Small Plant Inspection Report

 

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Plant Hazard and Risk Assessment

OWNER/INSPECTION DETAILS

Inspection #[inspection:inspection_number]

Date of Inspection[inspection:inspection_date]
Provided for[inspection:provided_for]
Plant Make & Model[inspection:vehicle_year] [inspection:vehicle_make] [inspection:vehicle_model]
Identification No.s[inspection:vehicle_registration] 
Hour Meter Reading[inspection:hours_reading]
Inspection Done at[inspection:inspection_locale]
[inspection:asset_image]
Assessment Conducted By 
Steersafe Training and Assessment ABN 84 137 032 681 
Scott Haynes 
Certificate IV Training & Assessment TAA40104 
Certificate No 1678 
Phone: 0418 536 870 
 

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CONTENTS

OWNER DETAILS1
ACKNOWLEDGEMENT AND AGREEMENT3
RISK MATRIX & HIERARCHY OF CONTROLS4
PLANT HAZARD & RISK ASSESSMENT5
NOISE ASSESSMENT10
OPERATOR ACKNOWLEDGEMENT11
DISCLAIMER12

 

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AGREEMENT

THIS AGREEMENT is made on [inspection:inspection_date_agreement]

and is made between:

SCOTT HAYNES of Steersafe Training and Assessment, and

[inspection:customer_representative] of [inspection:provided_for]

The owner/operator agrees to engage Scott Haynes to perform Risk Assessment on the basis of agreement to the following disclaimer.

DISCLAIMER

"Mobile Plant" means the mobile plant, vehicle or equipment described in the assessment and inspected by the assessor.

This assessment is based upon information provided to the assessor up until the date of the assessment. If any modification, alteration or addition is made to the mobile plant following that date, this asessment is null and void and cannot be relied upon for any purpose. In particular, this assessment will then provide no assurance that the mobile plant complies with the Occupational Health and Safety Regulations 2017 or any regulation amending or replacing those regulations. The owner and operator of the mobile plant must conduct regular inspections and maintain the mobile plant at regular intervals. If any alteration or addition is made to the mobile plant, such alterations or additions must be recorded in writing and retained by the owner and operator. The mobile plant will then need to be re-assessed.

At all times it is the responsibility of the owner and operator of the mobile plant to maintain the mobile plant according to the Occupational Health and Safety Regulations 2017 and all other applicable legislation and regulations. The assessor is not and shall not be liable for the mobile plant complying with the Occupational Health and Safety Regulations 2017 or any regulation amending or replacing those regulations. This assessment does not pass any responsibility for such compliance to the assessor, and does not in any way exempt the owner and operator from the continuing responsibility for such compliance. The owner and operator agree to indemnify the assessor against all liability of whatever kind in relation to the mobile plant assessed.

This assessment will be conducted by a qualified workplace assessor. This assessment will not be conducted by a qualified mechanic nor a roadworthy assessor, and no responsibility is assumed by the assessor for any mechanical malfunction of the mobile plant nor lack of roadworthiness.

This assessment identifies risks in relation to the mobile plant only, and does not assess risks in relation to the site where the mobile plant is to be used. A job safety and environmental analysis is required to identify such site risks and should be reviewed by the owner and operator prior to commencement of work on site.  

ACKNOWLEDGEMENT AND AGREEMENT

I confirm that I have read and understood the disclaimer and notes set out about and agree with all terms

Name: [inspection:customer_representative]                 

Company/Organization: [inspection:provided_for]		Signed:[inspection:customer_signature] 
Date: [inspection:inspection_date]  

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RISK MATRIX

Risk Matrix

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PLANT HAZARD & RISK ASSESSMENT

HazardInitial RiskControlControl in placeAction RequiredResidual Risk
  1. CRUSHING
    Can anyone be crushed by:
(a) material falling off the plantH

I

G

H		Operator licensed to operate plant[inspection:licence_valid][inspection:licence_valid_issues]M

E

D

I

U

M
Decals fitted[inspection:decals][inspection:decals_issues]
(b) uncontrolled or unexpected movement of the plant or its loadLifting points for transport in good condition[inspection:lifting_points][inspection:lifting_points_issues]
Decals fitted[inspection:decals][inspection:decals_issues]
Flashing beacon[inspection:flashing_beacon][inspection:flashing_beacon_issues]
Parking brake operational[inspection:brakes][inspection:brakes_issues]
(c) difficulty in slowing, stopping or immobilising the plantLifting points for transport in good condition[inspection:lifting_points][inspection:lifting_points_issues]
Service brake operational*[inspection:service_brake][inspection:service_brake_issues]
Regular maintenance of plant as recorded[inspection:service_maintenance_records][inspection:service_maintenance_records_issues]
(d) being trapped between the plant, materials or a fixed structure.Lifting points for transport in good condition[inspection:lifting_points][inspection:lifting_points_issues]
Neutral start switch[inspection:neutral_start][inspection:neutral_start_issues]
(e) attachments. ie buckets, blades, drills, etcPins and bushes in good condition[inspection:pins_bushes][inspection:pins_bushes_issues]
(f) any other factors not mentioned [inspection:crushing_other][inspection:crushing_other_issues]
  1. SHEARING
    Can anyone's body parts be cut off or sheared:
(a) between two parts of the plantH

I

G

H		Decals fitted[inspection:decals][inspection:decals_issues]M

E

D

I

U

M
Burst protection valves fitted where required[inspection:burst_valves][inspection:burst_valves_issues]
Guards fitted as required
 
[inspection:cutting_guards_issues]
(b) between a part of the plant and a work piece or structureLifting points for transport in good condition[inspection:lifting_points][inspection:lifting_points_issues]
(c) any other factors not mentioned [inspection:shearing_other][inspection:shearing_other_issues]

*Brakes are checked for function, and not for brake adjustment or brake wear. This is solely the responsibility of the owner/operator.

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HazardInitial RiskControlControl in placeAction RequiredResidual Risk
  1. STRIKING   
    Can anyone be struck by moving objects due to:
(a) uncontrolled or unexpected movement of the plant or materialM

E

D

I

U

M		Lifting points for transport in good condition[inspection:lifting_points][inspection:lifting_points_issues]L

O

W
 
Controls/levers identified[inspection:controls_levers][inspection:controls_levers_issues]
(b) the plant, or parts of the plant disintegratingRegular maintenance of plant as recorded[inspection:service_maintenance_records][inspection:service_maintenance_records_issues]
Decals fitted[inspection:decals][inspection:decals_issues]
Guards fitted as required[inspection:striking_guards][inspection:striking_guards_issues]
(c) the mobility of the plantLifting points for transport in good condition[inspection:lifting_points][inspection:lifting_points_issues]
Decals fitted[inspection:decals][inspection:decals_issues]
(d) any other factors not mentioned [inspection:striking_other][inspection:striking_other_issues]
  1. ENTANGLEMENT   
    Can anyone be injured by:
(a) hair, clothing or any other items they are wearing or attached to them, become entangled in the moving parts of the plant or materials on the plant?M

E

D

I

U

M		Guards fitted as required[inspection:entanglement_guards][inspection:entanglement_guards_issues]L

O

W
 
Warning decals for moving parts[inspection:entanglement_decals][inspection:entanglement_decals_issues]
(b) any other factors not mentioned [inspection:entanglement_other][inspection:entanglement_other_issues]
  1. CUTTING, STABBING & PUNCTURING   
    Can anyone be injured by:
(a) contact with sharp or moving parts on the plantM

E

D

I

U

M		Guards fitted as required[inspection:cutting_guards][inspection:cutting_guards_issues]L

O

W
 
Decals fitted[inspection:decals][inspection:decals_issues]
(b) the plant, or parts of the plant disintegratingRegular maintenance of plant as recorded[inspection:service_maintenance_records][inspection:service_maintenance_records_issues]
(c) any other factors not mentioned [inspection:cutting_other][inspection:cutting_other_issues]

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HazardInitial RiskControlControl in placeAction RequiredResidual Risk
  1. TRIPPING, SLIPPING OR FALLING
    Can anyone using or in the vicinity of the plant, trip, slip, or fall due to
(a) slippery or uneven work surfacesM

E

D

I

U

M		Non slip steps and work area[inspection:nonslip_work_area][inspection:nonslip_work_area_issues]L

O

W
 
(b) obstacles in the vicinity of the plant. E.g.: oil spill or plant attachmentsNo visible signs of fluids leaking from plant[inspection:no_visible_fluids][inspection:no_visible_fluids_issues]
Work area free from debris and work materials[inspection:work_area][inspection:work_area_issues]
(c) any other factors not mentioned [inspection:tripping_other][inspection:tripping_other_issues]
  1. ERGONOMIC
    Can anyone be injured by:
(a) any factors not mentionedN

O

N

E

 		 [inspection:ergonomic_other][inspection:ergonomic_other_issues]L

O

W
 
  1. ELECTRICAL
    Can anyone be injured or burnt from electrical shock by:
 
(a) exposed and damaged battery or leadsM

E

D

I

U

M		Guards around battery or wiring[inspection:electrical_guards][inspection:electrical_guards_issues]L

O

W
 
Regular maintenance of plant as recorded[inspection:service_maintenance_records][inspection:service_maintenance_records_issues]
Decals fitted[inspection:decals][inspection:decals_issues]
(b) damaged electrical wiring, switches or cablesRegular maintenance of plant as recorded[inspection:service_maintenance_records][inspection:service_maintenance_records_issues]
(c) any other factors not mentioned [inspection:electrical_other][inspection:electrical_other_issues]

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HazardInitial RiskControlControl in placeAction RequiredResidual Risk
  1. BURNS
    Can anyone be burnt by:
(a) contact with exhaustM

E

D

I

U

M		Guards around exhaust[inspection:exhaust_guards][inspection:exhaust_guards_issues]L

O

W
 
Decals fitted[inspection:decals][inspection:decals_issues]
Exhaust mounted away from easy access[inspection:exhaust_inaccessible][inspection:exhaust_inaccessible_issues]
(b) fire in the plantRegular maintenance of plant as recorded[inspection:service_maintenance_records][inspection:service_maintenance_records_issues]
Fire extinguisher supplied in plant[inspection:fire_extinguisher][inspection:fire_extinguisher_issues]
(c) any other factors not mentioned [inspection:burns_other][inspection:burns_other_issues]
  1. HIGH PRESSURE AND EXPLOSION
    Can anyone be injured by:
(a) high pressure fluidM

E

D

I

U

M		Regular maintenance of hydraulic hoses and couplings as recorded[inspection:hydraulic_maintenance][inspection:hydraulic_maintenance_issues]L

O

W
 
(b) explosions caused by gas, vapours, liquids or other substancesAll seals and tanks in good working order[inspection:seals][inspection:seals_issues]
(c) any other factors not mentioned [inspection:pressure_other][inspection:pressure_other_issues]

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HazardInitial RiskControlControl in placeAction RequiredResidual Risk
  1. SUFFOCATION/ASPHYXIATION
    Can anyone suffer or become ill from:
(a) fumes, toxic gases or vapours within the plant cabinM

E

D

I

U

M		Exhaust in good operating condition[inspection:exhaust_condition][inspection:exhaust_condition_issues]L

O

W
 
(b) any other factors not mentioned [inspection:suffocation_other][inspection:suffocation_other_issues]
  1. OTHER HAZARDS
    Can anyone be injured or become ill from:
(a) excessive noiseM

E

D

I

U

M		Hearing protection supplied         
N.B. See noise level test for more detail		[inspection:hearing_protection][inspection:hearing_protection_issues]L

O

W
 
(b) vibrationExcessive Vibration[inspection:vibration][inspection:vibration_issues]
(c) excessive temperaturesExcessive Temperatures[inspection:heater][inspection:heater_issues]
Adequate ventilation and sealing doors and windows[inspection:ventilation][inspection:ventilation_issues]
(d) any other factors not mentioned [inspection:misc_other][inspection:misc_other_issues]
  1. DOCUMENTATION         
    Has information been provided on the following:
(a) daily pre start inspection check listM

E

D

I

U

M		Pre start provide[inspection:daily_check_list][inspection:daily_check_list_issues]L

O

W
 
(b) service and maintenance recordsService history provided[inspection:maintenance_records][inspection:maintenance_records_issues]
(c) plant operation manualPlant Manual provided[inspection:operators_manual][inspection:operators_manual_issues]
(d) suitable licence for operation of the plantLicence provided[inspection:licence_valid][inspection:licence_valid_issues]

NOTE 

High risk denotes a possible or probable occurrence and possible death, or life threatening injury, or permanent disability without the use of controls.  
Medium risk denotes unlikely or possible occurrence and possible injury without the use of controls. [inspection:page_break]

NOISE ASSESSMENT

The noise level reading shall be taken at exhaust level, and within 1050mm of the exhaust emission. The reading will be taken at idle and at “Engine Speed at Maximum Power”. This procedure is in accordance with the Environment Protection (Vehicle Emissions) Regulations 2003.

A further reading shall then be taken from the cabin of the Plant.

The sound meter used for this assessment is a Digitech QM-1589, Serial No 10060748 in accordance with the Environment Protection (Vehicle Emissions) Regulations 2003.

Plant Details[inspection:vehicle_year] [inspection:vehicle_make] [inspection:vehicle_model]
Identification No.[inspection:vehicle_registration]
Background Noise[inspection:background_noise]
Noise in Cabin at Idle[inspection:cabin_idle]
Noise in Cabin at Maximum Power[inspection:cabin_power]
Noise at Idle[inspection:noise_idle]
Noise at Maximum Power[inspection:noise_power]

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OPERATOR ACKNOWLEDGMENT 

Operator to read this risk assessment report and complete and sign below. 

I have read and understood this risk assessment report and confirm that I hold the required qualifications to operate the assessed Plant equipment.

Operator Full NameOperator QualificationOperator SignatureDate Signed

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

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DISCLAIMER

“Mobile Plant” means the mobile plant, vehicle or equipment described in the assessment and inspected by the assessor.

This assessment is based upon information provided to the assessor up until the date of the assessment. If any modification, alteration or addition is made to the mobile plant following that date, this assessment is null and void and cannot be relied upon for any purpose. In particular, this assessment will then provide no assurance that the mobile plant complies with the Occupational Health and Safety Regulations 2017 or any regulation amending or replacing those regulations. The owner and operator of the mobile plant must conduct regular inspections and maintain the mobile plant at regular intervals. If any alteration or addition is made to the mobile plant, such alterations or additions must be recorded in writing and retained by the owner and operator. The mobile plant will then need to be re-assessed.

At all times it is the responsibility of the owner and operator of the mobile plant to maintain the mobile plant according to the Occupational Health and Safety Regulations 2017 and all other applicable legislation and regulations. The assessor is not and shall not be liable for the mobile plant complying with the Occupational Health and Safety Regulations 2017 or any regulation amending or replacing those regulations. This assessment does not pass any responsibility for such compliance to the assessor, and does not in any way exempt the owner and operator from the continuing responsibility for such compliance. The owner and operator agree to indemnify the assessor against all liability of whatever kind in relation to the mobile plant assessed.

This assessment has been conducted by a qualified workplace assessor. This assessment was not conducted by a qualified mechanic nor a roadworthy assessor, and no responsibility is assumed by the assessor for any mechanical malfunction of the mobile plant nor lack of roadworthiness.

This assessment identifies risks in relation to the mobile plant only, and does not assess risks in relation to the site where the mobile plant is to be used. A job safety and environmental analysis is required to identify such site risks and should be reviewed by the owner and operator prior to commencement of work on site.

ACKNOWLEDGMENT AND ACCEPTANCE

I confirm that I have read and understood the disclaimer and notes set out above and agree with all terms.

I also acknowledge I have received the completed Risk Assessment for the aforementioned Mobile Plant

Name: [inspection:customer_representative]Company/Organisation: [inspection:provided_for]  
Signed: [inspection:customer_signature]Date: [inspection:inspection_date]