GMR Self-Assessments
Parent Document: Workplace Hazard Identif ication and Inspection Procedure
Instructions
Work through the applicable GMR critical controls and record project compliance against each. Additional criteria have been added to the self -assessment to help
workplaces determine whether they have ef f ectively implemented the GMRs. For more inf ormation on how to comply with the GMRs, consult the guidance on the
GMR website. Once the workplace self -assessment is complete, the results and any associated actions must be entered into Soteria as a GMR Assessment and
approved by the workplace manager.
GMR 1 – TRAFFIC, PLANT AND PEOPLE - Review the Workplace Traffic Management Plan, Traffic Control Plans, Activity Method Statement (AMS), relevant
TRAs, and conduct a site inspection to answer the following.
Workplace Name:
Assessor / Assessing Team:
Relevant Supervisor / Leading Hand:
Work Description / Location:
GMR
Critical Control
Criteria
1.1
Always give pref erence to
separating light and heavy
vehicles
Has a Traf f ic Management Plan (TMP) and/or Traf f ic
Control Plan (TCP) been developed f or the site?
Does the plan include controls to separate light and
heavy vehicles if possible?
Is the plan up to date and does it ref lect the current site
conditions?
Has the site been set up as per the requirements of the
TMP or TCP?
Are there any overhead services or existing structures
within the site boundary?
Has the relevant AMS identif ied the most ef f ective
control to prevent a service strike in accordance with the
Hierarchy of control?
Have all the services been either removed, isolated,
redirected or controlled using physical barriers or
f lagging?
Have existing structures been protected f rom damage?
Does the site TMP/TCP detail separate access and
egress routes f or pedestrians and
vehicles/plant/machinery?
Do the pedestrian routes on site ref lect the requirements
of the TMP/TCP?
1.2
1.3
Physically identif y the
location of all overhead
services and structures
and implement controls to
prevent damage
Physically separate
pedestrian routes f rom
operating plant, machinery
and vehicles
Date:
Check
Compliance
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Description / Immediate
Actions Taken
Further
Action
Required?
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 1 Of 39
GMR Self -Assessments
GMR
1.4
Critical Control
Criteria
☐
Seek to eliminate the need
f or people to work in the
operating zone of mobile
plant and vehicles
Are there designated pedestrian crossings on site where
required?
Do the separation controls meet the requirements of the
Barricading and Signage Procedure?
Has the risk of working in the operating zone of mobile
plant been identif ied in the relevant TRA? (e.g. spotters,
pipe layers)
Are controls stipulated in the TRA implemented on site?
Identif y 3 items of plant on site and conf irm:
• All plant has a completed Plant Hazard Assessment
and pre-acceptance checklist
• Plant has been approved to work on site (JH plant
sticker attached)
• the plant is the most suitable f or the task?
• Does rolling stock comply with the BU Managers
rolling stock acceptance process (if relevant)?
For any modif ied plant on site, conf irm the f ollowing has
taken place:
• Modif ication request submitted using the Plant/rolling
stock modif ication management f orm
• Initial review of the proposed modif ication
undertaken by the project or regional plant manager.
• The impact of the modif ication accessed as either
high or low.
• The modif ication has been approved by the Project
or Regional Plant Manager
Identif y 3 items of operating plant and conf irm the
f ollowing:
• A daily plant pre-start check has been conducted
• The operator holds a licence (if required) to operate
the item of plant
• The operator has a valid verif ication of competency
(VOC) f or the item of plant
• Copies of the operators licences and competency
are maintained in the site of f ice
1.5
Verif y all plant must be f it
f or purpose and saf e to
operate prior to coming to
site
1.6
Ensure any plant modif ied
outside of manuf acturer’s
specif ications must be
engineered, certif ied and
approved by a competent
authorised person
1.A
Only operate plant,
machinery or vehicles, if
you hold the applicable
license, have been verif ied
as competent (if required),
and have completed a
daily pre-start check of the
equipment.
Check
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 2 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
1.B
Only operate plant,
machinery or vehicles if
you are f it to work and
agree to comply with all
relevant road and rail rules
1.C
Always sit in the dedicated
seating position with the
seatbelt f astened
1.D
Use a spotter when there
is potential f or interaction
between operating plant,
vehicles, people,
structures and/or other
hazards
1.E
Only enter the operating
zone of mobile plant or
vehicles if permission is
received
Check
Compliance
Description / Immediate
Actions Taken
Engage in a conversation with 2 operators of plant,
machinery and/or vehicles. Conf irm the person(s):
• Is not under the inf luence of alcohol or other drugs.
• Is not on any prescribed medication which might
af f ect their cognitive abilities in any way.
Ask the operators if they believe:
• Their mental state enables them to competently and
saf ely perf orm their work.
• They are physically able to perf orm their tasks
adequately and saf ely.
Identif y 3 items of operating plant and conf irm the
operator is sitting in the dedicated seating position with
their seatbelt f astened.
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Identif y any operating plant onsite that is required to
interact with other plant, people or other hazards and
conf irm:
• There is a spotter in place
• The spotter has established an ef f ective means of
communication with the operator/s
• If the spotter can identif y at least 2 risks associated
with the work and the controls in place to minimise
these risks
• The spotter has participated in the Spotter Duties
Awareness Presentation
Identif y a worker working within the operating zone of
mobile plant. Review the applicable TRA and ensure:
• the risk of working in the operating zone of mobile
plant is identif ied.
• The controls identif ied in the TRA have been
implemented on site.
• The worker has signed the TRA
Get the attention of the Spotter and Plant Operator, ask
the operator to stand the machine down while you ask
them the f ollowing questions:
• Did the worker ask your permission to enter the
operating zone of the plant? If not, did they ask
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 3 Of 39
GMR Self -Assessments
GMR
1.F
Critical Control
Criteria
Only position plant,
machinery and vehicles on
even, solid ground unless
they are designed /
assessed as saf e to
operate on the ground
conditions present.
permission of another person in control of the
operating zone?
• Is there an ef f ective means of communication
between you and the worker (e.g. radio, hand signals
etc.)?
If plant, machinery or vehicles are required to work on or
near uneven or sof t ground, conf irm:
• The equipment is specif ically designed to saf ely
operate in those conditions
• The TRA addresses the risks associated with
working in those conditions
• Areas that are not designed to be accessed by
equipment have been identif ied and delineated
Is the task being completed as planned?
Question the workers as to whether they think there
is a better way to complete the task
Appreciative Enquiry Question
Check
Compliance
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Description / Immediate
Actions Taken
Further
Action
Required?
Page 4 Of 39
GMR Self -Assessments
Actions
GMR No.
Action
Due Date
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Person Responsible
Action Closed
(Y/N)
Page 5 Of 39
GMR Self -Assessments
GMR 2 – EXCAVATION AND TRENCHING
Workplace Name:
Assessor / Assessing Team:
Relevant Supervisor / Leading Hand:
Work Description / Location:
GMR
Critical Control
Criteria
2.1
Assess excavation design
requirements and
implement appropriate
protective systems
2.2
Obtain all relevant service
and structural drawings
and identif y services and
structural clashes that
may impact the planned
excavation
2.3
Plan the location of plant,
equipment, vehicles and
stored materials (including
soil) to ensure they remain
outside the zone of
inf luence
Date:
Check
Compliance
Description / Immediate
Actions Taken
Review the design documentation f or an excavation
greater than 1.5m in depth and conf irm:
• Design has been completed by a Temporary Works
Engineer in line with the Temporary Works
Procedure
• Design documentation includes a certif ied sketch of
the design
• The design has been validated via a permit to load
Tunnelling Projects Only
• Constraints are included and communicated in the
Permit to Tunnel (PTT)
Has the relevant Engineer obtained a combined service
and structural drawing showing the location of all known
services or inf rastructure within 5m of the proposed
excavation area
Has an excavation and trenching permit been completed
and approved?
Is the permit valid f or 28 days f rom the service drawings
date of issue?
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Have Stakeholder approvals been obtained f or
excavations in or near the stakeholders assets.
Has the AMS captured the location of plant, equipment,
vehicles and stored materials to ensure they remain
outside the zone of inf luence?
If plant, equipment, vehicles or materials are required
inside the zone of inf luence, has the excavation been
designed to take the additional pressure into account?
Conduct a site inspection and conf irm all materials and
plant are at a minimum of 1m behind the excavation’s
zone of inf luence
Tunnelling Projects Only
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 6 Of 39
GMR Self -Assessments
GMR
2.4
2.5
2.6
2.A
Critical Control
Identif y and implement
barricading, signage and
edge protection
requirements f or the
planned excavation
Communicate the location
of all services (isolated or
live) within 5m of the
excavation area with
workers and explain the
permit conditions.
Ensure a Permit to Tunnel
(PTT) is approved and
permit controls are in
place prior to commencing
tunnelling work
Mark and positively locate
all underground services
within 5m of the ground
being excavated
Criteria
Check shaf t barricades and edge protection are suitable
f or loading on the shaf t top
Has the selection of barricading and signage been
considered during the excavation planning?
Is the barricading selected f or the excavation
appropriate, taking into consideration the depth and width
of the excavation, the ground conditions and the
proximity to public areas and near by mobile plant?
Have all services within 5m of the excavation area been
identif ied on the relevant service drawings?
Question a worker on site and ask if :
• The permit conditions have been explained to
them
• Their Supervisor has communicated the location
of all existing services in the area to them
Tunnelling Projects Only
Has the Permit to Tunnel been developed, approved,
signed and communicated to all relevant personnel on
the shif t?
Does the permit clearly state the def inition of supported
ground and give the requirements f or personnel re-entry?
Conduct a site inspection and conf irm:
• All relevant service drawings are attached to the
excavation and trenching permit
• All services identif ied on the drawings as being
within 5m of the excavation area have been
physically exposed
• Services were exposed using a f orm of nondestructive excavation equipment (e.g. vacuum
or hand digging)
Check
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 7 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
2.B
Only access an
excavation deeper than
1.5 metres if it has been
benched, battered,
shored, or it has been
signed of f by a
Geotechnical Engineer
2.C
Do not enter the saf e
approach distance of a
service unless authorised
by the relevant utility
provider / asset owner
2.D
Conduct inspections f or
excavations and trenches
greater than 1.5 metres
deep prior to persons
entering the excavation
2.E
Maintain barricading and
signage requirements to
prevent unauthorised
access to excavations.
Check
Compliance
Description / Immediate
Actions Taken
Identif y all excavations deeper than 1.5m and conf irm:
• The excavation has been benched, battered, shored
or signed of f by a Geotechnical Engineer.
• The benching/batter/shoring box has been installed
as per design
• There is a saf e means of access f or personnel to
enter and exit the trench
• Access is provided at least every 10m along the
excavation
Tunnelling Projects Only
Is barricading and signage in place and ef f ectively
prohibiting access to areas of unsupported ground?
Is an Emergency Plan in place, communicated and
current?
Does the workplace have a Ventilation Plan f or
underground works, which is in line with the GMR2
Guidance documentation (GMR Website).
If overhead or underground services have been identif ied
within 5m of the excavation area, conf irm:
• Any relevant utility providers or asset owners have
been notif ied of the works
• Any saf e approach distances provided by the asset
owner/utility provider are being maintained
Have daily/shif t inspections been completed f or all
excavations and trenches deeper than 1.5m?
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Conf irm the person completing the inspection has been
trained in the Excavation and Trenching Awareness
Training as a minimum.
Tunnelling Projects Only
Has the inspection regime and f ace mapping been
included in the Permit to Tunnel?
Is the barricading suitable f or the task in accordance with
the barricading and signage matrix?
Has the barricading been placed 1m outside the zone of
inf luence?
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 8 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
Check
Is the barricading maintained, in good condition and
ef f ective?
Has clear signage been erected?
Appreciative Enquiry Question
Is the task being completed as planned?
Question the workers as to whether they think there is
a better way to complete the task
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
☐
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Actions
GMR No.
Action
Due Date
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Person Responsible
Action Closed
(Y/N)
Page 9 Of 39
GMR Self -Assessments
GMR 3 – LIFTING OPERATIONS
Workplace Name:
Assessor / Assessing Team:
Relevant Supervisor / Leading Hand:
Work Description / Location:
GMR
Critical Control
Criteria
3.1
All lif ting operations must
be planned, managed
and conducted by a
competent person(s)
3.2
Nominate the role of a Lif t
Designer f or both
precontracts and delivery
phases
Date:
Check
Compliance
Use the Lif ting Planning Matrix to identif y the risk category
f or the lif t (i.e. low, medium or critical).
• Is there a lif t plan in place?
Lif t Risk
Lif t Plan Must Include:
Category
Low risk
Crane capacity, wind speed, load
details and pre-lif t start card
Medium
Medium risk lif t data, rigging diagram
risk
and plan view
Critical
Lif t planning tool, rigging diagram,
risk
plan view and elevation
• Has the lif t been planned by the appropriate person?
Lif t Risk
Lif ting Planner
Category
Low risk
Crane Operator / Dogger
Medium risk
Medium Lif t Planner
Critical risk
Lif t Designer
• Is the lif t planner appropriately trained (ref er to the
Lif ting Operations Competency Matrix on the IMS)?
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Action
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Has a Lif t Designer been nominated by the Workplace
Manager or Bid Manager?
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Has the Lif t Designer attended the Lif ting Designer
Training, completed the theoretical assessment,
completed practical component and been issued a
competency letter?
☐
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
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Description / Immediate
Actions Taken
Page 10 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
3.3
Ground bearing
capacities must be
assessed, certif ication is
mandatory f or critical lif ts
and setups on suspended
slabs.
3.4
Cranes, lif ting appliances
and equipment must be
regularly inspected,
certif ied, tested and
maintained
3.5
Plant and equipment
used f or lif ting must be
specif ically designed and
certif ied and shall not
exceed its Working Load
Limit
3.6
Conduct a site inspection
to visually conf irm there
are no f undamental
changes or additional
hazards posing a risk to
the lif t which were not
previously identif ied in the
lif t plans
Conduct a daily pre-start
inspection f or all cranes
and lif ting equipment and
tag def ected equipment
out of service.
3.A
Check
Compliance
Description / Immediate
Actions Taken
Has the ground bearing capacity been assessed by the
appropriate person?
Lif t Risk
Accessor
Category
Low risk
Accessed by Work Team
Medium risk
Assessed by Lif t Planner
Critical risk
Certif ied by Prof essional Engineer
Has the crane/lif ting device been set up with outriggers
extended as per manuf acturers specif ications?
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Action
Required?
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Has the crane / lif ting device been inspected has per
manuf acturers specif ications?
Have the most recent inspection records been maintained
with the Workplace Plant Register?
Has all lif ting equipment been inspected and captured on
a Workplace Lif ting Equipment Register?
Conf irm the plant/equipment being used as a lif ting device
has the f ollowing:
• Burst valves f itted
• Audible warning device f itted
• slope and level indicators f itted
• Working load limit decals with corresponding
documentation
• Compliant load chart
Was a site inspection completed prior to the lif t to ensure
the hazards and surrounding environment captured in the
lif t plan was a true and accurate representation of the
current site conditions?
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Has a daily pre-start inspection been completed f or the
crane / lif ting device and lif ting equipment?
Conf irm no issues were raised as part of the pre-start
inspection
For low risk lif ts, has a pre-lif t start card been completed?
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 11 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
3.B
Complete Earthmoving
Equipment Used as a
Lif ting Device – Pre-Start
Checklist prior to using
other plant as a mobile
crane
3.C
Do not enter an exclusion
zone unless authorised
3.D
Do not place yourself
underneath a suspended
load or in the line of f ire of
lif ting operations
3.E
Do not undertake any
lif ting operations unless
you are trained, qualif ied
and competent to do so
Appreciative Enquiry Question
Check
Compliance
For mobile plant being used as a lif ting device, has an
“earthmoving equipment used as a lif ting device pre-start
checklist” been completed?
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Action
Required?
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Has an exclusion zone been erected around the lif ting
activity?
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Is the barricading used suitable f or the task in accordance
with the barricading and signage matrix?
☐
Is the exclusion zone ef f ective in preventing unauthorised
persons f rom entering the area?
Conduct a site inspection and conf irm:
• Loads are not being lif ted or suspended over people
• There is a process in place to maintain the ef f ective
separation of plant and people to eliminate the risk of
crushing
• There is a system in place to ensure workers are
consulted when loads are being lif ted over their work
area
Identif y 1 crane / plant operator and 1 Dogger / Rigger
and conf irm
• They all hold the appropriate licence (if required) to
perf orm their activity
• They hold a valid verif ication of competency (VOC)
• Copies of the licences and competency are
maintained in the site of f ice
Is the task being completed as planned?
Question the workers as to whether they think there is
a better way to complete the task
☐
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Description / Immediate
Actions Taken
Page 12 Of 39
GMR Self -Assessments
GMR 4 – ELECTRICAL SAFETY
Workplace Name:
Assessor / Assessing Team:
Relevant Supervisor / Leading Hand:
GMR
Critical Control
GMR 4 – ELECTRICAL SAFETY
4.1
All persons carrying out
electrical work and
supervision of electrical
work must be licensed
and/or verif ied competent
Criteria
Has the electrical contractor/project team nominated an
Electrical Supervisor in their saf e system of work?
Is specialist electrical work (HV, hazardous areas, patient
areas) being complete on site? If so, has the contractor
verif ied their competence?
Date:
Work Description / Location:
Check
☐
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
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☐
If self -delivered, has the project team verif ied the
employee’s competencies to carry out specialist work
(HV, hazardous areas, patient areas).
4.2
No work on live electrical
systems, installations and
equipment is conducted
unless it is solely f or the
purpose of f ault f inding or
testing work
Select 2 electrical workers and supervisors and conf irm
• They are appropriately licenced to perf orm or
supervise the work
• Copies of their licences / competencies are
maintained in the site of f ice
☐
Does the electrical contractor/project team have a
documented Live Work process in accordance with the
Electrical Saf ety Procedure as part of their saf e system of
work?
☐
Has the contractor/project team provided a list of
employees authorised to work on live testing,
commissioning and/or f ault f inding of electrical systems?
☐
Has the relevant AMS identif ied the risk of contacting live
services during structural penetrations (e.g. core holing)?
Is live work PPE on site (gloves, mats, hot sticks,
multimeters) tested and within date?
Are permits being ef f ectively used to control the risk of
contacting live services when penetrating structures?
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 13 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
4.3
Document saf e systems
of work f or all electrical
work
Does the electrical contractor/project team have a written
saf e system of work (Electrical Works Management
Plan)?
Has the electrical contractor’s saf e system of work been
reviewed and accepted by John Holland using the
Electrical Contractor Saf e System of Work Checklist?
4.4
Ensure all electrical
equipment is connected
to an electrical supply that
is protected by an
appropriate protective
device (e.g. RCD and
circuit breakers)
4.A
Treat all exposed
electrical parts and
conductors, including
earthing conductors, as
live until proven otherwise
If self -delivered has the project team implemented and
reviewed John Holland’s Saf e Systems of work?
Does the contractor/project team have onsite access to all
relevant Legislation and Australian Standards on site,
including:
• Electrical saf ety acts, regulations and Codes of
Practice
• AS/NZS 3000 , AS/NZS 4836, AS/NZS 3012 ,
AS/NZS 3017 , AS/NZS 3760
Conduct a site inspection and conf irm:
• Electrical equipment sited on inspection is protected
by a protective device (RCD/circuit breaker)
• RCD’s have been tested in accordance with the below
Test type Portable
Fixed RCDs
RCDs
Push
Daily
Monthly
Button
Test
Timed
Every 3
Annually
Test
months
• Testing records are maintained in the of f ice
Ref er to the Electrical Contractors Saf e System of Work
and ensure they have a system in place f or conf irming
electrical isolations.
If self -delivered ensure John Holland’s Electrical isolation
and permit to work systems are in place f or conf irming
electrical isolations.
Check
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item.
Further
Action
Required?
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item.
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item.
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item.
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item.
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item.
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item.
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Compliance
Description / Immediate
Actions Taken
☐
If Electrical Contractor/Project team are working on High
Voltage system operated by asset owner, are the asset
owner system and processes f ollowed?
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 14 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
Has a contractor been engaged to carry out high voltage
or hazardous area work? If so, can the contractor
demonstrate the competence of personnel?
4.B
4.C
4.D
Install, inspect, test and
tag electrical equipment
to legislative
requirements
Maintain regulated saf e
approach distances when
working near Live
Overhead Line
Equipment (OHLE),
underground services or
live electrical parts
Ensure electrical supply
panels are secured,
labelled and signed to
prevent unauthorised
access
Appreciative Enquiry Question
If self -delivered does the project have competent
employees authorised to carry out high voltage or
hazardous area work? If so, have employee’s
competencies been verif ied?
Conf irm the electrical contractors/project teams TRAs
cover this requirement.
Conduct a site inspection and conf irm portable electronic
equipment has been tested, tagged and are in date.
Inspect and conf irm electrical test equipment and PPE
(gloves, hot sticks, mats, multimeters) are within test
dates.
Have overhead or underground services within the work
area been identif ied?
Will the work require personnel, equipment or materials to
enter saf e approach distances around overhead line
equipment? If so, are the spotters competent?
Has the relevant AMS identif ied the most ef f ective
controls to prevent a service strike in accordance with the
Hierarchy of control?
Question a worker working near the service and ask if
they can conf irm the saf e working distance to the service.
Conduct a site inspection and conf irm:
• Access to all main switch boards are locked
• Temporary power distribution boards are locked if
possible
• All electrical supply panels are signed
• Substation access is limited to authorised personnel
• Or correct permits are in place f rom asset owner.
Is the task being completed as planned?
Question the workers as to whether they think there is
a better way to complete the task
Check
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
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item.
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item.
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item.
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item.
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item.
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item.
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item.
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item.
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 15 Of 39
GMR Self -Assessments
Additional Notes (If the space above is not enough)
Actions
GMR No.
Action
Due Date
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Person Responsible
Action Closed
(Y/N)
Page 16 Of 39
GMR Self -Assessments
GMR 5 – WORKING AT HEIGHT
Workplace Name:
Assessor / Assessing Team:
Relevant Supervisor / Leading Hand:
Work Description / Location:
GMR
Critical Control
Criteria
5.1
Identif y all tasks that
present a potential f all
f rom height of a
person and implement
appropriate control
measures
Has the risk of f alls f rom heights been adequately identif ied
in the WRA / AMS?
Has elimination or using f all prevention devices (such as
scaf f old, MEWPs and perimeter screens) been considered
wherever possible?
Do the controls listed in the TRA ref lect the methodology
and controls identif ied in the AMS?
Is the way the work is being perf ormed in line with the AMS
and TRA?
If a Ladder or workbox permit is required, conf irm:
• the requirements outlined in the applicable permit have
been upheld
• the permit is in date
• the permit is captured on the relevant register
Has the risk of f alling objects been adequately identif ied in
the WRA / AMS?
Has elimination or height perimeter protection with mesh
been considered wherever possible?
Have exclusion zones and/or overhead protection been
implemented as a secondary control where required?
Is the way the work is being perf ormed in line with the AMS
and TRA?
Have penetrations been Identif ied in the AMS?
Have penetrations been adequately controlled using one of
the f ollowing methods
• Cast in mesh
• Structural grade plywood
• Perimeter protection (e.g. handrails with mesh)
• For lif t shaf ts – Full height, lockable security access
gates
Are all penetration adequately secured and signed?
5.2
5.3
Identif y areas where
f alling object risks are
present and implement
appropriate control
measures
Prevent persons and
objects f rom f alling
through penetrations,
shaf ts and risers
Date:
Check
Compliance
Description / Immediate
Actions Taken
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Action
Required?
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
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Page 17 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
5.4
Only accept boom lif ts
f itted with secondary
protection devices
(SPDs).
5.5
Ensure grid mesh and
chequer plate f looring
is installed and
removed by a
competent person as
per design
requirements
5.A
Do not remove or
travel through any
edge protection,
barricade or exclusion
zone unless
authorised
Check
Compliance
Description / Immediate
Actions Taken
Is the MEWP being used the most suitable f or the task?
☐
Are boom lif ts on site f itted with a secondary protection
device (SPDs)? This may include a cage, side protection
barriers, operator protective structures, break away bars or
pressure sensing bars or control panels.
Is the SPD f itted the most suitable f or the task being
conducted?
Are scissor lif ts required to manoeuvre through doorways?
If so:
• are they f itted with detachable controls
• Does the TRA address this risk?
• Is the umbilical cord long enough to allow the operator
to stand at a saf e distance during operation
Is a grid mesh permit in place and approved?
Identif y 2 workers perf orming gridmesh activities and
conf irm:
• They were consulted in the development of the TRA
• They are aware of risks and controls related to
gridmesh install / removal?
• They have attended (as a minimum) the Grid Mesh
Procedural Awareness Training
Select an activity that is being perf ormed at heights and
conf irm:
• The TRA has identif ied appropriate edge protection and
exclusion zones controls
• The controls stipulated in the TRA have been
adequately installed on site.
• All barricading, edge protection and signage is
maintained and ef f ective in preventing unauthorised
access
• Any exclusion zones have a designated access point
Question 2 workers working in close proximity to edge
protection and ask if :
• they have suf f icient access to their work area?
• they need to gain access to any areas currently
barricaded of f or excluded? If yes, does the work
☐
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Action
Required?
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 18 Of 39
GMR Self -Assessments
GMR
Critical Control
5.B
Do not overload, or
make any adjustments
to, working platf orms
or f all protection
devices unless
authorised
5.C
Only use a harness as
a primary control if
approved by the BU
Operations Manager
and a more ef f ective
control is not
reasonably practical.
5.D
Install roof sheeting
f rom below or f rom a
solid platf orm only
af ter roof saf ety mesh
and edge protection
Criteria
method f or this task detail how work at height risks will
be controlled?
NOTE – YOU CANNOT GAIN ACCESS TO OVERLOAD A
PLATFORM
Conduct a site inspection and conf irm working platf orms
(e.g. scaf f old, f ormwork, MEWPs):
• Have been installed /set up in accordance with any
design requirements or manuf acturers specif ications
• Are being used as intended
• Have not been modif ied outside design or
manuf acturers specif ications
• Do not have additional loads imposed on them (e.g
point loads)
• Any alterations/modif ication to temporary works has
been approved by the Temporary Works Coordinator
• Review the AMS and conf irm a higher f orm of control
(such as working platf orms, edge protection and
perimeter screens) is not possible f or the work.
• Does the TRA detail a saf e means of access to the
work area?
• Has the f all protection system been certif ied as being
installed correctly?
• Has the f all restraint equipment been inspected and
captured on the work at height equipment register?
• Has the installation of anchor points been approved by
a competent person?
Review the work at height permits and conf irm:
• The permit has been endorsed by the Workplace
Manager and Saf ety prof essional
• Approved by the BU Operations Manager
Has the AMS stipulated how roof sheeting will be installed
to ensure work is only perf ormed on a solid platf orm?
Conf irm workers are only accessing the roof af ter saf ety
mesh and edge protection is installed and approved f or use.
Has roof saf ety mesh and edge protection been inspected
by a competent person prior to roof access being granted?
Check
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
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item.
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item.
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item.
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item.
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item.
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
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Page 19 Of 39
GMR Self -Assessments
GMR
5.E
5.F
Critical Control
Criteria
has been installed and
signed of f
A roof loading plan has been developed indicating where
roof ing material will land so that workers do not have to
walk on the purlins while laying roof sheets.
Conf irm there is a saf e method f or workers to access the
roof
Have personnel planning work at height activities attended
working at height procedural awareness training?
For work where a work positioning system or f all
minimisation system is required:
• Have personnel directly supervising the work (e.g. a
subcontractor supervisors supervising the work)
attended accredited work at height training (e.g.
RIIWHS204D)?
• Have workers perf orming the work attended accredited
work at height training (e.g. RIIWHS204D)?
• Are copies of these training records retained in the site
of f ice?
Have relevant personnel undertaken the Gridmesh
procedural awareness training?
If access to the back or top of any vehicle / item of plant is
required, conf irm:
• The need to access this area cannot be eliminated
• Access to this area has been identif ied and
appropriately controlled in the TRA
• There is saf e access to the area
• There is appropriate edge protection or controls to
protect the worker f rom a potential f all
Ensure you are trained
to perf orm your role in
any work at height
and/or grid mesh
activities.
Only access the back
or top of any vehicle or
item of plant if f all
protection controls are
in place
Appreciative Enquiry
Question
Check
Is the task being completed as planned?
Question the workers as to whether they think there is a
better way to complete the task
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
☐
☐
☐
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item.
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item.
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item.
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item.
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item.
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item.
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Actions
GMR No.
Action
Due Date
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Person Responsible
Action Closed
(Y/N)
Page 20 Of 39
GMR Self -Assessments
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 21 Of 39
GMR Self -Assessments
GMR 6 - WELLBEING
Workplace Name:
Assessor / Assessing Team:
Relevant Supervisor / Leading Hand:
Work Description / Location:
GMR
Critical Control
Criteria
6.1
Assess Wellbeing risks
and develop and
implement a Wellbeing
and Fatigue Management
Plan
Has a WRA been used to risk assess wellbeing risks?
Has a Wellbeing and Fatigue Management Plan
(WFMP) been developed to address the risks f ound in
the WRA?
Has the WFMP been implemented across the
workplace and is it ef f ective in controlling the risks
f ound in the WRA?
Has the WFMP been updated where Wellbeing risks
were previously not being ef f ectively mitigated?
Have all JH workers been made aware of the f lexible
arrangements available to them?
Have work rosters been planned and implemented to
mitigate the risk of f atigue and ensure work-lif e balance
wherever possible?
Have any JH workers at this workplace requested
f lexible working arrangements? If yes, ask the worker
the f ollowing:
• Did your Workplace Manager or Supervisor discuss
your options with you?
• Were you and your Manager able to come to an
agreement that suited both you and the workplace
requirements?
Have Wellbeing risks been considered in the design of
the workplace?
Is there a dedicated area separate f rom work areas f or
workers to eat and socialise?
Is appropriate cleaning done on a regular basis to
maintain the cleanliness of workplace f acilities and
amenities?
Is there someone responsible f or managing the
maintenance of f acilities on an ongoing basis?
6.2
6.3
Plan and implement work
rosters and wellbeing
programs that manage the
risk of f atigue and support
f lexible working
arrangements
Establish and maintain
f acilities and amenities that
support healthy working
conditions and habits
Date:
Check
Compliance
√
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Actions Taken
☐
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
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Page 22 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
6.4
Identif y and manage
occupational hygiene risks
ef f ectively
6.5
Implement a monitoring
and testing program f or
Alcohol and Other Drugs
Have the f ollowing risks been adequately identif ied and
ef f ectively managed in the WRA and relevant AMS?
• Asbestos
• Hazardous Substances
• UV Radiation
• Use of Lasers
• Noise
• Vibration
Is there an ef f ective drug and alcohol testing program in
place f or the workplace?
Is testing being conducted in accordance with the
established testing program?
Have all conf irmed positive results been managed as
an incident and recorded in Soteria?
Have workers nominated potential wellbeing champions
f or the workplace?
Is there evidence of this nomination taking place?
Has the Workplace Manager appointed a Wellbeing
Champion (WCh) f rom the pool of nominees with the
WCh requirements in mind?
Has a Wellbeing Committee been f ormed f ollowing the
guidelines within the Wellbeing Procedure?
Does the Wellbeing Committee have a scheduled
meeting to discuss Wellbeing matters as per the
Wellbeing Procedure?
Note: this can be conducted as an agenda item of a
larger workplace leaders meeting
Engage in a conversation with 4 workers. Conf irm each
person:
• Is not under the inf luence of alcohol or other drugs.
• Is not on any prescribed medication which might
af f ect their cognitive abilities in any way.
Ask the workers if they believe:
• Their mental state enables them to competently
and saf ely perf orm their work.
6.6
6.A
Appoint Wellbeing
Champion(s) and establish
a consultation f orum to
ensure Wellbeing is
addressed within the
workplace
Be f it f or work
Check
Compliance
Description / Immediate
Actions Taken
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 23 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
Check
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
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item.
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item.
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•
6.B
6.C
6.D
Notif y an appropriate
person if you or someone
else may not be f it f or work
Create and maintain a
work environment that
supports Wellbeing in the
workplace
Provide/attend training
associated with wellbeing
They are physically able to perf orm their tasks
adequately and saf ely.
• Has there been a situation at this workplace where
someone has been deemed unf it f or work? If yes,
conf irm the unf it person was sent home to rest or
ref erred to the appropriate health prof essionals
where applicable.
Question 2 workers (dif f erent f or those above) and
conf irm:
• They know who to notif y if they are concerned that
they, or someone else, may be unf it f or work
Has the Workplace Managers completed the Black Dog
Managing for Team Wellbeing training?
Are f lexible working arrangements being utilised
ef f ectively by workers where needed?
Is the number of Mental Health First Aiders consistent
with the requirements outlined in the Wellbeing
Procedure?
Are f acilities available and maintained which support
wellbeing in the workplace?
Are Wellbeing Risks being ef f ectively mitigated across
the project as per the f indings in the WRA and the
Workplace Wellbeing Survey?
Has the WRA been reviewed in the last 6 months?
Has the Workplace Wellbeing Survey been run in the
last 6 months?
Have all Mental Health First Aiders completed Mental
Health First Aid training and associated accreditation?
Are all Wellbeing Champions accredited in Mental
Health First Aid?
Have f urther training opportunities been provided as per
the f indings of the WRA and Workplace Wellbeing
Survey in order to mitigate Wellbeing risks?
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
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Page 24 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
6.E
Know who your Wellbeing
Champions are at your
workplace
6.F
Participate in regular
events that promote the
value of healthy
relationships
Appreciative Enquiry Question
Check
Compliance
Description / Immediate
Actions Taken
Is a current list of workplace Mental Health First Aiders
displayed on WHS notice boards?
Are the contact details of the Wellbeing Champion
displayed on WHS notice boards?
Are all Mental Health First Aider and the Wellbeing
Champion MHFA accreditations up to date?
Question 3 workers at the workplace and conf irm:
• They are aware of who their Mental Health First
Aiders are.
• They are aware of who their Wellbeing champion(s)
is/are.
Does the wellbeing program schedule ref lect the current
f indings of the WRA and Wellbeing Survey
Questionnaire?
Is the wellbeing program schedule being implemented?
Do the programs of f ered on the schedule promote
healthy relationships and socialisation between
workers?
☐
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item.
Further
Action
Required?
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item.
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item.
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item.
Is wellbeing being managed as planned?
Question the workers as to whether they think there is a
better way to complete the task
☐
Choose an
item.
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item.
☐
☐
☐
☐
☐
☐
Actions
GMR No.
Action
Due Date
Action Closed
(Y/N)
Person Responsible
GMR 7 – TEMPORARY WORKS
Workplace Name:
Assessor / Assessing Team:
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Date:
Page 25 Of 39
GMR Self -Assessments
Relevant Supervisor / Leading Hand:
Work Description / Location:
GMR
Critical Control
Criteria
7.1
Appoint a Temporary
Works Coordinator f or precontracts and project
delivery
Identif y, adequately scope
and capture Temporary
Works in the Temporary
Works Register
Has a Temporary Works Coordinator been appointed by
the Workplace Manager
Is the Temporary Works Coordinator f amiliar with the
Temporary Works Procedure and its requirements?
Has the AMS identif ied temporary works required f or the
activity?
Has a temporary works register been established f or the
workplace?
Does the register detail all temporary works currently
installed at the workplace?
Identif y 2 types of temporary works detailed on the
temporary work register and conf irm:
• The temporary works has been assessed against
the Temporary Works Risk Matrix and identif ied as
either a Category 0, 1, 2 or 3.
• The risk category assigned adequately ref lects the
consequence and design complexity
• The risk category f or the temporary works has been
approved by the Temporary Works Coordinator
Using the Temporary Works Risk Matrix f or the 2 types
of temporary works identif ied in 7.3, conf irm the
temporary work has:
• the appropriate level of design certif ication
• the appropriate level of design review
• a site validation f orm has been completed (where
necessary)
• A design Brief has been developed (where
appropriate)
Has the TRA identif ied areas where temporary work
protection is required to prevent damage?
Conduct a site inspection and conf irm site temporary
work is protected f rom the risk of damage.
7.2
7.3
Ensure Temporary Works
are planned, assessed
and approved by a
competent person.
7.4
Identif y appropriate design
controls and minimum
design documentation
based on the temporary
works risk category
7.5
Protect temporary works
f rom accidental impact
through physical means or
through the provision of
suitable impact loading in
the design
Check
Compliance
Description / Immediate
Actions Taken
☐
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item.
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Action
Required?
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item.
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item.
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item.
☐
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item.
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item.
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item.
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item.
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Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
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Page 26 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
7.6
Ensure Temporary Works
design, installation and
removal requirements and
loading limits are
communicated to any
persons delivering
Temporary Works
Install and remove
temporary works in
accordance with the
approved methodology
and design documentation
7.A
7.B
7.C
7.D
7.E
Complete a site validation
prior to the initial use of
Temporary Works
Do not exceed the
specif ied working load limit
of temporary works
Implement a temporary
work inspection schedule
f or all temporary works
Check
Compliance
Have design, installation/removal requirements and
loading limits been captured in the AMS f or category 1, 2
or 3 temporary work?
Have these requirements been communicated to
persons involved in the temporary work?
☐
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item.
Further
Action
Required?
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item.
Has the methodology f or correct installation and/or
removal of temporary works been captured in the AMS
and TRA?
Does the TRA outline all required competency
requirements f or temporary work installation / removal
(e.g. scaf f old high risk work licence, VOC etc.)?
Conf irm workers on site installing or removing temporary
works are appropriately licenced to do so where required
(e.g. scaf f old qualif ications and VOC)
☐
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Conf irm a site validation as per the Temporary Work
Risk Matrix has been perf ormed prior to the initial use of
temporary work
Is the working load limit clearly displayed on the
temporary work structures?
If the temporary work is not a structure (e.g. piling
platf orm), question a worker using the temporary work
and ask if the working load limit has been
communication to them
Conf irm the current load imposed on the temporary work
is less than the working load limit.
Has the working platf orm certif ication been used f or all
crane pads and heavy vehicle platf orms (such as piling)?
Identif y an item on the temporary work register and
conf irm:
• The register stipulates inspection intervals f or the
temporary work
• Inspections are being carried out in accordance with
the f requency stipulated on the register
Question the Temporary Works Coordinator and conf irm:
Description / Immediate
Actions Taken
☐
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☐
☐
☐
☐
☐
☐
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☐
☐
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 27 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
Alterations to installed
Temporary Works can only
be carried out f ollowing
approval f rom the
Temporary Works
Coordinator
•
Appreciative Enquiry Question
Check
No temporary work alterations have taken place
without their approval
If alterations have been required, has the f ollowing taken
place:
• Proposed changes submitted to the temporary
works coordinator
• The temporary works coordinator has communicated
these changes to the temporary works designer
• If considered necessary by the designer, design
changes have been recertif ied
• Changes made to the relevant AMS and TRA if
required
• Once alterations have been made, temporary works
has been re-validated prior to initial use.
Is the task being completed as planned?
Question the workers as to whether they think there
is a better way to complete the task
Compliance
Description / Immediate
Actions Taken
Choose an
item.
Further
Action
Required?
Choose an
item.
Choose an
item.
Choose an
item.
☐
☐
Actions
GMR No.
Action
Due Date
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Person Responsible
Action Closed
(Y/N)
Page 28 Of 39
GMR Self -Assessments
GMR 8 – ISOLATION
Workplace Name:
Assessor / Assessing Team:
Relevant Supervisor / Leading Hand:
Work Description / Location:
GMR
Critical Control
Criteria
8.1
Identif y when hazardous
material or energy sources
require isolation and
determine if an isolation
permit is needed
Has an Isolation Permit Controller been appointed f or the
workplace?
Have all non-JH isolation procedures in use been
reviewed by a John Holland SME?
Has the Isolation Permit Controller attended the isolation
procedural awareness training?
Is the f ollowing equipment being used (if necessary)
during an isolation
• Red personal locks
• Other coloured locks
• Document satchels, hasps, lock dogs and lockboxes
• Danger, permit holder, inf ormation and out of service
tags
Has an isolation permit been raised? Note, isolation
permits are not required where the worker has direct
control, or the Workplace Manager has applied an
exemption to a single point isolation (see Isolation
Procedure).
Review the relevant TRA and conf irm the f ollowing:
• The isolation methodology has been detailed
• The TRA stipulates that
- Isolation points must be labelled and lockable
- All energy sources are identif ied and controllable
- Isolation integrity and “zero energy” state is
conf irmed
- Isolation details are verif ied in the f ield
- All persons must correctly lock on in accordance
with their role
Has the TRA identif ied the competency requirements f or
the person conducting the isolation?
Conf irm the worker perf orming the isolation has the
competency requirements stipulated in the TRA?
8.2
Assess the potential risks
involved in isolation / deisolation and communicate
control measures to
ef f ected workers
8.3
Physical isolation and deisolation must be
completed by a competent
and authorised person
Date:
Check
Compliance
Description / Immediate
Actions Taken
☐
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item.
Further
Action
Required?
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item.
☐
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item.
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item.
☐
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item.
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item.
☐
☐
☐
☐
☐
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 29 Of 39
GMR Self -Assessments
GMR
8.4
8.5
8.A
8.B
8.C
8.D
8.E
Critical Control
All isolation points must be
clearly identif ied, proven
isolated, tagged, locked
and controlled to prevent
inadvertent energisation
Assess machinery f or
components with potential
stored energy under
tension or pressure.
Test bef ore touch - Test
f or hazardous material and
stored energy prior to
breaking containment
system
Release any stored energy
prior to opening hoses or
vessels under pressure or
working with belts and
cables under tension
Review the Isolation status
af ter any work break or
change in conditions
Continually monitor
isolation controls to ensure
they are in place and
working as intended
Re-instate all guarding and
saf ety systems upon
completion of work prior to
de-isolation
Criteria
Check
Review the isolation permit and conf irm the isolation has
been conducted in accordance with the permit conditions
Conduct a site inspection and conf irm:
• The isolation point(s) is/are clearly identif ied
• Each person involved in the isolation has f ixed a red
personal danger lock and tag to the isolation point (for
single point) or designated lock box (f or multi-point)
Does the relevant AMS identif y the need to test f or stored
energy prior to breaking containment systems?
☐
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
☐
Choose an
item.
Choose an
item.
☐
Choose an
item.
Choose an
item.
Has the Isolation of f icer or Permit Holder (where an
Isolation Of f icer is not required) conf irmed the “zero
energy state” of the equipment?
☐
Choose an
item.
Choose an
item.
Conf irm the TRA contains inf ormation on the method f or
the testing of , removal and restoration of stored energy
Question an isolation worker and ask if they can describe
how this process is conducted. Does this ref lect the
method stipulated in the TRA?
Does the relevant TRA include a step f or reviewing the
status of an isolation
• Bef ore work commences that day
• Af ter a work break
• When conditions change
Conduct a site inspection af ter a work break and conf irm
the isolation status is reconf irmed bef ore recommencing
work
Conduct a site inspection and conf irm all controls
identif ied in the TRA have been ef f ectively implemented
on site.
☐
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
☐
Choose an
item.
Choose an
item.
Bef ore plant and equipment is de-isolated, conf irm the
f ollowing:
• Non-essential items have been removed and
equipment components are intact
☐
Choose an
item.
Choose an
item.
☐
☐
☐
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 30 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
Check
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
☐
Choose an
item.
Choose an
item.
☐
Choose an
item.
Choose an
item.
•
8.F
Do not remove another
person’s danger tag or
isolation lock unless an
Authority to Remove
Personal Danger Lock
Form has been approved.
Appreciative Enquiry Question
All personnel are at a saf e distance f rom the area
where energy is to be returned to the equipment
• All guards and saf e systems have been reinstated
• The work crew have removed their personal locks
• All permits issued f or the work have been signed of f
and returned to the permit controller.
• The permit has been closed.
Question 2 isolation workers and ask if :
• They have ever removed another persons danger tag
or isolation lock?
• they have ever had their danger tag or isolation lock
removed by someone else while working under an
isolation at this workplace
Is the task being completed as planned?
Question the workers as to whether they think there
is a better way to complete the task
Actions
GMR No.
Action
Due Date
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Person Responsible
Action Closed
(Y/N)
Page 31 Of 39
GMR Self -Assessments
GMR 9 – ENVIRONMENT MANAGEMENT
Workplace Name:
Assessor / Assessing Team:
Relevant Supervisor / Leading Hand:
Work Description / Location:
GMR
Critical Control
Criteria
9.1
Identif y environment risks
in the planning phase and
allocate appropriate
controls and resources to
manage the risks
Have environmental risks been identif ied via the
Workplace Risk Assessment, Activity Method
Statements and Task Risk Assessments with controls
identif ied and resources allocated?
Have environmental controls been documented in the
Environmental Control Plan (ECP) and Site
Environment Plan (SEP) and ref erenced in the Activity
Method Statement?
Have environmental risks, sensitive areas and controls
been documented in the Site Environment Plan (SEP)
Have all environmental investigations, such as
contaminated land, heritage, vegetation and f auna
investigations been completed as necessary?
Have all environmental approvals, licences and permits
been obtained (as necessary) and documented in the
Approvals and Licenses Register in Project Pack Web
(or equivalent system), with individual conditions and
requirements documented in the obligations register in
Project Pack Web?
Has a John Holland Clearing, Dewatering, Out of Hours
Work and/or Hot Work Permit been obtained where
necessary?
Have the requirements of all approvals, licences and
permits been captured in the AMS and TRA f or the
work?
Have the requirements of all approvals, licences and
permits been communicated to the work group by the
Supervisor, or another suitable person prior to work
commencing?
Are all ERSED controls documented on an Erosion and
Sediment Control Plan (ESCP) or Site Environment
9.2
9.3
Conf irm all approvals,
licenses, permits and
environmental
investigations are
completed and
communicated prior to
commencing work
Implement all drainage,
sediment, erosion, spill
Date:
Check
Compliance
Description / Immediate
Actions Taken
☐
Choose an
item.
Further
Action
Required?
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
☐
☐
☐
☐
☐
☐
☐
☐
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 32 Of 39
GMR Self -Assessments
GMR
9.4
9.5
Critical Control
Criteria
response and water quality
controls prior to
commencing work
Plan (SEP), which is updated as works progress and
communicated to the relevant work groups?
Are controls in place to prevent mud and dirt being
tracked onto public roads by trucks and plant?
Are spill kits available at the work area, f ully stocked
and ready f or use?
Are water diversion controls in place to prevent water
entering the work area?
Are areas of exposed earth being minimised, with
controls installed as soon as practicable to prevent
erosion and sedimentation of water?
Are all stockpiles stored on f lat ground, or have upslope
water diversion controls in place to prevent erosion?
Is wind and rain erosion of stockpiles being prevented
by covering with geof abric, plastic, hydromulch etc. or
by bunding or installation of sediment f ence?
Have all protected heritage, f lora, f auna and other
sensitive areas been delineated f rom works using
barricading and signage?
Are these areas clearly identif ied on the Site
Environment Plan?
Identif y and protect
heritage, f lora or f auna
and other sensitive areas
and delineate using
physical demarcation
and/or signage
Minimise energy, water
and waste and prioritise
the selection of resource
ef f icient materials
Are sources of non-potable water being used f or
construction and sanitary purposes (where suitable)?
Are water minimising controls (such as f low restrictors,
sprung taps and waterless urinals) being used?
Are low impact materials being used or opportunities to
reduce material consumption in place?
Is energy ef f icient lighting being used?
Are sources of renewable energy being used?
Is construction and demolition waste, paper, cardboard,
electronics, printing cartridges, f luorescent lights, glass,
plastics and batteries being recycled where services are
available?
Are materials designated f or re-use, recycling or
disposal segregated and clearly signed?
Check
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
☐
☐
☐
☐
☐
☐
☐
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
☐
☐
☐
☐
☐
☐
☐
☐
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 33 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
9.6
Assess and, if required,
classif y spoil and waste
prior to being lawf ully
removed and disposed
Has the waste classif ication, and/or contamination
status of all spoil and waste been determined?
Have suitably licenced waste f acilities been identif ied to
receive spoil and other waste, and have they conf irmed
that they can receive it?
Are appropriately licenced waste transporters being
used to transport spoil and other waste?
Is all necessary waste tracking being undertaken to
conf irm that the material can be accounted f or, and that
it is tracked f rom origin to f inal destination?
Has the workplace boundary been clearly delineated
using barricading and signage?
Is the workplace boundary clearly shown on the Site
Environment Plan?
If work needs to occur outside of the project boundary
has the work been authorised by the Workplace
Manager?
Is dust f rom works being suppressed and controlled?
Are controls in place to minimise noise and vibration
and prevent it causing a nuisance to sensitive
receivers?
Are all works, including deliveries, scheduled to occur
within approved site hours?
Have any works needing to occur outside of approved
site hours been identif ied, af f ected persons notif ied and
all necessary permits, licences and approvals obtained
(e.g. John Holland Out of Hours Work Permit, client
approval, Regulator approval etc. (where necessary))
Are hazardous chemicals being stored appropriately, in
a bunded area or container – is the size of the bund
suf f icient (i.e. at least 10% larger than the volume of the
largest container)?
Are chemical storage, plant laydown, ref uelling,
washdown/washout and stockpiling areas sited and
constructed to prevent any impact on surf ace or
stormwater?
9.A
9.B
9.C
Do not enter sensitive
areas or work outside the
workplace boundary
unless authorised by the
Workplace Manager
Minimise dust, noise and
vibration at all times and
work within approved site
working hours
Store, handle, use and
dispose of waste and
hazardous substances in a
manner that minimises
environmental impact
Check
Compliance
Description / Immediate
Actions Taken
☐
Choose an
item.
Further
Action
Required?
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 34 Of 39
GMR Self -Assessments
GMR
9.D
9.E
9.F
Critical Control
Maintain and review
drainage, erosion and
sediment controls as
works progress.
Stop and notif y site
management if potential
heritage artef acts,
protected f lora and f auna
or contaminated soils are
f ound
Do not discharge water
without authorisation to do
so.
Appreciative Enquiry Question
Criteria
Check
Have all waste types and classif ications been identif ied,
f acilities put in place to manage them and measures
taken to appropriate dispose of them to a licensed
f acility?
Are drainage, erosion and sediment controls being
routinely inspected to ensure they remain suitable and
ef f ective?
Are pre and post rainf all inspections occurring to ensure
controls are adequate and in working order?
Have workers been instructed to stop work and notif y
their Supervisor if potential heritage artef acts, protected
f lora, f auna or contaminated soils are f ound?
Does the Activity Method Statement and Site
Environment Plan include a protocol f or the
management of unexpected f inds?
Does the Activity Method Statement and Site
Environment Plan include the contact details f or
appropriate personnel in case of unexpected or
unanticipated f inds?
Has the requirement to discharge surplus water been
identif ied in the Activity Method Statement and Site
Environment Plan, where applicable?
Has a John Holland Dewatering Permit been obtained
f or any water discharge?
☐
Is water discharge occurring in a controlled manner, in
accordance with permit requirements and with water
quality and overf low potential being monitored?
☐
Is the task being completed as planned?
Question the workers as to whether they think there
is a better way to complete the task
☐
☐
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
☐
☐
☐
☐
☐
☐
Actions
GMR No.
Action
Due Date
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Person Responsible
Action Closed
(Y/N)
Page 35 Of 39
GMR Self -Assessments
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 36 Of 39
GMR Self -Assessments
GMR 10 – WORK ON RAIL
Workplace Name:
Assessor / Assessing Team:
Relevant Supervisor / Leading Hand:
Work Description / Location:
GMR
Critical Control
Criteria
10.1
Conf irm all workers
perf orming rail saf ety work
hold the relevant
competency
10.2
10.3
10.4
10.5
Conf irm the qualif ied
worker in charge of rail
worksite protection
understands and can
perf orm their
responsibilities
Ensure the qualif ied worker
in charge undertakes a
worksite protection site
specif ic risk assessment
Develop a Worksite
Protection Plan to manage
the risks identif ied in the
worksite protection site
specif ic risk assessment
Implement controls
identif ied in the worksite
protection plan prior to
commencing work
Date:
Check
Compliance
Description / Immediate
Actions Taken
Using the Rail Competency Matrices, identif y 3 people
perf orming rail saf ety work and conf irm they hold the
necessary competencies to saf ety perf orm their work
☐
Choose an
item.
Further
Action
Required?
Choose an
item.
Are copies of these competencies maintained at the
workplace?
Conf irm the qualif ied worker in charge holds the relevant
rail saf ety worker competencies to implement the
network operator’s rules applicable to the specif ic rail
corridor being managed.
☐
☐
Choose an
item.
Choose an
item.
Has the Worker in Charge undertaken a worksite
protection site specif ic risk assessment?
Does the risk assessment include the f ollowing where
necessary:
• An easily accessible saf e place f or workers
• Speed of rail traf f ic
• Adjacent line protection
• Consideration of other workgroups on track
• Sighting distance
Does the risk assessment ref er to relevant rail network
saf ety critical communication protocol?
Conf irm a worksite protection plan is in place
Has the worksite protection plan incorporated the highest
level of controls where possible?
☐
Choose an
item.
Choose an
item.
☐
☐
Choose an
item.
Choose an
item.
Review the worksite protection plan and conduct a site
inspection to conf irm the controls stipulated have been
ef f ectively implemented on site.
☐
Choose an
item.
Choose an
item.
☐
☐
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 37 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
10.A
Always wear rail compliant
personal protective clothing
and carry your Rail Industry
Worker Card
10.B
10.C
10.D
10.E
Participate and sign onto a
pre-work brief with the
qualif ied worker in charge
Conf irm with the qualif ied
worker in charge that the
worksite protection controls
are in place prior to
commencing work
Follow the network rules
and rail saf ety instructions
of the qualif ied worker in
charge
Review and revise the
worksite protection plan if
required and when changes
af f ect the worksite
protection controls
Check
Compliance
Description / Immediate
Actions Taken
Question 3 rail workers and ask them to produce their
Rail Industry Worker Card (this question is not applicable
f or NZ workplaces)
Conduct a site inspection and conf irm all workers on site
are wearing:
• Protective Helmets (as per AS 1800)
• Protective Footwear (high sided lace ups)
• Long sleeve and pant protective clothing (as per AS
4602)
• Approved eye protection (as per AS 1337)
• Gloves - to be carried at all times
Review the pre-work brief and conf irm:
• The brief includes the site specif ic risks identif ied in
the worksite protection plan
• The brief was delivered by the qualif ied working in
charge
Identif y 3 rail workers and conf irm they have participated
in and signed onto the pre-work brief .
Did the Site Supervisor or Superintendent conf irm all
worksite protection controls were in place prior to works
commencing?
Was this conf irmation communicated to the workers?
☐
Choose an
item.
Further
Action
Required?
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
Choose an
item.
Question 2 workers working in the rail corridor and ask if
the qualif ied worker in charge gave them permission to
enter the corridor?
☐
Choose an
item.
Choose an
item.
Question the qualif ied worker in charge and conf irm all
workers are f ollowing their instructions
Review the worksite protection plan and conf irm:
• The requirements within are up to date and ref lect
the current environment
• No changes are required.
Question 2 rail workers and ask what the process is if
changes are required to the worksite protection plan.
Conf irm they mention:
☐
Choose an
item.
Choose an
item.
☐
☐
☐
☐
☐
☐
☐
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Page 38 Of 39
GMR Self -Assessments
GMR
Critical Control
Criteria
Check
Compliance
Description / Immediate
Actions Taken
Further
Action
Required?
☐
Choose an
item.
Choose an
item.
☐
Choose an
item.
Choose an
item.
•
10.F
Ensure rail inf rastructure is
certif ied f or operation and
clear of any obstructions
prior to handback to the
Network operator
Appreciative Enquiry Question
Discussing proposed changes with their
supervisor/superintended
• Revising the worksite protection plan
• Communicating these changes to all relevant
personnel
For areas that have been handed back to the network
operator, conf irm a Network Track Certif ication or
Network Operators Certif ication of Completion has been
completed.
Is the task being completed as planned?
Question the workers as to whether they think there is a
better way to complete the task
Actions
GMR No.
Action
Due Date
Revision No: 6
Issue Date: 15/12/2021
Document Number: GCLR-FRM-WHS-006-05
When Printed This Document Is an Uncontrolled Version and Must Be Checked Against The IMS Electronic Version For Validity
Person Responsible
Action Closed
(Y/N)
Page 39 Of 39