SITE/WORKSHOP HEALTH AND SAFETY INSPECTION/JOB HAZARD CHECK LIST AND APPRAISAL FORM The attached Check List

and Appraisal Forms contain 25 activities that are essential in maintaining a Health and safe Working Environment on a construction site or in a workshop. Each Activity contains a number of elements which shall be checked - off for conformity or, where necessary, defining and corrective action required. For the purpose of appraisal, points are allocated to each element, dependent on how effectively each elements is being implemented determines the number of points assessed to that element, based on the maximum listed. Should a particular element not be applicable then the points for that element are deleted and a Applicable Total obtained on which the appraisal will be based. These Check List shall be utilised as the basis for carrying out independent Safety Audits.

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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ACTIVITY

POSSIBL E POINTS 28 14 36 20 36 32 20 32 24 48 32 28 28 48 32 20 12 40 24 40 48 12 14 18 16 702

APPLICABLE POINTS

ASSESSE D POINTS

POOR 0-25%

FAIR 26-60%

GOOD 61-90%

EXCELLENT 91-100%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Procedure, Management & Supervisory Involvement First Aid Emergency Control Measures Amenities and Sanitation Housekeeping Personal Protective Equipment Induction Training Safety Publicity / Promotion Material Handing & Storage Hazardous Material Control / Hygiene Flammable Gases & Liquids Vehicles & Cranes Scaffolding Ladders Barricades Trenching Electrical Powered Tools Compressors & Compressed Air Tools Explosive Powered Tools Welding & Cutting Fumes, Dust, Smoke & Noise Control Recording & Analysis of injury & Date Accident Investigation & Reports Site Control Possible Total Applicable & Assessed totals & Overall Assessment

Health and Safety Inspection carried out on job/location .......................................................................................................... on ...................................... (date) By .................................................................... (name) ............................................. (title) Persons contacted ........................................................................................................................................................ Comments / Action Required ...................................................................................................................................... ...................................................... Signed

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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MAX POINTS

ASSESSED POINTS

COMMENTS

Procedures, Management & Supervisory Involvement 2 a) b) c) d) e) Copy of current Safety Manual on file. 2 Responsibilities assigned. Are the Safety Manual Procedures understood, adhered to and responsibilities followed. Are the procedures reviewed regularly. Knowledge and compliance with Statutory requirements, applicable to the Country/State where the work is located and the discipline being constructed to manufactured. Policy displayed prominently. 2 g) h) Safety and Agenda item at management meetings. 4 Are safety inspections carried out on a regular basis with the results properly recorded and filed and any corrective action followed and taken. 4 i) Are tool-box meetings held regularly with the minutes properly recorded and filed and any corrective action followed up and taken. 28 Possible Total Dependent on 1 (e) Applicable Total (8) Assumed 2 2

2 f)

First Aid a) b) c) d) e) f) g) First aid station-equipped. First aid supplies per recommended list. Medical care available. Sufficient certificated first-aiders available at work areas. Telephone number and location of nearby physician. Telephone number and location of nearest hospital. All shifts adequately covered. 14 Possible Total Applicable Total 2 2 2 2 2 2 2

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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MAX POINTS

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COMMENTS

Emergency Control Measures a) b) c) d) e) h) i) Types of emergency evaluated. Appropriate control personnel selected. Emergency procedures developed. Fire leams, evacuation crew selected and trained. Portable equipment appropriate / maintained. Emergency vehicle access / direction adequate. No smoking signs posted and enforced where applicable. 4 4 8 8 4 4 4 36

Possible Total Applicable Total 4 Amenities & Sanitation a) b) c) f) g) h) i) j) Toilets/Shower blocks clean & maintained. Dining & Mess rooms satisfactory. Office layout satisfactory. Accommodation to a satisfactory standard. Rest room facilities for women of applicable. Drinking water supplied from approved outlets from potable water system. Adequate supply of water. Water coolers & potable coolers clean.

4 4 2 2 2 2 2 2 20

Possible Total Applicable Total

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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Housekeeping a) b) c) d) e) f) g) h) i) Standards are set. General neatness of working areas & not cluttered. Regular disposal of waste and trash. Passageways and walkways clear. Floors, footing in good condition. Adequate lighting. Projecting nails removed. Oil and grease removed. Waste containers provided and used.

Possible Total Applicable Total 6 Personnel Protective Equipment a) b) c) d) e) f) g) h) Need for equipment addressed. Appropriate equipment provided. Instruction on equipment use. Induction described need for such equipment Wearing of equipment is condition of employment. All personnel wear required equipment. 4 Visitors required to wear equipment. 4 Hazard areas clearly identified and sign posted. 32 Possible Total Applicable Total 4 4 4 4 4 4

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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COMMENTS

Induction a) b) c) d) e) Has the formal induction process been implemented. Was there a written handout. Is all relevant information recorded in employee file. Was management involved in process. Is continued follow-up part of the process. 4 4 4 4 4 20

Possible Total Applicable Total 8 Training a) b) c) d) e) f) g) h) Training needs of personnel reviewed. Continuous programme is operation. Detailed training programme available (course content timetable) Action plans submitted by participants. Personnel training record system maintained. Specialized (skills) training arranged as necessary. Specific training (job related) conducted.

4 4 4 4 4 4 4 4

Key personnel appropriately trained. 32

Possible Total Applicable Total

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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COMMENTS

Safety Publicity / Promotion a) b) c) d) e) f) g) h) i) Safety signs used appropriately. Posters, bulletins used effectively. Minutes of safety meetings being posted and discussed. Videos, talks keyed to specific themes. Scoreboard used and kept up to date. Displays and demonstrations used. Accidents / corrective action discussed. Other imaginative measure used. Safety suggestion scheme in operation. 4 2 4 2 2 2 4 2 2 24

Possible Total Applicable Total 10 Material Handling & Storage a) b) c) d) e) f) g) h) i) j) k) j) Manual Handling - limits of size, weight and shape apply. Mechanical aids used where applicable. Proper number of men for each operation. Men picking up loads correctly. Adequate handling technique training carried out. Storage standards set out and maintained. Appropriate certification of equipment / operators. Storage areas well defined.

4 4 4 4 4 4 4 4 4

Neat storage area, clear passageways. 4 Materials neatly stacked. 4 Stacks on firm footings, not too high. 4 Materials protected from heat and moisture as applicable. 48

Possible Total Applicable Total

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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11

Hazardous Materials Control / Hygiene a) b) c) d) e) f) g) h) No hazardous material purchased without full data. All hazardous materials clearly labelled. 4 Appropriate data posted at workplace. 4 Data issued and used effectively. 4 Alternative materials purchased where excessive hazard exists, 4 Emergency treatment known and readily available. Protective equipment available where necessary. Health monitoring programme used where necessary. 4 4 32 4 4

Possible Total Applicable Total 12 Flammable Gases and Liquids a) b) c) d) e) f) g) All containers clearly identified. Proper storage practices observed. Fire hazards checked. Proper types and numbers of extinguishers nearby. Proper storage temperatures. 4 Carts for moving cylinders. 4 All cylinders secured upright. 28 Possible Total Applicable Total 4 4 4 4 4

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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13

Vehicle & Cranes a) b) c) d) e) f) g) Regular inspection and maintenance. Crane operating manuals & maintenance manuals retained in cabs and up to date. Qualified operators - correct state licences and on file. Local and state vehicle laws and regulations observed. Brakes, lights, warning devices operative. Weight limits and load sizes controlled. Personnel carried in a safe manner. 4 4 4 4 4 4 4 28

Possible Total Applicable Total 14 Scaffolding a) b) c) d) e) f) g) h) i) j) k) i) Erection under proper certified supervision & in compliance with Regulations. All structural members adequate for use. All connections adequate. Safe tie-in to structure. Ladders and working areas free of debris, grease. Exits adequately maintained. Proper footings provided. Passerby protected from falling objects. Supports plumb, adequate crossbracing provided. Guard rails and toe boards in place. Slings / Tackle in good condition. Timber planks in good condition.

4 4 4 4 4 4 4 4 4 4 4 4 48

Possible Total Applicable Total

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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15

Ladders a) b) c) d) e) f) h) Stock ladders inspected and in good condition. Stock ladders not spliced. Properly secured, top and bottom. Siderails on fixed ladders extend above top landing. Built-up ladders extend above top landing. 4 Rungs not over 12 inches no center. Proper maintenance and storage. 4 32 4 4 4 4 4

Possible Total Applicable Total 16 Barricades a) b) c) d) e) Floor openings properly & securely planked over or barricaded. Proper barriers / warning taps around trenches and excavations. Roadways and sidewalks effectively protected. Adequate lighting provided. Traffic controlled by adequate warring devices.

4 4 4 4 4 20

Possible Total Applicable Total 17 Trenching a) Shoring and bracing as needed properly installed, and in good condition or trench sides battered correctly. Trench excavation and or access / lifting equipment correct and in good working. Proper access to deep trenches.

b) c)

4 4 12

Possible Total Applicable Total

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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Electrical Powered Tools a) b) c) Proper tool being used for each job - NO IMPROVISATION. Proper instruction in use. Inventory / inspection Status Log & Inspection Record Forms (Exhibits 9/1 & 9/2) on file and up to date. Regular maintenance and programme with coding exists & servicing / tests are carried out by licensed personnel. Tools & cords in good condition. Obvious faults being reported & equipment labelled faulty and removed from work until rectified or replaced. Proper earth protection. Extension cables neatly run & protected against passing traffic. All mechanical safeguards in use. Equipment checked visually on return to store and stored neatly when not in use. 4 4 4

d)

e) f)

4 4

g) h) i) j)

4 4 4 4 40

Possible Total Applicable Total 19 Compressors & Compressed Air Tools a) b) c) d) e) f) Equipment adequately silenced. Equipment properly maintained. Safety catches/chains/wire ties fitted & used on hose connections. Outlet nozzles clean and identified. Safety valves and gauges working. Any additional manifolds properly tested and identified.

4 4 4 4 4 4 24

Possible Total Applicable Total

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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Explosive Powered Tools a) b) c) d) e) f) g) h) i) j) Statutory laws complied with. Tools have current certificates. All operators qualified and certificated. Tools and charges protected from unauthorized use. Competent instruction and supervision. 4 Tools checked and in working order. 4 Tools not used on any but recommended materials. Safety goggles or face shields and hearing protection. Flying hazard check. Warning signs displayed. 4 4 4 40 4 4 4 4 4

Possible Total Applicable Total

21

Welding and Cutting a) b) c) d) Qualified operators. Screens and shields for protection of adjacent personnel. Goggles, gloves, clothing used properly. Equipment in good and proper operating condition (no oil leaks, silenced correctly and without excessive fumes). Power cables protected and in good condition, and routed neatly. Fire extinguishers of proper type nearby. Inspection of fire hazards. Flammable materials protected. Gas cylinders chained upright. Gas lines protected and in good condition. Earth return lead placed immediately adjacent to the work. Fire retardant mats to be used in vicinity of electrical cables and flammable items when welding. 4 4 4 4

e) f) g) h) i) j) k) l)

4 4 4 4 4 4 4 4

Possible Total Applicable Total

48

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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Fumes, Dust, Smoke, Noise Control a) b) c) d) e) f) Processes identified in terms of fumes, dust, smoke, noise. Standards known and applied. Equipment is properly selected and maintained. Correct protective equipment supplied and worn. Fume extraction equipment available and used. All control equipment maintained. 2 2 2 2 2 2 12

Possible Total Applicable Total 23 Recording & Analysis of Injuries & Data a) b) c) d) Recording Format defined and available. Classification of injuries defined. Analysis of Data carried out regularly. Trends in data analysis acted on.

2 4 4 4 14

Possible Total Applicable Total 24 Accident Investigations & Reports a) b) Accidents Investigated promptly and accurately in prepared format. Accident reports and recommendations acted on i.e. follow-up tool box meeting.

8 10 18

Possible Total Applicable Total

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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Site Control a) b) c) d) e) f) g) h) Security provided, assessed adequate. Contraction informed of all procedures. Corrective measures taken where contractors do not follow procedures. Traffic control systems in operation. Speed control applies. Access to areas satisfactory. Parking facilities adequate. Visitors checked/equipped for entry. 2 2 2 2 2 2 2 2 16

Possible Total Applicable Total

AWI 201 Att. 2 App. 6 Rev. 1 30 Jan. 2000

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