Plumber / Drainlayer / Gas Fitter Task Analysis
This form is designed to assist you in setting up safely for the work you are about to undertake and provides a list of hazards that may be present on your worksite.You should always Eliminate (E) the risk of a hazard causing death, injury, or illness if you can. Where this is not possible, you must Minimise (M) the risk. There may be occasions where multiple controls are appropriate.
Enter your work method in the space provided below then use this checklist to identify any associated hazard/s. Brief everyone involved in the work being undertaken, ensure the appropriate controls are in place to control the risk/s, sign the form and submit as part of your job documentation.
Please contact HazardCo on 0800 555 339 if you require any assistance to identify hazards or implement the required controls. / Company:
TA Completed By:
Contact Cell Ph:
Site Address/Ref:
Date:
Task Description:
Ref Document: / A guide to designing, installing and maintaining safe electrical and gas installations and distribution systems – published June 2014 3rd Edition by Energy Safety with the Ministry of Economic Development
Job Start Checklist – to be completed prior to the commencement of any work
At Base / Yes / No / At Site / Yes / No1. HazardCo Team Pack is in vehicle. / ❑ / ❑ / 1. Park in a safe place. / ❑ / ❑
2. Vehicle has a current WOF/COF, lights and tyres in working condition. / ❑ / ❑ / 2. Ensure you wear your PPE/PPC and it is in good condition and appropriate for the work to be undertaken i.e. overalls, boots, mask, gloves, eye, hearing and dust protection. / ❑ / ❑
3. Minimum PPE/PPC available and in good condition. / ❑ / ❑ / 3. HazardCo Hazard Board set up in the vicinity of where work is being undertaken. / ❑ / ❑
4. All emergency equipment and materials required for the work being undertaken loaded and secured. / ❑ / ❑ / 4. Ensure you are inducted onto site - liaise with any Site Manager/Contractor/Client present to establish exactly what they are doing on site and any hazards associated with their work. Conduct your own induction if alone on site. Ensure the Hazard Board is updated and Emergency Plan is complete. / ❑ / ❑
5. All work documents for job in vehicle. / ❑ / ❑ / 5. Explain to Site Manager/Contractor/Client any hazards you are bringing to site or that may be present as a result of your work (use HazardCo Client Induction Cards where appropriate). / ❑ / ❑
Work Method Statement
Describe how you plan to carry out the work, using the example shown in the left hand column as a guide. Write your own method in the Work Method column on the right.
Work Method Example / Our Work Method1. On Arrival complete Job Start Checklist on Task Analysis
2. Complete / Review Task Analysis questionnaire and brief all workers on hazards and required risk controls – sign off form.
3. Warning and safety signage in place
4. Ensure all equipment is tagged, tested and up to date
5. Identify the equipment to be worked on
6. Isolate Gas Source and ensure controls in place
7. Install new gas line
8. Connect new oven
9. Test and verify installation is safe to connect
10. Record test results
11. Reconnect to supply and remove isolation
12. Issue gas safety cert
13. Tidy up and depart site
Hazard Identification & Risk Management (E & M) – General Hazards
1. Will you use any subcontractors? / ❑ / ❑ / Visitors/Contractors / q All Contractors to be inducted to site (M);
q Visitors to be escorted (M).
2. Is the job in a residential area or near a school ? / ❑ / ❑ / Injury to public
(residential area) / q Site to be fenced off (M);
q Hazard Boards and warning signage used (M);
q All visitors to be inducted to site (M).
3. Will a toilet be available and is there running water on site? / ❑ / ❑ / Illness/Disease / q Toilets are available (M);
q Running water is available on site (M);
q Good hygiene practices to be maintained (M).
4. Will there be any vehicles coming on to site? / ❑ / ❑ / Moving Vehicles / q Keep clear off all designated roadways (M);
q Hi-vis clothing to be worn (M);
q Speed limit to be enforced on site (M);
q Traffic management plan in place (M);
q Designated areas for vehicle parking and deliveries (M).
5. Are any electrical appliances to be used? / ❑ / ❑ / Electricity in use / q RCDs to be used (M);
q Leads and appliances to be in good condition and checked before use (M);
q RCDs, leads and appliances to be tagged and tested (M).
6. Are hand and power tools to be used? / ❑ / ❑ / Hand and Power tools / q All workers using tools to be competent or supervised by a competent person (M);
q Tools to be checked in good condition before use, with guards in place and leads tagged (M);
q Equipment to be serviced regularly (M);
q Workers to keep clear of any moving parts (M);
q Appropriate PPE to be used (M);
q Tools to be used correctly (M).
7. Will there be any overhead work? / ❑ / ❑ / Overhead work / q Tools are to be secured from falling (E);
q Visitors to be kept clear of any overhead work (M);
q The area under the work area to be isolated from workers (M).
Hazard Identification & Risk Management (E & M) – General Hazards
8. Will the Client/Children be present on site? / ❑ / ❑ / Injury to occupants / q Keep Children out of the area of work (E);
q Induct Clients to site with HazardCo Client Induction Cards (M);
q Escort Visitors (M).
9. Will work be carried out in areas of restricted access or cramped conditions eg work under floor? / ❑ / ❑ / Manual handling / q Proper and secure access provided (M);
q Appropriate PPE such as eye protection to be worn (M);
q Work is to be conducted in the open where possible (M).
10. Could someone else turn the gas supply back on while work is being carried out? / ❑ / ❑ / Gas leak/Explosion / q Equipment to be dissconnected from source prior to work (E);
q Lock out Tag out system to be implemented (M);
q Employee to be staioned at point of supply to ensure full control of isolations (M).
11. Will there be any other Contractors on site? / ❑ / ❑ / Visitors/Contractors / q Induct all Visitors/Contractors to site using HazardCo Client Induction Cards (M);
q Non essential workers to be kept clear of work area (E);
q Escort all Visitors (M).
12. Will any workers not be fully qualified Gas fitters? / ❑ / ❑ / Un-competent personel / q No work to be carried out by untrained personnel (E);
q All workers on site to be competent or supervised by a competent person (M).
13. Will there be any loud noises on site e.g. power tools, nail guns? / ❑ / ❑ / Noise / q Noisy equipment to be substituted for less noisy equipment (E);
q Non essential persons or visitors kept clear (E);
q Hearing protection to be used at all times and noise levels monitored (M);
q Equipment set up in enclosed spaces to be avoided (M).
14. Will there be any hazardous substances on site?
e.g. paint, fuel, gas etc / ❑ / ❑ / Hazardous substances / q Correct storage, handling and disposal techniques (M);
q Licensed handlers used (M);
q Required PPE to be used (M);
q Hazardous Substance Register and Safety Data Sheets (SDS) to be available on site (M).
Hazard Identification & Risk Management (E & M) – General Hazards
15. Will the work being undertaken involve repetitive lifting, bending, twisting or other types of manual handling? / ❑ / ❑ / Manual handling / q Use mechanical aids (E);
q Manual handling training (M);
q Use correct lifting techniques (M).
16. Is there likely to be trip or slip hazards on site? / ❑ / ❑ / Slips and Trips / q Keep access ways clear of debris M);
q Keep worksite clean & tidy (M):
q Use appropriate lighting (M):
q Rubbish bins to be used (M).
17. Will there be any work at heights? / ❑ / ❑ / Work at height / q Work to be done at ground level (E);
q Appropriate work platform to be provided e.g scaffold, EWP (M):
q Fall restraint equipment to be used (M):
q Ladders to be used as a last resort and for short periods only (M).
18. Will there be any work of ladders? / ❑ / ❑ / Ladders / q Don’t use as a working platform (M);
q Only commercial grade ladders in good condition (M):
q Use correctly e.g. 1 in 4 method (M):
q Use for access to the work area only (M);
q Regular maintenance checks (M);
q Ladders to be used as a last resort and for short periods only (M).
19. Could you come into contact with underground services/utilities? / ❑ / ❑ / Underground services / q Dial before you dig (M);
q Contact local authority/suppliers for any drawings or information concerning underground services (M):
q Isolate all services (M).
Hazard Identification & Risk Management (E & M) – Specific Gas Fitting Hazards
Answer the following questions relevant to the task you are doing (Tick “Yes” or “No”) / Yes / No / Hazard Identified / The following Risk Controls will be used for the identified hazards. (tick the risk controls you will be using)1. Will you be conducting work on domestic premises? / ❑ / ❑ / Gas/Explosion / q Isolate the supply at the metre box (M);
q Tag and lock out (M):
q Test before touch (M):
q Trained and qualified persons only (M).
2. Are there any damaged gas lines in the vicinity of the work? / ❑ / ❑ / Gas/Explosion / q Isolate supply from source (M);
q Test for gas flow (M);
q Use correct PPE (M);
q Locate and mark all lines (M);
q Only competent workers to work in area (M).
3. Will you be conducting work in a public area? / ❑ / ❑ / Public safety / q Get permission from the local authority (M);
q Work area to be securely fenced and monitored (M).
4. Will you be conducting High risk Gas fitting? / ❑ / ❑ / High risk work / q All worked to be certified as per AS/NZS 5601.1 (M);
q All work to be tested as per AS/NZS 5601.1 (M):
q Trained and qualified persons only (M).
If answered yes to any of the above please refer to the checklist on the last page
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Any additional hazards you identify for the work to be undertaken that are not listed, should be written in the “Additional Site Information” box.
Please contact HazardCo on 0800 555 339 if you have an accident on the worksite.
Additional Site Information / Hazards
PPE Required / SignageRequired
Safety Briefing Completed By: / Date: / Signed:
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Workers Receiving Safety Briefing:
Name: / Name:Gas fitting Checklist
Answer the following questions relevant to the task you are doing upon completion of worko Completed all required tests as set out in AS/NZS 5601.1? / q Yes
q No
q N/A
o Removed all locks and tags installed by you? / q Yes
q No
q N/A
o Re-instated all isolated supplies? / q Yes
q No
q N/A
o Completed all certification? E.g CoC / q Yes
q No
q N/A
o High Risk work has been registered on the high risk database? / q Yes
q No
q N/A
o Informed local Authority/Asset owner that work has been completed? / q Yes
q No
q N/A
o Updated any drawings/information to reflect changes caused by new works? / q Yes
q No
q N/A
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