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ANGLOGOLD ASHANTI: Mine Waste Solution CCIX

RISK ASSESSMENT RECORD
RA NO: 004

CONTRACTOR: Fibre-Wound Company (Pty) Ltd DATE: 2013-05-17

BRIEF DESCRIPTION OF SCOPE OF WORK/ACTIVITY: Laminating of GRP 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 Remarks

Required
Yes No Yes No Yes No

Scope of work (Logical steps

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

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Frequency Scale Severity Scale: Probability Scale

Frequent Occurrence/ daily Catastrophic (Many Fatalities />10 Million Has happened before
(3) damage) (8) (3)
It has happened/ Monthly Disaster (Fatal injury / >1 Million damage )
(2) (7) Quite possible
(2)
Could occur/ Yearly Very Serious (Reportable Accident/ >R
(1) 100,000 damage (6) Unusual but possible
(1)
Serious ( Disability Injury (LTI) />R10000
damage (5)

Important (Non Disabling Injury/<R1000

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

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RISK ASSESSMENT

NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY O CCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK P REVENTATIVE SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
1. Responsible  Tools and 3 8 3 72 AA All equipment that Appointed
Sec 6(1) to equipment will are going to be used GMR2.(7)(a)
ensure all tools not be with their registers
and equipment identified shall be checked by
(Personal numbered and the site’s responsible
protective inspected and person and signed
equipment etc) couldn’t off before work shall
to be used are comply with commence
identified legal (Electrical Machinery
numbered requirements/s Reg.9+10 & driven
inspected and ite standards Machinery Reg
on register which can 20 /General Safety Appointed
result in legal Reg 14a (5)(b) GMR2.(7)(a)
liability claims. 3 8 3 72 AA
Where any
certification is
 People could required this will
be exposed to form part of the
injury due to register to ensure
failure of failure of equipment
equipment. is kept to a minimum

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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
2. Responsible  Personnel may 3 8 3 72 AA Responsible 6(1) to Appointed
Sec 6(1) will be exposed to ensure Works GMR2.(7)(a)
ensure all hazards not Instruction WI – 19 –
his/her known to him 04 – 2/1 is followed
personnel go to the letter.
through the  Possible
medical Health related
surveillance issues will not
and attend be identified
induction that could
before work will result in injury
commence
 Possible
Health
related issues will
not be identified
that could result in
injury or legal
liability claims
3. Responsible  Exposures to 3 8 3 72 AA Responsible 6(1). to Appointed
Sec 6(1) will unknown ensure no job will GMR2.(7)(a)
ensure that all hazards commence before all
relevant necessary permits
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK P REVENTATIVE SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
permits and  Exposure to are obtained and
clearance to legal liability clearance to work
work will be has been given by
obtained before  Possible the responsible
the work will process person of the section
commence interruptions work is to be
performed (Occ H&S
Act Const Reg 7 )
4. Responsible to  Exposures 3 8 3 72 AA  All
workers to sign Appointed
ensure risk to unknown the workman’s GMR2.(7)(a)
assessment is hazards declaration.
discussed;  Working on
understood and wrong equipment
signed prior to and machinery
work is
commenced  People can
be exposed to
Injury
5. Ensure that the If the dangers and 2 7 3 42 B Supervisor to ensure Appointed
work permit hazards are not that activities to be GMR2.(7)(a)
received is pointed out and executed are clearly
signed by the discussed in the understood and the
responsible area that work is possible hazards
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
supervisor and to be done,it can and dangers have
that the permit lead to injuries been pointed out.
is discussed/ and damage to
understood and equipment and
signed by the property.
co-workers
6. Proper Substandard 3 8 2 48 B Supervisor to ensure Appointed
preparation of preparation can that proper GMR2.(7)(a)
the GRP lead to failure of inspections are done
product must joints and and the preparation
be done before laminate that can area approved
the cause injuries and before work starts
commencemen damage to
t of work property and
equipment
7. Select Appointed
quantities and Multiple injuries, 2 7 2 28 C Only correct GMR2.(7)(a)
collect from health hazards, quantities to be
stores. Resin, fires and drawn from stores..
MEKP explosions. Proof of MSDS
Hardner, training to Safety
300CSM, officer. Supervisor to
450CSM, complete DSTI and
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
600WR, Veil, Safety talk before
Tissue, Glass work commences.
string,
Adhesive putty,
Acetone, Paint
brushes,
rollers, and
mixing buckets.
8. Prepare As per RA 026 2 5 2 20 C RA 026 discussed Appointed
surface for communicated & GMR2.(7)(a)
application with training provided to
grinder and drill all employees using
and jig-saw. grinders/jig-saws
and drills
9. Apply resin and Eye injuries, 2 6 2 24 C Correct PPE to be
mat, to surface health hazards. worn. Rubber Appointed
as per spec Fumes/vapor/fires chemical gloves, GMR2.(7)(a)
with . FF2 dustmasks, No
rollers/brushes. spillages – No
smoking/open
flames allowed. Well
ventilated area. (1.5
kg) Fire extinguisher
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
available at all times.
10. Use acetone to Use acetone to 2 6 2 24 C Wear appropriate Appointed
clean clean equipment PPE as stipulated. GMR2.(7)(a)
equipment only only when leaving
when leaving the vessel or after
the vessel or the work has been
after the work completed.
has been
completed.
11. Dispose spent Environmental Dispose into 210lt. Appointed
acetone. pollution, air, Container – marked GMR2.(7)(a)
ground and water. spent acetone and
dispose of – to
wastech class ‘A’
dumping site. Proof
of disposal
forwarded to Safety
officer.
12. Use correct Health hazards. 2 6 2 24 C Use correct type Appointed
PPE. dust masks if fibre is GMR2.(7)(a)
grinded or drilled in
confined spaces
where the dust
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
exceeds the TLV.
13. Clean area Multiple health 2 4 2 24 C Use a vacuum Appointed
from all fibres – hazards and cleaner to suck up GMR2.(7)(a)
don’t use air to pollution. all dust and contain
clean. to dispose safely

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I the undersigned Responsible person: ______________________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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