RISK

MATERIAL DELIVERY CONTRACT NAME

ASSESSMENT

DOCUMENT
RA-MD IMPLEMENTED 01/2019 REVISION 01 CONTRACT NO. CDC/3336/19
REFERENCE.

HAZARD IDENTIFICATION PRECAUTIONS

WORK LOCATION SAFETY HAZARDS HEALTH HAZARDS WORK LOCATION EMPLOYEES
Difficult Entry/Exit Falling Objects Noise (plant & equipment) Excavation Permit Inducted
Remote Area Poor Lighting Inhalant Dusts/Fibres/Fumes Confined Space Entry Permit Risk Assessment Communicated
Potential for Difficult Rescue Slippery Surfaces Skin absorption Barricading & Signage Safe Work Procedure Communicated
Engulfment Electrical Services Eye contact Hazardous Work Clearance (Hot work permit) Competency
Defined Confined Space Trip Hazards Digest Fall protection plan Medical Fitness
Temperature Extremes Manual Handling Use of Chemicals (HCS) ADITIONAL PPE
Hazardous Substances Sharp Materials Hazardous Biological Agents Lighting Safety Shoes
Explosive Gas Present Ladders used in the task Electricity Ventilation Overalls
Oxygen Deficiency Working near Plant & Equipment ENVIRONMENTAL HAZARDS Fire Extinguishers High Visibility Vest
Oxygen Excess Flammable Materials Present High Noise Levels First Aid Harness
Toxic Substances Suspended loads Spills to drains/waterways/ground Emergency Management Plan Gloves: type ………………….
Poisonous Gas Present Poor Visibility Soil Erosion Floatation devices Goggles
Water environment Communication amongst workers Hazard to Flora /Fauna Fall protection Respirator or Dust mask
Working at heights Electricity Air Pollution (dust, fumes) Legal Registers Life Jackets

CONSEQUENCE PROBABILITY

H
S
E This Risk Assessment is intended to identify hazards and
A
Z
V
E PERSONAL
INJURIES
HEALTH ENVIRONMENT
EMPLOYEES
EXPOSED
CORPORATE
IMAGE (MEDIA
ASSETS/ REVENUE
RANDS
Practically
Impossible
Not Likely to
occur
Could Occur
Know n to
occur
Common or
Frequent
assess risks associated with the construction work.
R
A COVERAGE) previously Occurrence
I
R
T
D
Y

A B C D E Document Approval
0
No Injury No effect No effect None No impact No damage 0 1 2 3 4
COMPILED APPROVED
F-aid/ M TC case Over-exposure
Slight effect, contained
spill
Negligible
1% - 19%
Slight impact
Slight damage
(<R15 000)
1 2 3 4 5 BY BY
1
Disabling/ Loss Time Revearsable health M inor Effect, Resgtricted Localised damage
2 3 4 5 6
DATE DATE
Limited impact
Injury condition temporary nature 20% - 39% (<R15 000 - R0,15 M il)
2
Reportable(LTI)
Occupational Disease Localised effect, Significant Localised damage
P ermanent Disability Considderable impact 3 4 5 6 7
Section 25 limited damage 40% - 59% (R0,15 M il - R0.3 M il)
3 Section 24

Single fatality : M ajor effect, severe Widespread M ajor damage

Single Fatality National impact 4 5 6 7 8
occupational disease damage 60% - 79% (R0,3 M il - <R1,5 M il)
4
M assive effect,
M ultiple fatality : Extensive Extensive damage
M ultiple Fatality persistent severe International impact 5 6 7 8 9
5 occupational disease
damage
80% - 100% (>R1,5 M illion)

Low Risk Manage continuously to maintain tolerable level SIGNATURE SIGNATURE

Medium Risk Medium priority, reduce risk to tolerable level , WSWP
High Risk High priority, terminate activity or treat risk immediately, WSWP
 RISK
MATERIAL DELIVERY CONTRACT NAME
ASSESSMENT

DOCUMENT
RA-MD IMPLEMENTED 01/2019 REVISION 01 CONTRACT NO. CDC/3336/19
REFERENCE.

Risk Rating Recommended Corrective Action or Procedure

Step Potential Safety & Environmental Hazards/Impacts Of the risk you have Determine what actions are necessary to eliminate or minimise all hazards that
No. Sequence of Basic Job Steps
Identify the hazards (health and safety or environmental) identified on the left could lead to an accident, injury, illness or environmental incident. The risk must be
Logical Break down Job into steps. Each step should Responsibility
associated with each step, examine each to find all possible risk reduced or controlled to a level that is acceptable before work commences.
sequence accomplish a major task and be logical.
factors Indicate Responsible Person to perform the action where applicable against each
P S RR action
Preliminary Activities Operator Competencies various Plant & Equipment previously verified. (Operators and personnel trained in task activity) Project Inductions completed and records held.
Personnel issued with project mandated PPE and site with ‘Emergency Response Plan’ and first aid kits.
Daily pre start meeting undertaken and recorded, new or site specific hazards added to SWP.
Safety Concerns  Sunburn Exposure Issue / use of site and task PPE.
 Fatigue & heat exhaustion Fatigue management induction and adequate cold water supplies.
Supervisor & Safety
 Slips trips and falls ‘Emergency Response Plan’ & first aid kits available to the area. Officer
 Cuts gashes and abrasions Communication systems in place (radios, cellular).
 Serious Injury and emergency response difficulty Fire extinguishers in all vehicles (Inspections completed per code)
 Potential fires
1
Environmental Concerns  Damage to rare plants and injury / disturbance to endangered fauna Areas of cultural significance and or endangered or rare species, defined and as
applicable barricaded to prevent disturbance.
 Disturbance or damage to items of Cultural Significance Cultural heritage monitors & fauna spotters in place (as required). Flora and fauna
 Hydrocarbon spills protection measure per contract defined ‘Environmental Plan’.
 Noise pollution Spill kits available for site. Supervisor & Safety
Fuel containing equipment to be stored on plastic sheeting or with practical Officer
 Construction waste containment measures
Dust suppression measures i.e. water truck, etc.
All construction produced wastes removed daily

Pre-use inspection of all equipment  Using of faulty equipment resulting in injuries and / or Faulty equipment to be repaired or replaced. Supervisor &
property damage C 3 5 Enforce pre-use inspections against critical item check list Operator
2

Use competent trained operators  Results in injuries to persons and / or property damage Enforce the use of trained competent operators only Supervisor &
3 C 4 6
Operator
Wear appropriate Personal Protective  Results in injuries to persons and / or property damage Ensure the correct use of Personal Protective Equipment
Equipment, assess which of the following are Supervisor
4 C 4 6 Welding Gloves, Welding Safety boots, Overalls, Apron, Welding hat, Hearing
required in conjunction with the site protection, Eye protection
conditions and task on hand:
Vehicles speeding Instruction given to transportation vehicle drivers that they are to obey the set Supervisor
 Lack of control of the vehicle, collisions with employees, speed limit when on site. Vehicles speed on site must be monitored, and speeding
5 construction vehicles and / or damage to property or materials C 4 6
vehicles stopped and warned not to exceed the speed limit. Vehicles to follow traffic
routes. Supervisor(s) to enforce the above.
Warning systems on vehicles  Failure to warn employee(s) or other vehicles, which results Vehicle drivers are to be informed that they must use and ensure that their Supervisor
in injury to person(s) or damage to property indicators, lights (during poor lighting conditions), hooter, reversing alarm and other
6 C 4 6
warning devices are all working and are used when and where appropriate on the
site.
Vehicles reversing Driver informed to ensure he checks and ensures the off-load area is safe and no Supervisor
 Not knowing what is behind the vehicle, collisions with person(s) is within an unsafe distance or behind him when he is offloading. If the
7 employee(s), vehicles or damage to property or materials C 4 6
driver is unsure, or cannot see, he must get help from an employee to help guide
him. Supervisor(s) to enforce the above practice.
 RISK
MATERIAL DELIVERY CONTRACT NAME
ASSESSMENT

DOCUMENT
RA-MD IMPLEMENTED 01/2019 REVISION 01 CONTRACT NO. CDC/3336/19
REFERENCE.

Risk Rating Recommended Corrective Action or Procedure

Step Potential Safety & Environmental Hazards/Impacts Of the risk you have Determine what actions are necessary to eliminate or minimise all hazards that
No. Sequence of Basic Job Steps
Identify the hazards (health and safety or environmental) identified on the left could lead to an accident, injury, illness or environmental incident. The risk must be
Logical Break down Job into steps. Each step should Responsibility
associated with each step, examine each to find all possible risk reduced or controlled to a level that is acceptable before work commences.
sequence accomplish a major task and be logical.
factors Indicate Responsible Person to perform the action where applicable against each
P S RR action
Offloading materials Vehicle drivers are to be informed to offload materials at the designated area. The Supervisor
 Materials are offloaded at the wrong location, which affect C 4 6 Supervisor(s) are to ensure that adequate storage areas are available on site for
8 production and / or causes obstructions materials being delivered.
Vehicles left running unattended Vehicle drivers to be informed not to leave their vehicles running unattended. They Supervisor
 Unauthorized persons gain access to, operate or steal the C 4 6 should switch off and not leave the keys in the vehicle, and must lock their vehicle,
9 vehicle, or steal the contents of the vehicle to protect its contents / the vehicle. Supervisor(s) to enforce the above.
Drivers to wear their safety belts  The driver sustaining injury resulting from the driver not All vehicle drivers are to wear their safety belts, as well as any passengers of their Supervisor
10 being secured in his seat C 4 6 vehicles when driving. This to be enforced upon entry on site and throughout the
stay on site. Supervisor(s) to ensure this is done.
Materials are secured to the vehicle if necessary Delivery vehicle drivers are to be informed to ensure that the materials they are Supervisor
 Damage to materials / persons / or property from materials transporting are suitably and sufficiently secured from falling, sliding, rolling or
falling off of the delivery vehicle. Damage to the materials while moving in any manner which may cause them to become damaged or to cause
11 being transported. Injury sustained to persons loading / off- C 4 6
damage to any other material, persons or property. And protected / barricaded from
loading / working close to vehicle. falling from the vehicle thereby damaging the material or causing damage to
property or causing harm to any persons. Supervisor(s) are to enforce the above.

RISK ASSESSMENT COMMUNICATION SHEET PRESENTER SIGNATURE DATE

The following employees/ attendees were inducted regarding the hazards and risks and resolutions as to remedy hazards & risks associated with the tasks involved in the abovementioned Risk Assessment.
Attendees/ Employees Particulars
Initial & Surname Signature Date Initial & Surname Signature Date Initial & Surname Signature Date
RISK
MATERIAL DELIVERY CONTRACT NAME
ASSESSMENT

DOCUMENT
RA-MD IMPLEMENTED 01/2019 REVISION 01 CONTRACT NO. CDC/3336/19
REFERENCE.