Adopt-a-Road Site Safety Plan
Adopt-a-Road Group Name:
Adopt-a-Road Group Leader:
Keep Australia Beautiful Contact:
Telephone:
Jai Ogilvie
Road Authority Contact:
Telephone:
3252 2886
Telephone:
Proposed Road Site:
SAFETY PLAN REVIEW
Keep Australia Beautiful Queensland (KABQ) has reviewed this plan and has found that it satisfies the requirements of
the Adopt-a-Road Safety Guidelines and site specific needs of the proposed road site. The Adopt-a-Road Group
Leader agrees to comply with this plan and ensure all group members also comply with this plan.
The Adopt-a-Group Leader and all group members understand and acknowledge the potential risks and agree to
undertake due care in any and all Adopt-a-Road activities.
Please note this document must be read in conjunction with the Adopt-a-Road Safety Guidelines. This site safety plan
addresses the major issues listed in the guidelines. Further detail is provided in the guidelines.
Please note the sections marked with an asterisk* must be completed by the Group Leader.
......................................................
*Signature
*Name and Title (please print)
*Date
Name and Title (please print)
Date
Adopt-a-Road Group Leader
......................................................
Signature
KABQ
AAR Site Safety Plan
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CONTENTS
1.0
Scope
2.0
Activity Information
3.0
Site Establishment
3.1
Communications
3.2
Personal Protective Equipment
3.3
Safety Signs
4.0
Site Induction
5.0
Major Hazards, Risk Management Process and Off Limit Areas
5.1
Major Hazards
5.2
Off Limit Areas
6.0
Road Crossings
7.0
Drop Off, Meeting and Collection Points
8.0
Parking
9.0
Work Pattern
10.0
Litter Collection
11.0
Hazardous Materials
12.0
Emergencies
13.0
12.1
Emergency Response
12.2
Emergency Contacts
Site Diagram Instructions
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1.0
SCOPE
This site safety plan applies to activities conducted by the
their adopted road site
*(Name of Adopt-a-Road Group) in relation to
*(Road Site).
It has been developed in response to the requirements of clause 4.3 of the Adopt-a-Road Safety Guidelines,
and should be read in conjunction with these guidelines.
The purpose of this site safety plan is to:
 Define site specific safety issues identified within the Adopt-a-Road Safety Guidelines
 Define additional safety issues identified during planning of each Adopt-a-Road activity
 Ensure a safety communication and implementation process is applied to the activity
2.0
ACTIVITY INFORMATION
*The Adopt-a-Road Group proposes to undertake the following activities:
litter collection
3.0
weed eradication
graffiti removal
SITE ESTABLISHMENT
The following actions must be carried out prior to the commencement of any Adopt-a-Road on-site activity.
3.1
Communications
 Adopt-a-Road Group Leader must advise Keep Australia Beautiful Queensland (KABQ) prior to
any proposed Adopt-a-Road activity
 KABQ will advise all relevant parties including the road authority of any proposed Adopt-a-Road
activity
 Adopt-a-Road Group Leader shall undertake a detailed review of the Adopt-a-Road Safety
Guidelines, Adopt-a-Road safety video and site safety plan to ensure a high level of familiarity
with safety and activity requirements
 Adopt-a-Road Group Leader shall ensure all members are familiar with the safety and activity
requirements
 Adopt-a-Road Group Leader shall ensure there are sufficient adult supervisors for children
participating in the Adopt-a-Road activity (Note: If the speed limit is greater than 50km/h,
children under 12 years are not permitted on site; refer to clause 3.2 of the Adopt-a-Road Safety
Guidelines for specific information on adult/child ratio)
 Ensure participants are aware of transport to and from site, meeting points, collection points,
parking, road crossing etc
 Adopt-a-Road Group Leader shall contact the road authority with regard to disposal of rubbish
bags (if applicable)
 Adopt-a-Road Group Leader shall contact the nearest needle exchange facility to arrange
disposal of any sharps collected (if applicable)
3.2
Personal Protective Equipment
 Safety equipment must be reviewed to ensure all equipment is readily available and in good
working order prior to work commencing
 There should be sufficient vests, gloves etc for each participant
 Each participant should be wearing a safety vest prior to arrival at the site
 Each participant should be wearing enclosed shoes
 Sufficient sharps containers
 For further information, see Plant Code of Practice 2005 available at the Department of Industrial
Relations website at www.dir.qld.gov.au
3.3
Safety Signs
 Safety signs shall be installed facing oncoming traffic at the start and end points of the
designated site as indicated on the site diagram included as attachment 1
 Safety signs should be placed on reasonably level ground and so that the line of guideposts does
not obscure motorists’ view of the signs
 Safety signs shall remain in place only for the duration of activities and removed after each
Adopt-a-Road activity
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4.0
SITE INDUCTION
Prior to participants undertaking their first Adopt-a-Road activity they must complete safety induction training.
The safety induction shall include viewing of the Adopt-a-Road safety video and a thorough review of the
Adopt-a-Road Safety Guidelines and site safety plan – in particular parts 5 through to 13.
Prior to being allowed on site, the Adopt-a-Road Group Leader must be satisfied that all participants are
sufficiently familiar with the safety requirements and capable of performing their duties in a safe manner.
Information for each participant must be detailed and regularly updated using Form 5 in the resource folder.
5.0
MAJOR HAZARDS, RISK MANAGEMENT PROCESS AND OFF LIMIT AREAS
The Adopt-a-Road Group Leader shall ensure that all participants are aware of any site hazards or off limit
areas. These areas are described in the site diagram (attachment 1).
(Additional information about the Risk Management Process can be found in the Workplace Health and Safety
Risk Management Code of Practice.)
A hazard is something with the potential to cause harm. This can include substances, plant, work processes
and/or other aspects of the work environment. Some specific examples at your site may include the speed
limit, visibility, power lines, railway tracks, heavy traffic etc
Risk is the likelihood that death, injury or illness might result because of the hazard.
5.1
Major Hazards

Participants shall be advised on the location and nature of hazards, and instructed on
appropriate precautions. The Adopt-a-Road Group Leader has identified the following specific
hazards at the Adopt-a-Road site:
*Hazard Description
5.2
*Risk level (Low, Medium, High)
*Precautions (control measures)
Off Limit Areas
The Adopt-a-Road Group Leader has identified the following areas as off limits (private property,
railway lines, tunnels, bridges, open drains, creek beds, roads without kerbing etc) to participants:
*Off Limit Area
AAR Site Safety Plan
*Location
4
6.0
ROAD CROSSINGS
Participants shall cross the road only when necessary and shall do so only at the designated crossing points
described in the site diagram (attachment 1). These locations have been selected on the basis of visibility
distance and accessibility or the existence of appropriate facilities to ease crossing such as traffic lights,
overhead bridge, bikeway etc.
Please refer to part 5.0 for hazards.
7.0
DROP OFF, MEETING AND COLLECTION POINTS
Drop off, meeting and collection points must have sufficient space for participants to gather well clear of the
road. Participants must use the designated points as described in the site diagram (attachment 1).
Drivers are required to adhere to the road traffic rules.
8.0
PARKING
Participants are encouraged to car-pool where possible. Parking must be well clear of the road and road
shoulder. Parked cars should not obscure motorists’ view of safety signs or participants. Drivers should not use
their hazard lights when parked.
Parking shall occur only at the designated locations described in the site diagram (attachment 1).
9.0
WORK PATTERN
Participants are to work in the direction of oncoming traffic and to remain 3 metres clear of traffic lanes at all
times. Participants must not enter off limit areas as specified in part 5.2 of this document and with part 8.1 in
the Adopt-a-Road Safety Guidelines. Please refer to the site diagram (attachment 1).
10.0 LITTER COLLECTION
Full litter bags should be left 3 metres clear of the road edge ready for collection by the group or by the road
authority as arranged by the group. Refer to the site diagram (attachment 1)
Hazard lights or flashing lights may be operated whilst collecting bags and the pick-up team should consist of
a driver and a person to collect the bags. The person collecting the bags should alight from the side of the
vehicle which is away from the road.
11.0 HAZARDOUS MATERIAL
Participants will not touch any hazardous materials. The Adopt-a-Road Group Leader must be notified
immediately of any materials and he/she must record the exact location of the hazardous materials using
Form 4 in the resource folder and notify the relevant road authority.
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12.0
EMERGENCIES
12.1
Emergency Response
In the event of an emergency, participants are advised to:
12.2

Attend to their own safety, do not place themselves at risk

If safe, attend to the safety and wellbeing of others

Notify the Adopt-a-Road Group Leader immediately

Contact relevant emergency services immediately

Secure the site to prevent further incident
Emergency Contacts
You may like to include contact numbers for your local police, local council, rural fire service etc.
* Service
*Contact Number
*Group Leader mobile number
KABQ
13.0
07 3252 2886
SITE DIAGRAM INSTRUCTIONS
Your site diagram should including the following items:







Major hazards
Off limit areas
Safety sign locations
Drop off, meeting and collection points
Road crossings
Parking
Full litter bag pick up points
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*Please include your site diagram here (Feel free to attach the site diagram on a separate piece of paper should you
require more space):
Please complete the sections marked with an asterisk* in this site safety plan; sign and fax or post your completed
site safety plan, or direct enquiries to:
Keep Australia Beautiful Queensland
PO Box 3260, SOUTH BRISBANE 4101
Tel 07 3252 2886 Fax 07 3255 0232
Email: info@kabq.org.au
Web www.kabq.org.au
Privacy: The information you provide on this form is for the sole use of the Keep Australia Beautiful Queensland and
will not be disclosed to a third party without your consent.
AAR Site Safety Plan
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