POWER

JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT
ACTIVITY OR TASK: Scaffolding (Erection and Dismantling)
JSA Preparation & task work team:
Competence = Relevant Training/Qualifications + Experience

Location / Project: Job Number: JSA Number: G20 Codes of Practice & Legislation that are applicable: JSA Revision:

Competence/ Qualificn reqd to complete work safely JSA approved by person responsible i.e.
Team Leader / Tradesman

Name:

Position / Competence/ License:

Date:

2. HAZARD IDENTIFICATION
compulsory

Identify hazards that may be present by ticking items on the list below.

3. PRECAUTIONS: hard hat, safety glasses, safety boots

ADDITIONAL PRECAUTIONS
Gloves: type . Goggles Full Face Shield High Visibility Vest Harness Fire Extinguishers Barricades Ventilation Lighting Erect Scaffolding to access Respirator or Dust mask Erect Warning signs Personal Locks or Tag system Group isolation Welding screen Fall Arrest systems Welding Face Shield

WORK LOCATION
Difficult Entry/Exit Oxygen Deficiency Oxygen Excess Engulfment (trench collapse) Poisonous Gas Present Temperature Extremes Defined Confined Space Explosive Gas Present

HAZARDOUS AREA
Hazardous Substances - attach MSDS to JSA Working at Heights Remote Area Motor Room Hazards Toxic Substances Potential for Difficult Rescue

HIGH RISK
Falling Objects Poor Lighting Slippery Surfaces Multiple Electrical Feeds Trip Hazards Electrical Hazards - LV Electrical Hazards - HV Manual Handling Sharp Materials Ladders used in the task Working at Heights Working near Crane & Crane Runways Rail Movement Pressurised Fluids Flamm. Materials Present

HIGH RISK
Suspended loads Poor Visibility Inhalable Dusts/Fibres High Noise Levels Use of Chemicals Elevated Work Platform Difficulty to Communicate amongst workers Moving Machinery Tools & Equipment Heat/ Sunlight/ Radiation Traffic Movement Working near Operation Processing Lines Live Rails Pneumatics

PERMITS
Hot Work Excavation Confined Space Hazardous Work Clearance Access to Area High Voltage Access Scaffolding Other?

HAZARDOUS SUBSTANCES in work area / to be used

-attach MSDS

Permit Number

4. ENVIRONMENTAL HAZARDS (IMPACTS) tick those identified

Air Pollution (dust, fumes) Noise (plant & equipment) Spills to drains/waterways Spills to ground Soil Erosion Hazard to Flora /Fauna

Other:

RISK RATING TABLE

This table is used to calculate whether the hazard you have identified is Extreme: 9-10 High: 7-8, Medium: 5-6 or Low: 3-4
The objective of rating the risk is to lower the risk by initiating risk control measures. The score is

Likelihood: How likely is it to be that bad? Almost Certain Expected to Occur

Consequences: how severe an injury? Death

Serious Injuries Medical Treatment Reqd 1st Aid reqd

10 9 8 7 6

9 8 7 6

8 7 6 5

7 6 5 4 3

5. EQUIPMENT REQUIRED: Static Plant & Equipment

Mobile Plant & Equipment

Likely could
happen sometime

Moderate could
happen but not likely

Unlikely could
happen but very rare

Revision Date: March 2005

. of ..

Rare - could happen

but probably never will

OHS-03-F01 5 4

POWER

JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT
Safety / Emergency Equipt
noted in the JSA risk score column on the next page both before & after risk control measures have been nominated.

NAME OF TASK: Scaffolding (Erection and Dismantling)

JSA Number: Risk Rating

G20

Rev: Risk Rating

Of the risk following corrective action

Step No.
Logical sequence

Sequence of Basic Job Steps

Break down Job into steps. Each step should accomplish a major task and be logical. Environmental Aspects

Potential Safety & Environmental Hazards/Impacts

Recommended Corrective Action or Procedure

Determine what actions are necessary to eliminate or minimise all hazards that could lead to an accident, injury, illness or environmental incident. The risk must be reduced or controlled to a level that is acceptable before work commences. Indicate who is to perform the action where applicable against each action

Identify the hazards (health and safety or Use table on environmental) associated with each step, the previous examine each to find all possible risk factors page to score
risk

Site Inspection

Raise Permit

Transport scaffold equipment to site

Erect scaffolding

Injury as a result of exposure to substances released due to equipment failure Slips, Trips and Falls due to slippery surfaces, obstructions, restricted access. Injury due to equipment failure, moving equipment, activity Stress and frustration due to incorrect information misdirecting efforts Injury/damage related to vehicle operation and equipment handling Injury / damage due to collision / impact with other workgroups / equipment Injury / damage as a result of dropping tools and scaffold components Hot and cold burns as a result of contact with pipework Injury due to limited egress in emergency Injury / damage as a result of dropping tools and scaffold components

Be aware of and plan escape routes. Be aware of wind.

Due care and attention.

Liaise with permit authority / operations to minimize exposure to and creation of hazards. Ensure all information supplied is as accurate and understandable as possible. Use correct vehicle and handling procedures Plan route to avoid other personnel and equipment

Use appropriate barricades and bunting to protect personnel and equipment Adequate PPE with correct instruction and use. Ensure scaffold has adequate egress for any situation. Use appropriate barricades and bunting to protect personnel and equipment

Revision Date: March 2005

. of ..

OHS-03-F01

POWER

JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT
Injury / damage due to scaffold collapse Injury / damage due to damaged components causing equipment failure Injury / damage caused by scaffold collapse due to excessive load on scaffold Injury / damage due to scaffolding erected by unauthorized personnel Injury / damage caused by scaffolding erected by persons with limited competency Injury / damage caused by personnel falling from scaffolding Injury / damage caused by persons falling whilst working outside scaffolding Injury as a result of incomplete scaffold, loose boards, kickplates, etc causing slips,trips and falls Excess scaffold components cause clutter. Injury results. Injury results from untidy worksite Injury / damage caused by falling objects Injury / damage caused by incorrect sequence of dismantling Erect and dismantle all scaffold to comply with all legal and site requirements. All components to be checked prior to installation

Check specified limits of scaffold before utilization

Scaffold must only be erected by trained personnel Licenced scaffolder to supervise apprentices at all times

Use appropriate barricades and bunting to protect personnel and equipment. Use IFAS harness. Use independent fall arrest system. 1.8m fall limit and standby person precautions Check scaffold properly before attaching scafftag. Tag must be signed by qualified person. Use scaffold checklist. Stack scaffold gear in stillage and remove from site. Keep site clean Keep worksite clean and tidy at all times to reduce hazards to a minimum Inspect scaffold to ensure it is clear of debris before turning boards and dismantling Correct procedure for dismantling of scaffold is adhered to.

Handover of scaffold

Dismantle scaffold

Revision Date: March 2005

. of ..

OHS-03-F01

POWER

JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) CONSULTATION & SIGN-OFF RECORD
I confirm by my signature below, that I have attended a briefing on the requirements of the attached Job Safety & Environment Analysis and agree to perform the work in the manner detailed on it. I confirm that copies of the relevant Permits, MSDS's, Isolation Plans etc. have been reviewed.
JSA NAME JSA No:

Rev: DATE

NAME

(Please print)

SIGNATURE

THIS SAFE WORK BRIEFING / TRAINING WAS CARRIED OUT BY (responsible person at that location) : Name: Signature: Date: Client sign off (where applicable) Site / Project Manager sign off (document reviewed)

Revision Date: March 2005

OHS-03-F01