
30 November 2018
Page 2 of 9
Site assessment
Area of assessment
Y/N/
NA
Record observations /evidence
3.2 Quality of mobile phone reception?

Variations on site?
3.3 Are there language barriers with the
owner/manager &/or personnel?

Specify alternate language(s)
3.4 Are there other communication issues?
4.
Susceptible species, products &
things
4.1 Record (data/photo) susceptible species
 Description
 Quantity
 Location
 Domestic vs commercial
4.2 Record (data/photo) products
 Description
 Quantity/volume
 Location
4.3 Record (data/photo) things (potentially
contaminated)



Description
Quantity/volume
Location
5.
Animal Handling
5.1 Record (data/photo) available animal
handling facilities?

Crushes, yards, pens, sheds, scales
5.2 Could facilities be used for operations?

Safety, location, size
5.3 If required, is there a suitable location for
portable/temporary facilities?

Mark on map or GPS
5.4 Are experienced or trained animal
handlers required?
5.5 Are experienced or trained animal
handlers available?
5.6 Have the susceptible species been
treated with any substance recently?

Reason, substance, date, group
treated
Form – Site assessment v2
30 November 2018
Page 3 of 9
Site assessment
Area of assessment
6.
Y/N/
NA
Record observations /evidence
Animal Feed
6.1 Record (data/photo) animal feed
available

Type, quantity, quality, location,
containment, contamination
exposure
6.2 Record daily feed requirements

Type, quantity, source
6.3 Last time feed was accessed or
exposed?
[Do NOT open silos/bins]
7.
Environment
7.1 Will the runoff from decontamination
area(s) pose an environmental risk?
7.2 Is drainage &/or effluent from the site
contained on site?
7.3 Does the drainage/effluent pose a health,
disease or environmental risk?
7.4 Have contaminated items been disposed
on site? e.g. carcasses, litter, manure
 Details
 Location – map, GPS
 Photos
7.5 Identify & record environmental features

Map, photos - waterways, soil type,
topography, vegetation, water table
etc
7.6 Identify & record any environmental
hazards
8.
Infrastructure
8.1 Record (data/photo/video) infrastructure





Type/description – building, fence,
road, drain
Use
Condition including damage
Location – map/GPS
Unique identifier – number/name
Form – Site assessment v2
30 November 2018
Page 4 of 9
Site assessment
Area of assessment
Y/N/
NA
Record observations /evidence
8.2 Record hazards for infrastructure that
may impact on operations








Asbestos
Inadequate lighting
Ventilation
Access & egress
Floor surface & integrity
Falling objects
Working at height
Uncovered slurry ponds, pits, tanks,
channels & gullies
 Other
8.3 Issues for decontamination of
infrastructure e.g. electrical equipment
9.
Plant and equipment
9.1 Record (data/photo) equipment
 Type/description
 Quantity
 Condition
 Location
 Movement/contamination exposure
 Use off site
9.2 Issues for decontamination of equipment
e.g. incompatible substances
9.3 Permission from owner/manager to use
as part of operations (with site personnel
operating equipment)
10. Utilities - electrical
10.1 Is there electricity on site?
10.2 Record (data/photo) electrical power
box reading
10.3 Power type/fittings
10.4 Permission from owner/manager to use
10.5 Mark on map the location of electrical
infrastructure
 Overhead lines
 Underground lines
 Power boxes
 Electric fences
 Lighting – inside sheds
 Lighting – outside sheds
10.6 Is lighting sufficient inside and outside
buildings?
 Daytime activities
 Night time activities
10.7 Are overhead or underground lines a
hazard to operation?

Identify hazard on site i.e. put up
warning indicators
10.8 Are all electrical connections & fittings
safe for operations?
 Identify hazards for later treatment
Form – Site assessment v2
30 November 2018
Page 5 of 9
Site assessment
Area of assessment
Y/N/
NA
Record observations /evidence
11. Utilities - water
10.8 Is there a water supply on site?
10.9 Record water supply
 Source
 Quantity & quality (potable)
 Treatment
10.10 Record (data/photo) water meter
reading
10.11 Permission from owner/manager to
use
10.12 Mark on map the location of water
infrastructure



Pipes/tanks/drains
Water meter
Fittings
12. Utilities - gas
12.1 Is there gas on site?
12.2 Record (data/photo) gas meter reading
12.3 Gas type/fittings
12.4 Permission from owner/manager to use
12.5 Mark on map the location of gas
infrastructure
 Pipes/bottles
 Gas meter
 Fittings
12.6 Is gas infrastructure a hazard to
operations?

Identify hazard on site i.e. put up
warning indicators
13. Waste
13.1 Record (data/photo) waste existing &
future
 Type/description
 Quantity
 Location
13.2 Record (data/photo) any on site disposal
 Material disposed
 Method
 Location
13.3 What are the current waste services?


Contractor contact details
Frequency
Form – Site assessment v2
30 November 2018
Page 6 of 9
Site assessment
Area of assessment
Y/N/
NA
Record observations /evidence
14. Hazardous chemicals
14.1 Record (data/photo) hazardous
chemicals
 Type/name
 Quantity
 Location stored
 Location used – recent & future
 SDS available
 Condition of containers
14.2 Record (data/photo) emergency controls




Type/description e.g. fire
extinguisher, spill kits
Location
Accessibility
Available potable/non-potable water
15. Personnel working on site
15.1 Number of personnel working on site?

Reason
15.2 Record work/shift times
15.3 Are rest, ablution & meal facilities
available?

Details & location/s
15.4 Is there an induction process
implemented?

Details
16. Site emergency protocols
16.1 Is there a current site evacuation plan?

Obtain copy
16.2 Is there a current site medical plan?

Obtain copy
16.3 Are first aid kit/s readily available?

Type & location
16.4 Is there a First Aid Officer on site?

Contact details
16.5 Is there a list of emergency numbers
readily available or an emergency
communication system available?
16.6 Is further assessment by a Safety
Officer required?
Form – Site assessment v2
30 November 2018
Page 7 of 9
Site assessment
Area of assessment
Y/N/
NA
Record observations /evidence
17. Operational activities
17.1 Current destruction



Method/s
Personnel – No. required,
qualifications
Location/s
17.2 Identify potential areas for destruction?

Access, safety, location
17.3 Current disposal



Method/s
Personnel – No. required,
qualifications
Location/s
17.4 Identify potential areas for disposal?

Access, safety, location
17.5 Current decontamination



Method/s
Personnel – No. required,
qualifications
Location/s
17.6 Identify potential areas for
decontamination?

Access, safety, location
17.7 Record (data/photo) pests on site

Type, quantity, location
17.8 Current pest control program




Method
Frequency & last treatment
Personnel/contractor
Location/s
Form – Site assessment v2
30 November 2018
Page 8 of 9
Site assessment
Further Comments
Form – Site assessment v2
30 November 2018
Page 9 of 9
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