Daily Pre-start and JSA Meeting
Date:
TOW No.
Emergency Evacuation Point:
Location:
Project:
Field Manager:
Contact No:
‰ Crew on site is competent to carry out all tasks scheduled for the day, particularly competencies related to traffic management, operation of plant & equipment,
and asbestos management.
‰ Changes to Approved Design / Construction plan have been assessed for safety risk and communicated to workforce.
ATTENDEES:
I, the undersigned, hereby certify that I have been inducted to this job site by Visionstream, and that I have participated in the identification of hazards
associated with working at this location. I agree to implement the control measures identified, including the use of the appropriate PPE.
Surname
First Name
Signature
Company
Phone No.
PERSONAL PROTECTIVE EQUIPMENT OR OTHER PLANT & EQUIPMENT REQUIRED ON THIS SITE TODAY:
‰ Safety Boots
‰ Dust Mask
‰
‰ Safety Vest
‰ Gloves
‰
‰ Safety Helmet
‰ Hearing Protection
‰
‰ Safety Glasses / Goggles
‰ Other (Specify)
‰
VS-HS-FRM-016
Issue 5, January 2011
Page 1 of 3
REFER TO GUIDANCE NOTE &
ENVIRONMENT INSTRUCTION
NO.
Alpine Conditions
Asbestos
Backhoe
Bees and Wasps
Bobcat
Boring Machine
Bulldozer
Cable Plough
Ceilings and Under Floors
Chain Trencher
Chemicals
Concrete Saw
Confined Spaces
Contaminated Soil
Contaminated Water
Crane
Cyclones & Natural Disasters
Disturbance of Soil
Dogs
Driver Fatigue
Dust
Electrical - EPR Zones
Electrical - Live Comms Racks
Electrical - Overhead
Electrical - Tools
Electrical Wiring– Cavity Walls
Electrical - Underground
Electromagnetic Radiation
Excavator
Fire
Fire Ants (QLD Only)
Forklift
Gas
Gas Cylinders
Glass Fibres
Grader
Grundamat
Heat
PRESENT ON
THIS JOB
RISK
PRESENT ON
THIS JOB
PLEASE PLACE A TICK BESIDE ANY HEALTH, SAFTEY OR ENVIRONMENTAL RISK POSSIBLY ENCOUNTERED DURING THIS JOB
RISK
Heights - EWPs
Heights - Ladders
Heights - Masts & Towers
Heights - Poles
Heights - Roofs
Heights - Scaffolds
Horizontal Directional Drill
Hot Work
Humans
Lasers
Lightning
Manual Handling
Noise
Overhead Hazards (falling objects)
Polychlorinated Biphenyls(PCBs)
Rock Saw
Self-Loading Trailer
Sharps
Skid Steer Loader
Snakes
Spiders
Static Plant
Traffic Management
Trains
Trees
Track Trencher
Trenching & Shoring
Underground Services
Vehicles
Vibratory Plough
Waste Management
Winches
Winches – Optical Fibre
Working Hours
Other:
Other:
Other:
DAILY TASK REVIEW (To be completed when tasks are recurring or in the same areas as previous shift):
What are we doing today that is
different from yesterday or last
shift?
Discuss any safety incidents or
hazards from last shift?
Discuss any safety initiatives or
positive events from previous shift?
Page 2 of 3
JOB SAFETY ANALYSIS:
Determine Effective Controls
What are we doing?
What are the hazards?
How can we prevent harm?
Are the Controls In Place /
Working?
Controls in Place
(Y/N)
Certification:
Controls Working
(Y/N)
NOTE: IF CONTROLS ARE NOT WORKING – STOP
WORK AND DETERMINE NEW ACTION.
Discuss the Potential Hazards
NOTE: IF CONTROLS ARE NOT IN PLACE – STOP
WORK AND IMPLEMENT IMMEDIATELY.
Review the planned activities for shift
I certify that this risk assessment and job safety analysis was completed prior to commencing work on this site, and that all appropriate risk controls were
implemented as per the Guidance Notes and Environmental Instructions referenced on Page 2 of this document.
Signature:
__________________________________
Name: ___________________________________
Position:
__________________________________
Date:
SAFE WORK METHOD STATEMENTS
IN USE (list reference no.)
_______ / _______ / ______
Page 3 of 3