Form 07 (PLANNING)
FIELDWORK SAFETY
PLAN
Type into grey boxes and Tab between inputs
Unit of study / Research project / Other title:
Start date:
Finish date:
Fieldwork Description (this can be a brief outline if a comprehensive description of the proposed fieldwork has been attached):
A comprehensive description of the proposed fieldwork has been attached.
A risk assessment is attached.
Participants briefed on details of proposed fieldwork; relevant safety policies, procedures and expected
conduct whilst on the field work.
Field work information sheet provided to all participants + all
participants signed onto this safety plan.
All equipment, vehicles and tools will be checked for safety compliance prior to field work commencing.
Participants have disclosed any relevant medical conditions.
Required licenses, permits and agreements with land owners and other involved parties are up-to-date for the use of specialised equipment and/or plant.
Copies of this fully endorsed plan have been distributed to:
School/Unit
DBSO (if applicable)
Fieldwork Supervisor
Volunteer insurance details are to be retained by the School/Unit office. If the Head of School/Administrative Unit deems that proposed fieldwork involves complex hazards or a higher than
normal risk then a copy must also be sent to the Dean/Senior Manager.
UWA CONTACT AND CALL- HOME ARRANGEMENTS
UWA Contact Name(s):
Phone Number(s):
Call-Home Arrangement:
Emergency response plan if call-home arrangements fail:
Collaborators obligation when leading a fieldtrip: A member of the coordinating field team will contact the UWA nominated person (above) as soon as practicable in the event of an
incident, injury or near miss. If they cannot be contacted, Warren Starr (UWA DBSO) should be contacted on 0457835527. UWA must be involved in incident investigations and outcomes.
Name:
FIRST
AID:
Organisation:
(1) Provide first aid to
the injured person.
Position:
(2) Ensure Status of (3) Call 000. Mobile phones can call 112 for ambulance (on
all other persons.
any network and outside normal coverage area).
Signature:
(4) Emergency Service will request location (including GPS coordinates), contact number, clinical details and will offer advice.
(5) Transfer to Medical Unit as
directed by Medical Specialist(s)
(6) Contact POC,
School Manager,
TRANSPORT ARRANGEMENTS TO FIELDWORK SITE(S) (details of any off-road driving must be included)
Fieldwork Safety Plan
Published:
January 2015
Version 1.6
Authorised by UWA Safety and Health
Review:
January 2020
Page 1 of 2
This document is uncontrolled when printed. The current version is available on the Safety and Health website
ITINERARY DETAILS
Date / Time
Location
Accommodation
Phone / E-mail
PARTICIPANTS DECLARATION
I have read and fully understand the requirements of this Fieldwork Safety Plan and associated documents. I have completed and submitted Form 01 [REGISTRATION] FIELDWORK
PARTICIPATION DECLARATION which is renewed annually.
Name
Phone Number
Volunteer or
Driver Competence
(during fieldtrip)
Collaborator?
1
V
C
2
V
C
3
V
C
4
V
C
5
V
C
6
V
C
7
V
C
8
V
C
9
V
C
10
V
C
Approved
driver
4WD
trained?
Signature
Date
Off-road
trained?
PERMISSION TO PROCEED
Print Name
Signature
Date
Fieldwork Leader
Fieldwork Supervisor
DBSO (if applicable)
Head of School
Fieldwork Safety Plan
Published:
January 2015
Version 1.6
Authorised by UWA Safety and Health
Review:
January 2020
Page 2 of 2
This document is uncontrolled when printed. The current version is available on the Safety and Health website