AASD002 ON-SITE RISK ASSESSMENT AND CHECKLIST - Action Arbor Tree Services

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Company / Work Group:*

Date*

Time*

: HH

MM

Inspected By (Include All Personnel Who Took Part In The Inspection)

Name

First Last

Position

INSPECTION ITEMS

1. Is there anything RESTRICTING ACCESS & EGRESS*

YES
NO
N/A

Comments

1a. Is the area clear of rubbish or scattered materials and immediate dangers?*

YES
NO
N/A

Comments

1b. Are barricades required for such areas as: fences/around trenches/hazardous work areas? *If yes please detail which*

YES
NO
N/A

Comments

2. Is ASBESTOS involved in direct work areas? *If Yes, ensure the following is completed SWMS, JTA, SSSP Required*

YES
NO
N/A

Comments

2a. Are Asbestos SWMS completed and signed for working with or near Asbestos?*

YES
NO
N/A

Comments

2a.1 If YES to 2a, are the Asbestos SWMS available on site? *If not, work should not commence until SWMS are available on-site and signed by all employees attending site.*

YES
NO
N/A

Comments

2b. Are all correct work procedures being followed on-site as per Asbestos SWMS?*

YES
NO
N/A

Comments

3. Will there be any BIOLOGICAL/TOXIC MATERIALS /CHEMICALS / COMBUSTIBLE ITEMS/DANGEROUS GOODS on-site? *If Yes, ensure the following is completed - SWMS, JTA, SSSP Required*

YES
NO
N/A

Comments

3a. Does the site have a Hazardous Substances Register listing the chemical used on site?*

YES
NO
N/A

Comments

3b. Have Material Safety Data sheets (MSDS’s) been obtained for all chemicals used on site and are copies of the MSDS’s available?*

YES
NO
N/A

Comments

3c. Have site workers using these substances/items been trained in how to use and store them safely and correctly?*

YES
NO
N/A

Comments

3d. Are all hazardous materials including hydrocarbons (any combustible material/chemical) stored with correct labelling, within appropriate containment, areas away from risk and direct work areas?*

YES
NO
N/A

Comments

3d. Are all hazardous materials including hydrocarbons (any combustible material/chemical) stored with correct labelling, within appropriate containment, areas away from risk and direct work areas?*

YES
NO
N/A

Comments

3e. Is there an emergency plan for any risk of Fire and Explosion?*

YES
NO
N/A

Comments

4. Are any on-site staff working in a CONFINED SPACE situation? *If Yes, ensure the following is completed - SWMS, JTA, SSSP Required*

YES
NO
N/A

Comments

4a. Are Confined Space SWMS completed and signed for working in Confined spaces?*

YES
NO
N/A

Comments

4a.1 If YES to 4a, are the Confined space SWMS available on site? *If not, work should not commence until SWMS are available on-site and signed by all employees attending site.*

YES
NO
N/A

Comments

4b. Is the work area monitored by a spotter to communicate with the worker?*

YES
NO
N/A

Comments

4c. Are all correct work procedures being followed on-site as per Confined Spaces WMS?*

YES
NO
N/A

Comments

5. Is DUST a present risk during work actions?*

YES
NO
N/A

Comments

5a. If so, has a plan of action been implemented to reduce such dust?*

YES
NO
N/A

Comments

6. Will any work be carried out near or involving ELECTRICITY & OVERHEAD HAZARDS? *If Yes, ensure the following is completed - SWMS, JTA, SSSP Required*

YES
NO
N/A

Comments

6a. Has an action been implemented for disconnection of electricity?*

YES
NO
N/A

Comments

6a.1 If YES to 6a, how will staff know the connection of current is disconnected prior to starting work? (please explain)*

YES
NO
N/A

Comments

7. Will any EXCAVATION works be carried out by on-site staff? *If Yes, ensure the following is completed - SWMS, JTA, SSSP Required*

YES
NO
N/A

Comments

7a. Are Excavating SWMS completed and signed for working in Confined spaces?*

YES
NO
N/A

Comments

7b. Is all machinery to be used checked and all evidence of service, hydraulics, licencing (if req) on-site and available for all to see?*

YES
NO
N/A

Comments

7c. If relative, have all underground services been identified?*

YES
NO
N/A

Comments

7d. Is there an excavation plan displayed on site and all personnel of aware of the plan?*

YES
NO
N/A

Comments

8. Has proper training been provided for all MANUAL HANDLING to occur on-site?*

YES
NO
N/A

Comments

9. Will NOISE AND VIBRATION be a factor on this job?*

YES
NO
N/A

Comments

9a. Are site workers wearing hearing protection whilst doing and or working neat noisy work?*

YES
NO
N/A

Comments

9b. Have all efforts been implemented to advise and protect others of noise levels?*

YES
NO
N/A

Comments

9c. Will the monitoring of noise levels be monitored? *If NO, please provide reason.*

YES
NO
N/A

Comments

10. Is the site OCCUPIED or in PUBLIC areas?*

YES
NO
N/A

Comments

10a. If YES to 10, have all best efforts been implemented to make the area safe and access denied to non-on-site staff? *If NO, work is not to commence until this is actioned correctly.*

YES
NO
N/A

Comments

10b. Have Construction/No Entry warning signs/barricades been displayed correctly?*

YES
NO
N/A

Comments

11. Has the EMS (environmental Management System) been completed and passed including all WASTE DISPOSAL and recycling of any items?*

YES
NO
N/A

Comments

12. Have all WORKING AT HEIGHTS regulations been implemented? *If Yes, ensure the following is completed - SWMS, JTA, SSSP Required*

YES
NO
N/A

Comments

12a. Are Working at heights SWMS completed and signed for working in this procedure?*

YES
NO
N/A

Comments

12b. Are all the following items checked and confirmed safe to proceed: Harness points secure and checked; any use of scaffolding secure including handrails and planks and will not tip; any ladders safely secured prior to use; ladders, harnesses, scaffold in good repair and serviced?*

YES
NO
N/A

Comments

12c. Have all staff working at heights completed working at heights training?*

YES
NO
N/A

Comments

12d. Has Climbing & Rigging Gear been checked for safety recently?*

YES
NO
N/A

Comments

12e. Is it raining or a strong wind prevailing?*

YES
NO
N/A

Comments

13. Do the machines/tools on site have SAFETY GUARDS fitted?*

YES
NO
N/A

Comments

14. Are the LEADS AND PLUGS in good condition?*

YES
NO
N/A

Comments

15. Are the EXTENSION LEADS off the ground?*

YES
NO
N/A

Comments

16. Is there any ELECTRICAL EQUIPMENT overdue for inspection?*

YES
NO
N/A

Comments

17. Are there EXPLOSIVE TOOLS on site?*

YES
NO
N/A

Comments

18. Are there suitable FIRE EXTINGUISHERS on site?*

YES
NO
N/A

Comments

19. Is all PPE gear being used correctly and in good order? (Safety Helmets; Safety footwear; hearing protection; UV protective clothing; Eye Protection etc..)*

YES
NO
N/A

Comments

20. Is a first a current and fully stocked FIRST AID box available on-site?*

YES
NO
N/A

Comments

20a. Is there a trained first person on-site?*

YES
NO
N/A

Comments

21. Falling and above dangers?*

YES
NO
N/A

Comments

21a. Are powerlines or Telephone Cables nearby tree?*

YES
NO
N/A

Comments

21b. Nearby Roof, fence or structures, or cars that should be moved?*

YES
NO
N/A

Comments

21c. Are water or gas mains location nearby the drop zone?*

YES
NO
N/A

Comments

21d. Will branches fall onto the road or footpath? - Safety Cone or Barrier Tape Hazard zone.*

YES
NO
N/A

Comments

Other Inspection Items

22. Inspection Item

YES
NO
N/A

Comments

23. Inspection Item

YES
NO
N/A

Comments

24. Inspection Item

YES
NO
N/A

Comments

25. Inspection Item

YES
NO
N/A

Comments

26.

ISSUES RAISED DURING INSPECTION

ISSUE ONE

Insert Inspection # Item action relates to:

Actions Required

Due Date

Responsible Person

Entered in Action Tracking System (yes/no)

Yes
No

ISSUE TWO

Insert Inspection # Item action relates to:

Actions Required

Due Date

Responsible Person

Entered in Action Tracking System (yes/no)

Yes
No

ISSUE THREE

Insert Inspection # Item action relates to:

Actions Required

Due Date

Responsible Person

Entered in Action Tracking System (yes/no)

Yes
No

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