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ANGLOGOLD ASHANTI: Mine Waste Solution CCIX

RISK ASSESSMENT RECORD

RA NO: 013

CONTRACTOR: Fibre-Wound Company (Pty) Ltd DATE: 2013-04-08

BRIEF DESCRIPTION OF WORK/ACTIVITY: Manual handling of G.R.P LOCATION: Mine Waste Solution Stilfontein

RISK ASSESSMENT TEAM:

Title/Appointment
Contractors: Approved: Yes/ No
Initials & Surname Signature

Project Manager :
Chris Swart Project Coordinator Name: ___________________ Signature: ___________

Engineering Manager :
Andrè Gerber Project Engineer Name: _________________ Signature: _____________

Anton van Zyl CR 6.(6) Safety Officer:

Title/Appointment COMMENTS:
Client representative

Vaughan Swart
Safety Coordinator

Discipline Coordinator

REQUIRED AND EXISTING CONTROL MEASURES: (SUBMIT AND ATTACH TO RISK ASSESSMENT
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Available Adequate Changes Required Remarks

Yes No Yes No Yes No

Scope of work (Logical steps on how task

will be performed )
Procedures: (W I / SOP / Vendor spec's) X X X
Training (induction) / Competency certificates/ X X
X
Specific training identified / Other (Instructions)
Special Permits required (specify) X X X
Equipment /Tool registers / others (specify) X X X
Code of Practice: X X X
Other:

FREQUENCY SCALE SEVERITY SCALE PROBABILITY SCALE

Frequent occurrence / daily (3) Catastrophic (Many fatalities / > 10 Million damage) (8) Has happened before (3)

It has happened / monthly (2) Disaster (Fatal injury / > 1 Million damage) (7) Quite possible (2)

Could occur / yearly (1) Very Serious (Reportable Accident / > R100, 000 damage) (6) Unusual but possible (1)

Serious (Disability Injury (LTI) / > R100, 000 damage) (5)

Important (Non-disabling Injury / > R1, 000 damage) (4)

Of Concern (Minor injury / > R100 damage) (3)

RISK RANKING / PRIORITY FACTOR

If score is 61 to 72 AA Potentially Disaster, action needed immediately
If score is 49 to 60 A Potentially Major, action to be taken within 8 hours – during the shift
If score is 37 to 48 B Potentially Serious, action to be taken within 16 hours – during the second shift
If score is 20 to 36 C Potentially Minor, action to be taken within 7 days
If score is 0 to 19 D Potentially Concern, action not to be taken during work

RISK ASSESSMENT

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N LIST TASK WITH ALL POTENTIAL AND EXISTING PROB SEV OF FREQ SCORE RISK PREVENTATIVE MEASURES PERSON RESPONSIBLE
O TASK STEPS HAZARDS OF OCCUR OF TOTAL RANK / AND CONTROLS RESPONSIBLE TO PERSON’S
(WHO WILL DO WHAT,  INJURY OCCUR 3/4/5/6/7/8 OCCUR PXSXF PRIORITY  ELIMINATE RISK ENSURE SIGNATURE ON
WHERE AND WHEN) 1/2/3 1/2/3 FACTOR PREVENTATIVE COMPLETION
 HEALTH  CONTROL AT SOURCE MEASURES AND DATE
 PROCESS  PUT/FOLLOW PROCEDURE CONTROLS ARE IN
 MATERIAL  PROVIDE PPE PLACE

 ENVIRONMENT
1. Responsible 6(1) Tools and equipment 3 8 3 72 AA All equipment that is Appointed
to ensure all tools not identified, going to be used with GMR2.(7)(a)
and equipment to numbered and on their registers shall be S.ZONDI
be used are register couldn’t checked by the site’s
identified, comply with legal responsible person and
numbered and on requirements/site signed off before work
register. standards which can commences. (Electrical
result in legal liability machinery reg. 9+10 &
claims driven machinery reg. 20/
3 8 3 72 AA general safety reg.14a (5) Appointed
GMR2.(7)(a)
(b)
People could be Where any certification is S.ZONDI
exposed to injury due required this will form part
to failure of of the register to ensure
equipment failure of equipment is
kept to a minimum
2. Responsible 6(1) Person may be 3 8 3 72 AA Responsible 16.2 to Appointed
will ensure all exposed to hazards ensure works instruction GMR2.(7)(a)
his/her personnel not known to him from the client is followed S.ZONDI
go through the 3 8 3 72 AA to the letter.
medical Possible health
surveillance and related issues will not Responsible 16.2 to
attend induction be identified that ensure medical
before work will could result in injury 2 5 3 30 C surveillance systems are
commence. or legal liability claims adhered to.
Responsible 6(1)
to ensure all
his/her personnel Incompetent Certificate of competency
is certified personnel can lead to to be produced for all
competent for the injury or property labour.
tasks they are to damage
perform, and
legally appointed.
3. Responsible 6(1) Exposures to 3 8 3 72 AA Responsible 16.2 to Appointed
to Ensure all unknown Hazards ensure no job will GMR2.(7)(a)
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N LIST TASK WITH ALL POTENTIAL AND EXISTING PROB SEV OF FREQ SCORE RISK PREVENTATIVE MEASURES PERSON RESPONSIBLE
O TASK STEPS HAZARDS OF OCCUR OF TOTAL RANK / AND CONTROLS RESPONSIBLE TO PERSON’S
(WHO WILL DO WHAT,  INJURY OCCUR 3/4/5/6/7/8 OCCUR PXSXF PRIORITY  ELIMINATE RISK ENSURE SIGNATURE ON
WHERE AND WHEN) 1/2/3 1/2/3 FACTOR PREVENTATIVE COMPLETION
 HEALTH  CONTROL AT SOURCE MEASURES AND DATE
 PROCESS  PUT/FOLLOW PROCEDURE CONTROLS ARE IN
 MATERIAL  PROVIDE PPE PLACE

 ENVIRONMENT
relevant permits Exposures to legal commence before all the S.ZONDI
and clearance to liability necessary permits are
work are obtained Possible process obtained and clearance to
before the work interruptions work has been given by
will commence, People can be the responsible person of
where required. exposed to Injury the section where work is
Result in Legal to be performed
Claims
4. Responsible 6(1) Exposures to 3 8 3 72 AA All Employees to sign the Appointed
to ensure risk unknown hazards attendance register GMR2.(7)(a)
assessment is Exposures to legal S.ZONDI
discussed; liability
understood and Possible process
signed prior to interruptions
work is People can be
commenced exposed to injury
Result in legal claims
5. Before any work Accidents can happen 2 4 2 16 D Supervisor to barricade Responsible 2.1
can start the because other working area off so that
supervisor must contractors is also no other workers can
ensure that he working in that area enter it or work below the
receives the and will not stop gantry or walkway
access permit working unless
from the client in ordered so by the
writing client
6. Before climbing See RA-018 use of 2 6 3 36 C See RA-018 use of Responsible 2.1
onto scaffolding scaffolding scaffolding
check if the was
inspected on that
day
7. Ensure safe See RA-018 use of 2 6 3 36 C See RA-018 use of Responsible 2.1
access to Gantry scaffolding scaffolding
and walkway
8. Barricade area off Falling objects through 2 6 3 36 C All tools to have lanyards Responsible 2.1
below gantry ‘Open Areas’ on so that it can be tied to
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N LIST TASK WITH ALL POTENTIAL AND EXISTING PROB SEV OF FREQ SCORE RISK PREVENTATIVE MEASURES PERSON RESPONSIBLE
O TASK STEPS HAZARDS OF OCCUR OF TOTAL RANK / AND CONTROLS RESPONSIBLE TO PERSON’S
(WHO WILL DO WHAT,  INJURY OCCUR 3/4/5/6/7/8 OCCUR PXSXF PRIORITY  ELIMINATE RISK ENSURE SIGNATURE ON
WHERE AND WHEN) 1/2/3 1/2/3 FACTOR PREVENTATIVE COMPLETION
 HEALTH  CONTROL AT SOURCE MEASURES AND DATE
 PROCESS  PUT/FOLLOW PROCEDURE CONTROLS ARE IN
 MATERIAL  PROVIDE PPE PLACE

 ENVIRONMENT
where work is walkway and gantry the gantry and hand
going to be done. injuring workers below. railing. Small tools to be
tied to operator. Nuts and
bolts to be secure in bag
and tied to handrail.
9. Working on gantry Falling equipment and 2 7 2 28 C Supervision of work on Responsible 2.1
and walkway .Use workers. elevated level at all times
tape measure, by the supervisor
dumpy level,
portable electrical
equip. small
welding machines
and painting of
steel brackets.
10. Attaching to the When using the walk 2 6 3 36 C Supervisor to ensure that Responsible 2.1
walk way way the workers must the amount of workers
at all times be attached to the walk way
attached with double does not make movement
lanyards difficult in the working
area
11. Scaffolding, loose Resulting in serious 2 6 3 36 C All loose materials to be Responsible 2.1
materials on injuries and fatalities. removed and toe boards
working to be tied properly to
platform/toe scaffold. Proper house
boards. keeping to be done
before and after work
12. Attachment of Falling from elevated 2 4 2 16 D Supervisor to ensure that Responsible 2.1
ropes to the piping level damaging piping the correct type of rope
and equipment causing (2” sisal rope) is used for
injuries, fractures and the lifting and that he
fatalities
supervised every lift.

13. Pulling the piping Falling from elevated 3 7 3 63 A Before the lift takes place Responsible 2.1
up into position, level damaging piping the supervisor to ensure
two workers pull and equipment causing that the two ropes are
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N LIST TASK WITH ALL POTENTIAL AND EXISTING PROB SEV OF FREQ SCORE RISK PREVENTATIVE MEASURES PERSON RESPONSIBLE
O TASK STEPS HAZARDS OF OCCUR OF TOTAL RANK / AND CONTROLS RESPONSIBLE TO PERSON’S
(WHO WILL DO WHAT,  INJURY OCCUR 3/4/5/6/7/8 OCCUR PXSXF PRIORITY  ELIMINATE RISK ENSURE SIGNATURE ON
WHERE AND WHEN) 1/2/3 1/2/3 FACTOR PREVENTATIVE COMPLETION
 HEALTH  CONTROL AT SOURCE MEASURES AND DATE
 PROCESS  PUT/FOLLOW PROCEDURE CONTROLS ARE IN
 MATERIAL  PROVIDE PPE PLACE

 ENVIRONMENT
and two workers injuries, fractures and wound around the hand
taking up the slack fatalities rail of the walkway and
of the ropes. when the pipe is pulled up
the assistants must pull
the slacking up in order to
keep the ropes tight at all
times thus preventing a
snap if the rope slips.
Once the pipe is being
lifted the supervisor must
ensure that no worker is
in the barricaded area
14. Placing of pipe Falling from elevated 2 6 3 36 C The supervisor to ensure Responsible 2.1
onto the pipe level damaging piping that the ropes stays tight
gantry and equipment causing at all times event during
injuries, fractures and the placing of the
fatalities
pipes onto the pipe
gantry.
15. Removal of the Falling from elevated 2 8 2 32 C The supervisor must only Responsible 2.1
ropes by the rope level damaging piping allow the ropes to be
handlers and equipment causing removed once the pipe is
injuries, fractures and in position on the
fatalities
supports and there is no
chance of falling

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I the undersigned Responsible person (appointee) _______________________hereby
(Print name in full)
declare that:

I have after consultation with my employees as far as reasonably practicable identified and recorded all the significant hazards and risks associated with the
task that I am to perform with regards to this Risk Assessment
I have determined all measures that needs to be in place for this task, including changing the organization of work and design of safe systems of work, necessary
to eliminate, control, minimise, or where the risk still remains provided the necessary personal protective equipment, and implemented them.
I undertake to periodically review the hazards identified and the risk assessed, to determine whether further elimination, control and minimization of risk is
possible
I have provided every employee as part of this risk assessment with the necessary training, information, instruction or supervision to enable them to perform
their work without risk to his/her Safety and Health.

Signed on the: _____________/ 2013 at ANGLOGOLD ASHANTI by: ______________________

(Date) (Responsible person)

Employed by: FIBRE WOUND SA (Name of Company)

I / we the undersigned hereby declare that the Responsible person in charge has made us familiar with the work-related hazards and risk and the measures that
must be taken to eliminate, control and minimise those hazards and risks:

PRINT NAME IN FULL SIGNATURE

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