Self Assessment Questionnaire Safe Working at Height ... - MIRMgate

WMC Environment, Health & Safety Management System
Self Assessment Questionnaire
Safe Working at Height
Major Hazard Standard
MHS-08
DocsOpen Ref: 57249, 11/07/2000
Uncontrolled copy – check web for latest revision
Revision Reviewed Description of Changes Date Approved
1 A Barfield Revised 11/07/2000 P Plavina
0 First Issue 19/06/1999 K Thomas
© WMC Resources Ltd
WMC has developed this document for internal use, specific to circumstances and conditions within its operations. It is
intended to provide general information and its applicability to external parties may therefore be limited. WMC makes no
representations as to the applicability of the information for use by any party other than WMC and should not be relied
upon as such. WMC provides no representation or warranty as to safety or business outcomes arising from application
of this document and its requirements by third parties.

Major Hazard Standard
Safe Working at Heights
Self Assessment Questionnaire
CONTENTS
1 Purpose and Scope 3
2 How to use the Assessment 3
3 Roles and Functions 3
4 Interview Questionnaire 4
4.1 Senior Manager ..................................................... 4
4.2 Operations Manager.............................................. 7
4.3 Operations Team Leader .................................... 14
4.4 Operations Team Member .................................. 21
4.5 Maintenance Manager......................................... 26
4.6 Maintenance Team Leader ................................. 33
4.7 Maintenance Team Member ............................... 40
4.8 Support Manager................................................. 45
4.9 Support Team Leader ......................................... 52
4.10 Support Team Member ..................................... 59
Docs Open No 57249

Major Hazard Standard
Safe Working at Heights
Self Assessment Questionnaire
1 Purpose and Scope
This document is designed to allow each person in the organisation to understand what they are
responsible for when planning, designing, constructing, operating, maintaining or disposing of the
processes covered by the standard.
The assessment covers all requirements of the standard for Senior Managers, Managers, Team Leaders
and Team members in the Operations, Maintenance and Support functions.
By using this questionnaire, each person should be able to judge whether they have adequate skills, tools
or written procedures to safely carry out their responsibilities for Safe Working at Height. The
questionnaire is compiled from the Major Hazard Standard and the audit protocol.
3 Roles and Functions
The questionnaire is divided into different roles and functions. The aim has been to develop questions
that explore how you are complying with the requirements of the standard while taking into account the
different responsibilities and activities that are present on each site.
Each site will need to define where their management structure fits with the generic roles as listed below.
When this has been achieved, all personnel on site will understand which section of the questionnaire
applies to them.
Roles are defined as follows:
Role Title Responsible for: Example Titles
Senior
Manager:
The activities of the
whole site
General Manager, Site Manager, Project
Manager, Mines Manager
This self-assessment has no mandatory requirement to be used and how each site uses this questionnaire
is to be decided by the site.
Manager:
The output of a number
of teams
Metallurgical Manager, Underground
Manager, Maintenance Manager
Team Leader:
The output of a single
team
Shift coordinator, Shift Boss, Maintenance
Coordinator, Drilling Crew boss
2 How to use the Assessment
The questionnaire is divided into separate sections.
Team Member
Completing tasks so that
the team will reach
target outputs
Technician, Miner, Operator
Each section is designed for a different role and function. These are explained in roles and functions
below, together with a selection of examples.
Steps:
• First: Select the section of the questionnaire that applies to you;
• Next: Read through each question answering with a Yes, No or N/A (Not Applicable);
Functions are defined as follows;
Operations Working on the processes that achieve output for
sales.
Maintenance
Support
Doing work that keeps Operations functioning so that
they can make target output.
Providing specialist knowledge and advice to
Operations and Maintenance teams
• Finally: Add comments relevant to the question and your circumstances.
Docs Open No 57249

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
4 Questionnaire
4.1 Senior Manager
No.
Std
Ref
Questions to confirm compliance with the standard
1.1 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for the requirement that risk assessments are conducted only by
competent personnel?
1.2 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for selection of appropriate control measures by the hierarchy of
controls?
1.3 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for compliance with all applicable current statutory and regulatory
requirements
1.4 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for ensuring personnel are not exposed to hazards arising from
working at height?
1.5 1 Do the persons responsible understand their responsibilities?
1.6 2 Is there a written procedure being followed that states the site requirements to ensure
work is not undertaken, where there is the risk of falling, without adequate fall
prevention measures in place?
1.7 2 Do personnel who are responsible for conducting work at height understand the required
measures?
1.8 2 Have risk assessments been conducted?
1.9 2 Are the required measures identified in the risk assessments implemented on site?
1.10 2 Is there a written requirement that in the design of new facilities and modifications to
existing facilities all excavation, construction, operating, modification and maintenance
activities for the foreseeable life of the asset are considered?
1.11 2 Do the design personnel understand the requirements?
1.12 2 Do the designs conform to the above?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Senior Manager
Page 4 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
1.13 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
1.14 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
1.15 3 Has competence been assessed and confirmed by a person qualified and authorised for
the purpose and does their competence include training in workplace competence
assessment?
1.16 3 Is there a procedure being followed which specifies the competency requirements for
emergency services personnel to conduct a ‘rope rescue’?
1.17 4.1 Are there procedures being followed which state the design, construction, use and
disposal requirements for work platforms?
1.18 4.1 Are the required records being kept?
1.19 4.3 Is there a procedure being followed for the use of mancages and is it in accordance with
Appendix D4 of the standard?
1.20 4.3 Are there procedures being followed which state the measures for fall protection for
vehicles, trucks and heavy equipment?
Do these measures comply with the requirements of the standard?
1.21 4.3 Is work carried out on mobile equipment in accordance with the site requirements?
1.22 5 Are there procedures being followed which state that where persons are to work in an
area that has no work platform and has been deemed by the risk assessment, to require
controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured to
an appropriate anchorage?
1.23 5 Is work carried out in accordance with this requirement?
1.24 5.1 Do the site procedures for working on roofs state that prior to working on or accessing
any roof a risk assessment shall be conducted?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Senior Manager
Page 5 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
NA YES NO Documents that you should be able to
access and actions required
Comments
1.25 5.1 Are there procedures being followed which state the structural integrity of a roof shall
be determined and confirmed to be sound before:
• moving onto it?
• storing materials on it?
• rigging from it?
1.26 5.2 Do persons who supervise or work in shrink stopes understand the requirements?
1.27 6 Is there a procedure being followed for using, inspecting and servicing PFRE and
PFAE?
1.28 7 Is there a procedure being followed for working around open holes that states a risk
assessment process shall be used to define the controls required when personnel are
exposed to open holes?
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Senior Manager
Page 6 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
4.2 Operations Manager
No.
Std
Ref
Questions to confirm compliance with the standard
2.1 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for the requirement that risk assessments are conducted only by
competent personnel?
2.2 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for selection of appropriate control measures by the hierarchy of
controls?
2.3 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for compliance with all applicable current statutory and regulatory
requirements
2.4 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for ensuring personnel are not exposed to hazards arising from
working at height?
2.5 1 Do the persons responsible understand their responsibilities?
2.6 2 Is there a written procedure being followed that states the site requirements to ensure
work is not undertaken, where there is the risk of falling, without adequate fall
prevention measures in place?
2.7 2 Does the written procedure include measures to ensure that where practicable, the
need to work where there is the risk of a fall is eliminated?
2.8 2 Does the written procedure include measures to ensure that risk assessments are
conducted before the commencement of work and at any time the scope of work
changes or the risk of a fall increases?
2.9 2 Does the written procedure include measures to ensure that appropriate measures are
selected using the hierarchy of controls (Elimination, substitution, redesign,
separation, administrative and personnel protective equipment) ?
2.10 2 Does the written procedure include measures to ensure that all equipment used is fitfor-purpose?
2.11 2 Does the written procedure include measures to ensure that at shift changes, incoming
personnel are aware of the measures being used for work in progress?
2.12 2 Do personnel who are responsible for conducting work at height understand the
required measures?
NA YES NO Documents that you should be able to access Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Manager
Page 7 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
2.13 2 Have risk assessments been conducted?
2.14 2 Are the required measures identified in the risk assessments implemented on site?
2.15 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities all excavation, construction, operating, modification and
maintenance activities for the foreseeable life of the asset are considered?
2.16 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities, an appropriate design standard is used?
2.17 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities, designs conform to statutory regulations?
2.18 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities, provisions to prevent falls are clearly identified in specifications?
2.19 2.1 Do the design personnel understand the requirements?
2.20 2.1 Do the designs conform to the above?
2.21 2.2 Where provisions to prevent falls were contained in purchasing specifications, and
these provisions were changed, were changes made only with the consent of the
originator of the specification?
2.22 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
2.23 3 Are all persons responsible for work carried out at height competent in the site
management systems used for the prevention of falls?
2.24 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) able to participate in a risk assessment of the work?
2.25 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) familiar with the control measures for fall prevention?
2.26 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) competent in the correct use of control measures?
2.27 3 Are competencies assessed and documented?
NA YES NO Documents that you should be able to access Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Manager
Page 8 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
2.28 3 Has competence been assessed and confirmed by a person qualified and authorised for
the purpose and does their competence include training in workplace competence
assessment?
2.29 3.1 Is there an SWP procedure being followed which specifies the competency
requirements for emergency services personnel to conduct a ‘rope rescue’?
2.30 4.1 Are there procedures being followed which state the design, construction and disposal
requirements for work platforms?
2.31 4.1 Do persons who design, construct, and dispose of work platforms understand the
requirements?
2.32 4.1 Are there procedures being followed which state the, use requirements for work
platforms?
2.33 4.1 Are there procedures being followed which state the actions to be undertaken if work
platforms do not meet the above requirements, and do these actions comply with
Section 5 of the standard?
2.34 4.1 Do persons who use work platforms understand the requirements?
2.35 4.1 Are there procedures being followed which state the design and construction and
disposal requirements for access equipment?
2.36 4.1 Do persons who design, construct and dispose of access equipment understand the
requirements?
2.37 4.1 Are there procedures being followed which state the use requirements for access
equipment?
2.38 4.1 Are there procedures being followed which state the actions to be undertaken if access
equipment are to be used as a work platform, and do these actions comply with
Section 5 of the standard?
2.39 4.1 Do persons who use access equipment understand the requirements?
2.40 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate before the first use?
2.41 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate at intervals determined by
the operating conditions?
NA YES NO Documents that you should be able to access Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Manager
Page 9 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
2.42 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate prior to use following
repairs and modifications?
2.43 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate as soon as practicable and
prior to further use following an occurrence that could have affected the stability or
adequacy of the work platforms or access equipment e.g. fire, collision, earthquake,
overloading?
2.44 4.2 Is there a procedure being followed that requires scaffolds be inspected prior to first
use and every 14 days by a licensed and authorised scaffolder?
2.45 4.2 Do persons who inspect work platforms and access equipment understand the
inspection requirements?
2.46 4.2 Are records kept of inspections that have been completed?
2.47 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced at intervals determined by the operating
conditions?
2.48 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced where inspections indicate a need?
2.49 4.2 Do persons who service work platforms and access equipment understand the
servicing requirements?
2.50 4.2 Are records kept of services carried out?
2.51 Is there a procedure being followed for the use of mancages and is it in accordance
with Appendix D4 of the standard
2.52 4.3 Are there procedures being followed which state the measures for fall protection for
vehicles, trucks and heavy equipment?
Do these measures comply with the requirements of the standard?
2.53 4.3 Do persons who work on mobile equipment understand the requirements?
2.54 4.3 Is work carried out on mobile equipment in accordance with the site requirements?
NA YES NO Documents that you should be able to access Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Manager
Page 10 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
2.55 5 Are there procedures being followed which state that where persons are to work in an
area that has no work platform and has been deemed by the risk assessment, to require
controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured
to an appropriate anchorage?
2.56 5 Does this procedure state that PFAE only be used when all other control measures
have been explored and deemed to be inappropriate?
2.57 5 Do persons who work where there is no work platform understand the requirements
for PFRE and PFAE?
2.58 5 Is work carried out in accordance with this requirement?
2.59 5 Are there procedures being followed which state the requirements for anchorage
points? Do these requirements comply with Appendix J of this standard?
2.60 5 Do persons who work where there is no work platform understand the requirements
and selection of the appropriate anchorage points?
2.61 5 Are appropriate anchorage points used?
2.62 5.1 Do the site procedures for working on roofs state that prior to working on or accessing
any roof a risk assessment shall be conducted?
2.63 5.1 Do the site procedures for working on roofs state that appropriate control measures
determined by the risk assessment shall be implemented?
2.64 5.1 Are there procedures being followed which state the structural integrity of a roof shall
be determined and confirmed to be sound before:
moving onto it?
storing materials on it?
rigging from it?
2.65 5.1 Are there procedures being followed which state where the integrity of the roof
cladding cannot be determined, but the support structure isappears sound, access onto
the roof shall be by boarding installed by a competent and authorised person?
2.66 5.1 Do persons who are responsible for work on roofs understand the required actions
prior to and whilst persons are working on the roof?
2.67 5.1 Do persons who work on roofs understand the required actions prior to and whilst
working on the roof?
NA YES NO Documents that you should be able to access Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Manager
Page 11 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
2.68 5.1 Have risk assessment been conducted for work on roofs?
2.69 5.1 Have the required controls arising from risk assessments been implemented whilst
conducting work on roofs?
2.70 5.2 Are there procedures being followed which state PFAE shall be worn and secured to a
static line that extends to the working area?
2.71 5.2 Do persons who supervise or work in shrink stopes understand the requirements?
2.72 5.2 Do persons who work in shrink stopes comply with the standard?
2.73 6 Is there a procedure being followed for using PFRE and PFAE?
2.74 6 Does the procedure include anchorage points?
2.75 6 Does the procedure include static lines?
2.76 6 Does the procedure include lanyards?
2.77 6 Does the procedure include inertia reel arrest devices?
2.78 6 Does the procedure include safety harnesses?
2.79 6 Does the procedure include safety climb systems?
2.80 6 Does the procedure include belay systems?
2.81 6 Is there a procedure being followed Is there a procedure for inspecting and servicing
PFRE, PFAE and anchorage points?
2.82 6 Is there a procedure Is there a procedure being followed for keeping records of
acquiring, inspecting, servicing and disposing of PFRE and PFAE (including rescue
equipment)?
2.83 6 Is there a procedure Is there a procedure being followed for ensuring that PFAE
rescue equipment is used only for rescue purposes?
2.84 6 Is there a procedure being followed for keeping records of PFAE rescue equipment
use?
2.85 6 Is there a procedure being followed for ensuring that persons required to use, inspect,
service and dispose of personal equipment are competent and authorised to do so?
2.86 6 Is there a procedure being followed for specifying the age and condition for disposal
for each item of PFRE and PFAE?
NA YES NO Documents that you should be able to access Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Manager
Page 12 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
2.87 6 Are these procedures readily available to the workforce?
2.88 6 Do persons who are required to use these procedures understand the requirements
contained in them?
2.89 7 Is there a site procedure being followed for working around open holes that states a
risk assessment process shall be used to define the controls required when personnel
are exposed to open holes?
2.90 7 Is there a site procedure being followed for working around open holes that states
where indicated by the risk assessment, access points to an open hole shall have signs
identifying the risk?
2.91 7 Is there a site procedure being followed for working around open holes that states
additional access controls may include barricades and/or the use of PFRE?
2.92 7 Is this procedure readily available to the workforce?
2.93 7 Do persons who are required to use this procedure understand the requirements of the
procedure?
Counts
NA YES NO Documents that you should be able to access Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Manager
Page 13 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
4.3 Operations Team Leader
No.
Std
Ref
Questions to confirm compliance with the standard
3.1 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for the requirement that risk assessments are conducted only by
competent personnel?
3.2 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for selection of appropriate control measures by the hierarchy of
controls?
3.3 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for compliance with all applicable current statutory and regulatory
requirements
3.4 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for ensuring personnel are not exposed to hazards arising from
working at height?
3.5 1 Do the persons responsible understand their responsibilities?
3.6 2 Is there a written procedure being followed that states the site requirements to ensure
work is not undertaken, where there is the risk of falling, without adequate fall
prevention measures in place?
3.7 2 Does the written procedure include measures to ensure that where practicable, the
need to work where there is the risk of a fall is eliminated?
3.8 2 Does the written procedure include measures to ensure that risk assessments are
conducted before the commencement of work and at any time the scope of work
changes or the risk of a fall increases?
3.9 2 Does the written procedure include measures to ensure that appropriate measures are
selected using the hierarchy of controls (Elimination, substitution, redesign,
separation, administrative and personnel protective equipment) ?
3.10 2 Does the written procedure include measures to ensure that all equipment used is fitfor-purpose?
3.11 2 Does the written procedure include measures to ensure that at shift changes, incoming
personnel are aware of the measures being used for work in progress?
3.12 2 Do personnel who are responsible for conducting work at height understand the
required measures?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/08
Operations Team Leader
Page 14 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
3.13 2 Have risk assessments been conducted?
3.14 2 Are the required measures identified in the risk assessments implemented on site?
3.15 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities all excavation, construction, operating, modification and
maintenance activities for the foreseeable life of the asset are considered?
3.16 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities, provisions to prevent falls are clearly identified in specifications?
3.17 2.2 Where provisions to prevent falls were contained in purchasing specifications, and
these provisions were changed, were changes made only with the consent of the
originator of the specification?
3.18 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
3.19 3 Are all persons responsible for work carried out at height competent in the site
management systems used for the prevention of falls?
3.20 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) able to participate in a risk assessment of the work?
3.21 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) familiar with the control measures for fall prevention?
3.22 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) competent in the correct use of control measures?
3.23 3 Are competencies assessed and documented?
3.24 3 Has competence been assessed and confirmed by a person qualified and authorised for
the purpose and does their competence include training in workplace competence
assessment?
3.25 3.1 Is there an SWP procedure being followed which specifies the competency
requirements for emergency services personnel to conduct a ‘rope rescue’?
3.26 4.1 Are there procedures being followed which state the design, construction and disposal
requirements for work platforms?
3.27 4.1 Do persons who design, construct, and dispose of work platforms understand the
requirements?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/08
Operations Team Leader
Page 15 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
3.28 4.1 Are there procedures being followed which state the, use requirements for work
platforms?
3.29 4.1 Are there procedures being followed which state the actions to be undertaken if work
platforms do not meet the above requirements, and do these actions comply with
Section 5 of the standard?
3.30 4.1 Do persons who use work platforms understand the requirements?
3.31 4.1 Are there procedures being followed which state the design and construction and
disposal requirements for access equipment?
3.32 4.1 Do persons who design, construct and dispose of access equipment understand the
requirements?
3.33 4.1 Are there procedures being followed which state the use requirements for access
equipment?
3.34 4.1 Are there procedures being followed which state the actions to be undertaken if access
equipment are to be used as a work platform, and do these actions comply with
Section 5 of the standard?
3.35 4.1 Do persons who use access equipment understand the requirements?
3.36 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate before the first use?
3.37 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate at intervals determined by
the operating conditions?
3.38 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate prior to use following
repairs and modifications?
3.39 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate as soon as practicable and
prior to further use following an occurrence that could have affected the stability or
adequacy of the work platforms or access equipment e.g. fire, collision, earthquake,
overloading?
3.40 4.2 Is there a procedure being followed that requires scaffolds be inspected prior to first
use and every 14 days by a licensed and authorised scaffolder?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/08
Operations Team Leader
Page 16 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
3.41 4.2 Do persons who inspect work platforms and access equipment understand the
inspection requirements?
3.42 4.2 Are records kept of inspections that have been completed?
3.43 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced at intervals determined by the operating
conditions?
3.44 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced where inspections indicate a need?
3.45 4.2 Do persons who service work platforms and access equipment understand the
servicing requirements?
3.46 4.2 Are records kept of services carried out?
3.47 Is there a procedure being followed for the use of mancages and is it in accordance
with Appendix D4 of the standard
3.48 4.3 Are there procedures being followed which state the measures for fall protection for
vehicles, trucks and heavy equipment?
Do these measures comply with the requirements of the standard?
3.49 4.3 Do persons who work on mobile equipment understand the requirements?
3.50 4.3 Is work carried out on mobile equipment in accordance with the site requirements?
3.51 5 Are there procedures being followed which state that where persons are to work in an
area that has no work platform and has been deemed by the risk assessment, to require
controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured
to an appropriate anchorage?
3.52 5 Does this procedure state that PFAE only be used when all other control measures
have been explored and deemed to be inappropriate?
3.53 5 Do persons who work where there is no work platform understand the requirements
for PFRE and PFAE?
3.54 5 Is work carried out in accordance with this requirement?
3.55 5 Are there procedures being followed which state the requirements for anchorage
points? Do these requirements comply with Appendix J of this standard?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/08
Operations Team Leader
Page 17 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
3.56 5 Do persons who work where there is no work platform understand the requirements
and selection of the appropriate anchorage points?
3.57 5 Are appropriate anchorage points used?
3.58 5.1 Do the site procedures for working on roofs state that prior to working on or accessing
any roof a risk assessment shall be conducted?
3.59 5.1 Do the site procedures for working on roofs state that appropriate control measures
determined by the risk assessment shall be implemented?
3.60 5.1 Are there procedures being followed which state the structural integrity of a roof shall
be determined and confirmed to be sound before:
moving onto it?
storing materials on it?
rigging from it?
3.61 5.1 Are there procedures being followed which state where the integrity of the roof
cladding cannot be determined, but the support structure isappears sound, access onto
the roof shall be by boarding installed by a competent and authorised person?
3.62 5.1 Do persons who are responsible for work on roofs understand the required actions
prior to and whilst persons are working on the roof?
3.63 5.1 Do persons who work on roofs understand the required actions prior to and whilst
working on the roof?
3.64 5.1 Have risk assessment been conducted for work on roofs?
3.65 5.1 Have the required controls arising from risk assessments been implemented whilst
conducting work on roofs?
3.66 5.2 Are there procedures being followed which state PFAE shall be worn and secured to a
static line that extends to the working area?
3.67 5.2 Do persons who supervise or work in shrink stopes understand the
requirements?Counts
3.68 5.2 Do persons who work in shrink stopes comply with the standard?
3.69 6 Is there a procedure being followed for using PFRE and PFAE?
3.70 6 Does the procedure include anchorage points?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/08
Operations Team Leader
Page 18 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
3.71 6 Does the procedure include static lines?
3.72 6 Does the procedure include lanyards?
3.73 6 Does the procedure include inertia reel arrest devices?
3.74 6 Does the procedure include safety harnesses?
3.75 6 Does the procedure include safety climb systems?
3.76 6 Does the procedure include belay systems?
3.77 6 Is there a procedure being followed Is there a procedure for inspecting and servicing
PFRE, PFAE and anchorage points?
3.78 6 Is there a procedure Is there a procedure being followed for keeping records of
acquiring, inspecting, servicing and disposing of PFRE and PFAE (including rescue
equipment)?
3.79 6 Is there a procedure Is there a procedure being followed for ensuring that PFAE
rescue equipment is used only for rescue purposes?
3.80 6 Is there a procedure being followed for keeping records of PFAE rescue equipment
use?
3.81 6 Is there a procedure being followed for ensuring that persons required to use, inspect,
service and dispose of personal equipment are competent and authorised to do so?
3.82 6 Is there a procedure being followed for specifying the age and condition for disposal
for each item of PFRE and PFAE?
3.83 6 Are these procedures readily available to the workforce?
3.84 6 Do persons who are required to use these procedures understand the requirements
contained in them?
3.85 7 Is there a site procedure being followed for working around open holes that states a
risk assessment process shall be used to define the controls required when personnel
are exposed to open holes?
3.86 7 Is there a site procedure being followed for working around open holes that states
where indicated by the risk assessment, access points to an open hole shall have signs
identifying the risk?
3.87 7 Is there a site procedure being followed for working around open holes that states
additional access controls may include barricades and/or the use of PFRE?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/08
Operations Team Leader
Page 19 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
3.88 7 Is this procedure readily available to the workforce?
3.89 7 Do persons who are required to use this procedure understand the requirements of the
procedure?
Counts
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/08
Operations Team Leader
Page 20 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
4.4 Operations Team Member
No.
Std
Ref
Questions to confirm compliance with the standard
NA
YES NO Documents that you should be able to access
and actions required
Comments
4.1 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for the requirement that risk assessments are conducted only by
competent personnel?
4.2 2 Is there a written procedure being followed that states the site requirements to ensure
work is not undertaken, where there is the risk of falling, without adequate fall
prevention measures in place?
4.3 2 Does the written procedure include measures to ensure that where practicable, the
need to work where there is the risk of a fall is eliminated?
4.4 2 Does the written procedure include measures to ensure that risk assessments are
conducted before the commencement of work and at any time the scope of work
changes or the risk of a fall increases?
4.5 2 Does the written procedure include measures to ensure that appropriate measures are
selected using the hierarchy of controls (Elimination, substitution, redesign,
separation, administrative and personnel protective equipment) ?
4.6 2 Does the written procedure include measures to ensure that all equipment used is fitfor-purpose?
4.7 2 Does the written procedure include measures to ensure that at shift changes, incoming
personnel are aware of the measures being used for work in progress?
4.8 2 Do personnel who are responsible for conducting work at height understand the
required measures?
4.9 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
4.10 3 Are all persons responsible for work carried out at height competent in the site
management systems used for the prevention of falls?
4.11 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) able to participate in a risk assessment of the work?
4.12 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) familiar with the control measures for fall prevention?
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Team Member
Page 21 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
NA
YES NO Documents that you should be able to access
and actions required
Comments
4.13 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) competent in the correct use of control measures?
4.14 3 Are competencies assessed and documented?
4.15 3.1 Is there an SWP procedure being followed which specifies the competency
requirements for emergency services personnel to conduct a ‘rope rescue’?
4.16 4.1 Are there procedures being followed which state the, use requirements for work
platforms?
4.17 4.1 Are there procedures being followed which state the actions to be undertaken if work
platforms do not meet the above requirements, and do these actions comply with
Section 5 of the standard?
4.18 4.1 Do persons who use work platforms understand the requirements?
4.19 4.1 Are there procedures being followed which state the design and construction and
disposal requirements for access equipment?
4.20 4.1 Do persons who design, construct and dispose of access equipment understand the
requirements?
4.21 4.1 Are there procedures being followed which state the use requirements for access
equipment?
4.22 4.1 Are there procedures being followed which state the actions to be undertaken if access
equipment are to be used as a work platform, and do these actions comply with
Section 5 of the standard?
4.23 4.1 Do persons who use access equipment understand the requirements?
4.24 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate before the first use?
4.25 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate prior to use following
repairs and modifications?
4.26 4.2 Is there a procedure being followed that requires scaffolds be inspected prior to first
use and every 14 days by a licensed and authorised scaffolder?
4.27 4.2 Do persons who inspect work platforms and access equipment understand the
inspection requirements?
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Team Member
Page 22 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
NA
YES NO Documents that you should be able to access
and actions required
Comments
4.28 4.2 Are records kept of inspections that have been completed?
4.29 4.2 Do persons who service work platforms and access equipment understand the
servicing requirements?
4.30 4.2 Are records kept of services carried out?
4.31 4.3 Is there a procedure being followed for the use of mancages and is it in accordance
with Appendix D4 of the standard
4.32 4.3 Are there procedures being followed which state the measures for fall protection for
vehicles, trucks and heavy equipment?
Do these measures comply with the requirements of the standard?
4.33 4.3 Do persons who work on mobile equipment understand the requirements?
4.34 4.3 Is work carried out on mobile equipment in accordance with the site requirements?
4.35 5 Are there procedures being followed which state that where persons are to work in an
area that has no work platform and has been deemed by the risk assessment, to require
controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured
to an appropriate anchorage?
4.36 5 Does this procedure state that PFAE only be used when all other control measures
have been explored and deemed to be inappropriate?
4.37 5 Do persons who work where there is no work platform understand the requirements
for PFRE and PFAE?
4.38 5 Is work carried out in accordance with this requirement?
4.39 5 Do persons who work where there is no work platform understand the requirements
and selection of the appropriate anchorage points?
4.40 5 Are appropriate anchorage points used?
4.41 5.1 Do the site procedures for working on roofs state that prior to working on or accessing
any roof a risk assessment shall be conducted?
4.42 5.1 Do the site procedures for working on roofs state that appropriate control measures
determined by the risk assessment shall be implemented?
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Team Member
Page 23 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
NA
YES NO Documents that you should be able to access
and actions required
Comments
4.43 5.1 Are there procedures being followed which state the structural integrity of a roof shall
be determined and confirmed to be sound before:
• moving onto it?
• storing materials on it?
• rigging from it?
4.44 5.1 Are there procedures being followed which state where the integrity of the roof
cladding cannot be determined, but appears sound, access onto the roof shall be by
boarding installed by a competent and authorised person?
4.45 5.1 Do persons who work on roofs understand the required actions prior to and whilst
working on the roof?
4.46 5.1 Have risk assessment been conducted for work on roofs?
4.47 5.1 Have the required controls arising from risk assessments been implemented whilst
conducting work on roofs?
4.48 5.2 Are there procedures being followed which state PFAE shall be worn and secured to a
static line that extends to the working area?
4.49 5.2 Do persons who supervise or work in shrink stopes understand the requirements?
4.50 5.2 Do persons who work in shrink stopes comply with the standard?
4.51 6 Is there a procedure being followed for using PFRE and PFAE?
4.52 6 Does the procedure include anchorage points?
4.53 6 Does the procedure include static lines?
4.54 6 Does the procedure include lanyards?
4.55 6 Does the procedure include inertia reel arrest devices?
4.56 6 Does the procedure include safety harnesses?
4.57 6 Does the procedure include safety climb systems?
4.58 6 Does the procedure include belay systems?
4.59 6 Is there a procedure being followed for inspecting and servicing PFRE, PFAE and
anchorage points?
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Team Member
Page 24 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
NA
YES NO Documents that you should be able to access
and actions required
Comments
4.60 6 Is there a procedure being followed for ensuring that persons required to use, inspect,
service and dispose of personal equipment are competent and authorised to do so?
4.61 6 Is there a procedure being followed for specifying the age and condition for disposal
for each item of PFRE and PFAE?
4.62 6 Are these procedures readily available to the workforce?
4.63 6 Do persons who are required to use these procedures understand the requirements
contained in them?
4.64 7 Is there a site procedure being followed for working around open holes that states a
risk assessment process shall be used to define the controls required when personnel
are exposed to open holes?
4.65 7 Is there a site procedure being followed for working around open holes that states
where indicated by the risk assessment, access points to an open hole shall have signs
identifying the risk?
4.66 7 Is there a site procedure being followed for working around open holes that states
additional access controls may include barricades and/or the use of PFRE?
4.67 7 Is this procedure readily available to the workforce?
4.68 7 Do persons who are required to use this procedure understand the requirements of the
procedure?
Counts
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Operations Team Member
Page 25 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
4.5 Maintenance Manager
No.
Std
Ref
Questions to confirm compliance with the standard
5.1 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for the requirement that risk assessments are conducted only by
competent personnel?
5.2 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for selection of appropriate control measures by the hierarchy of
controls?
5.3 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for compliance with all applicable current statutory and regulatory
requirements
5.4 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for ensuring personnel are not exposed to hazards arising from
working at height?
5.5 1 Do the persons responsible understand their responsibilities?
5.6 2 Is there a written procedure being followed that states the site requirements to ensure
work is not undertaken, where there is the risk of falling, without adequate fall
prevention measures in place?
5.7 2 Does the written procedure include measures to ensure that where practicable, the
need to work where there is the risk of a fall is eliminated?
5.8 2 Does the written procedure include measures to ensure that risk assessments are
conducted before the commencement of work and at any time the scope of work
changes or the risk of a fall increases?
5.9 2 Does the written procedure include measures to ensure that appropriate measures are
selected using the hierarchy of controls (Elimination, substitution, redesign,
separation, administrative and personnel protective equipment) ?
5.10 2 Does the written procedure include measures to ensure that all equipment used is fitfor-purpose?
5.11 2 Does the written procedure include measures to ensure that at shift changes, incoming
personnel are aware of the measures being used for work in progress?
5.12 2 Do personnel who are responsible for conducting work at height understand the
required measures?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Manager
Page 26 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
5.13 2 Have risk assessments been conducted?
5.14 2 Are the required measures identified in the risk assessments implemented on site?
5.15 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities all excavation, construction, operating, modification and
maintenance activities for the foreseeable life of the asset are considered?
5.16 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities, provisions to prevent falls are clearly identified in specifications?
5.17 2.2 Where provisions to prevent falls were contained in purchasing specifications, and
these provisions were changed, were changes made only with the consent of the
originator of the specification?
5.18 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
5.19 3 Are all persons responsible for work carried out at height competent in the site
management systems used for the prevention of falls?
5.20 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) able to participate in a risk assessment of the work?
5.21 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) familiar with the control measures for fall prevention?
5.22 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) competent in the correct use of control measures?
5.23 3 Are competencies assessed and documented?
5.24 3 Has competence been assessed and confirmed by a person qualified and authorised for
the purpose and does their competence include training in workplace competence
assessment?
5.25 3.1 Is there an SWP procedure being followed which specifies the competency
requirements for emergency services personnel to conduct a ‘rope rescue’?
5.26 4.1 Are there procedures being followed which state the design, construction and disposal
requirements for work platforms?
5.27 4.1 Do persons who design, construct, and dispose of work platforms understand the
requirements?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Manager
Page 27 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
5.28 4.1 Are there procedures being followed which state the, use requirements for work
platforms?
5.29 4.1 Are there procedures being followed which state the actions to be undertaken if work
platforms do not meet the above requirements, and do these actions comply with
Section 5 of the standard?
5.30 4.1 Do persons who use work platforms understand the requirements?
5.31 4.1 Are there procedures being followed which state the design and construction and
disposal requirements for access equipment?
5.32 4.1 Do persons who design, construct and dispose of access equipment understand the
requirements?
5.33 4.1 Are there procedures being followed which state the use requirements for access
equipment?
5.34 4.1 Are there procedures being followed which state the actions to be undertaken if access
equipment are to be used as a work platform, and do these actions comply with
Section 5 of the standard?
5.35 4.1 Do persons who use access equipment understand the requirements?
5.36 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate before the first use?
5.37 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate at intervals determined by
the operating conditions?
5.38 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate prior to use following
repairs and modifications?
5.39 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate as soon as practicable and
prior to further use following an occurrence that could have affected the stability or
adequacy of the work platforms or access equipment e.g. fire, collision, earthquake,
overloading?
5.40 4.2 Is there a procedure being followed that requires scaffolds be inspected prior to first
use and every 14 days by a licensed and authorised scaffolder?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Manager
Page 28 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
5.41 4.2 Do persons who inspect work platforms and access equipment understand the
inspection requirements?
5.42 4.2 Are records kept of inspections that have been completed?
5.43 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced at intervals determined by the operating
conditions?
5.44 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced where inspections indicate a need?
5.45 4.2 Do persons who service work platforms and access equipment understand the
servicing requirements?
5.46 4.2 Are records kept of services carried out?
5.47 Is there a procedure being followed for the use of mancages and is it in accordance
with Appendix D4 of the standard
5.48 4.3 Are there procedures being followed which state the measures for fall protection for
vehicles, trucks and heavy equipment?
Do these measures comply with the requirements of the standard?
5.49 4.3 Do persons who work on mobile equipment understand the requirements?
5.50 4.3 Is work carried out on mobile equipment in accordance with the site requirements?
5.51 5 Are there procedures being followed which state that where persons are to work in an
area that has no work platform and has been deemed by the risk assessment, to require
controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured
to an appropriate anchorage?
5.52 5 Does this procedure state that PFAE only be used when all other control measures
have been explored and deemed to be inappropriate?
5.53 5 Do persons who work where there is no work platform understand the requirements
for PFRE and PFAE?
5.54 5 Is work carried out in accordance with this requirement?
5.55 5 Are there procedures being followed which state the requirements for anchorage
points? Do these requirements comply with Appendix J of this standard?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Manager
Page 29 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
5.56 5 Do persons who work where there is no work platform understand the requirements
and selection of the appropriate anchorage points?
5.57 5 Are appropriate anchorage points used?
5.58 5.1 Do the site procedures for working on roofs state that prior to working on or accessing
any roof a risk assessment shall be conducted?
5.59 5.1 Do the site procedures for working on roofs state that appropriate control measures
determined by the risk assessment shall be implemented?
5.60 5.1 Are there procedures being followed which state the structural integrity of a roof shall
be determined and confirmed to be sound before:
moving onto it?
storing materials on it?
rigging from it?
5.61 5.1 Are there procedures being followed which state where the integrity of the roof
cladding cannot be determined, but the support structure isappears sound, access onto
the roof shall be by boarding installed by a competent and authorised person?
5.62 5.1 Do persons who are responsible for work on roofs understand the required actions
prior to and whilst persons are working on the roof?
5.63 5.1 Do persons who work on roofs understand the required actions prior to and whilst
working on the roof?
5.64 5.1 Have risk assessment been conducted for work on roofs?
5.65 5.1 Have the required controls arising from risk assessments been implemented whilst
conducting work on roofs?
5.66 5.2 Are there procedures being followed which state PFAE shall be worn and secured to a
static line that extends to the working area?
5.67 5.2 Do persons who supervise or work in shrink stopes understand the
requirements?Counts
5.68 5.2 Do persons who work in shrink stopes comply with the standard?
5.69 6 Is there a procedure being followed for using PFRE and PFAE?
5.70 6 Does the procedure include anchorage points?
5.71 6 Does the procedure include static lines?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Manager
Page 30 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
5.72 6 Does the procedure include lanyards?
5.73 6 Does the procedure include inertia reel arrest devices?
5.74 6 Does the procedure include safety harnesses?
5.75 6 Does the procedure include safety climb systems?
5.76 6 Does the procedure include belay systems?
5.77 6 Is there a procedure being followed Is there a procedure for inspecting and servicing
PFRE, PFAE and anchorage points?
5.78 6 Is there a procedure Is there a procedure being followed for keeping records of
acquiring, inspecting, servicing and disposing of PFRE and PFAE (including rescue
equipment)?
5.79 6 Is there a procedure Is there a procedure being followed for ensuring that PFAE
rescue equipment is used only for rescue purposes?
5.80 6 Is there a procedure being followed for keeping records of PFAE rescue equipment
use?
5.81 6 Is there a procedure being followed for ensuring that persons required to use, inspect,
service and dispose of personal equipment are competent and authorised to do so?
5.82 6 Is there a procedure being followed for specifying the age and condition for disposal
for each item of PFRE and PFAE?
5.83 6 Are these procedures readily available to the workforce?
5.84 6 Do persons who are required to use these procedures understand the requirements
contained in them?
5.85 7 Is there a site procedure being followed for working around open holes that states a
risk assessment process shall be used to define the controls required when personnel
are exposed to open holes?
5.86 7 Is there a site procedure being followed for working around open holes that states
where indicated by the risk assessment, access points to an open hole shall have signs
identifying the risk?
5.87 7 Is there a site procedure being followed for working around open holes that states
additional access controls may include barricades and/or the use of PFRE?
5.88 7 Is this procedure readily available to the workforce?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Manager
Page 31 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
5.89 7 Do persons who are required to use this procedure understand the requirements of the
procedure?
Counts
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Manager
Page 32 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
4.6 Maintenance Team Leader
No.
Std
Ref
Questions to confirm compliance with the standard
6.1 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for the requirement that risk assessments are conducted only by
competent personnel?
6.2 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for selection of appropriate control measures by the hierarchy of
controls?
6.3 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for compliance with all applicable current statutory and regulatory
requirements
6.4 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for ensuring personnel are not exposed to hazards arising from
working at height?
6.5 1 Do the persons responsible understand their responsibilities?
6.6 2 Is there a written procedure being followed that states the site requirements to ensure
work is not undertaken, where there is the risk of falling, without adequate fall
prevention measures in place?
6.7 2 Does the written procedure include measures to ensure that where practicable, the
need to work where there is the risk of a fall is eliminated?
6.8 2 Does the written procedure include measures to ensure that risk assessments are
conducted before the commencement of work and at any time the scope of work
changes or the risk of a fall increases?
6.9 2 Does the written procedure include measures to ensure that appropriate measures are
selected using the hierarchy of controls (Elimination, substitution, redesign,
separation, administrative and personnel protective equipment) ?
6.10 2 Does the written procedure include measures to ensure that all equipment used is fitfor-purpose?
6.11 2 Does the written procedure include measures to ensure that at shift changes, incoming
personnel are aware of the measures being used for work in progress?
6.12 2 Do personnel who are responsible for conducting work at height understand the
required measures?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued:11/07/00
Maintenance Team Leader
Page 33 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
6.13 2 Have risk assessments been conducted?
6.14 2 Are the required measures identified in the risk assessments implemented on site?
6.15 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities all excavation, construction, operating, modification and
maintenance activities for the foreseeable life of the asset are considered?
6.16 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities, provisions to prevent falls are clearly identified in specifications?
6.17 2.2 Where provisions to prevent falls were contained in purchasing specifications, and
these provisions were changed, were changes made only with the consent of the
originator of the specification?
6.18 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
6.19 3 Are all persons responsible for work carried out at height competent in the site
management systems used for the prevention of falls?
6.20 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) able to participate in a risk assessment of the work?
6.21 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) familiar with the control measures for fall prevention?
6.22 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) competent in the correct use of control measures?
6.23 3 Are competencies assessed and documented?
6.24 3 Has competence been assessed and confirmed by a person qualified and authorised for
the purpose and does their competence include training in workplace competence
assessment?
6.25 3.1 Is there an SWP procedure being followed which specifies the competency
requirements for emergency services personnel to conduct a ‘rope rescue’?
6.26 4.1 Are there procedures being followed which state the design, construction and disposal
requirements for work platforms?
6.27 4.1 Do persons who design, construct, and dispose of work platforms understand the
requirements?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued:11/07/00
Maintenance Team Leader
Page 34 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
6.28 4.1 Are there procedures being followed which state the, use requirements for work
platforms?
6.29 4.1 Are there procedures being followed which state the actions to be undertaken if work
platforms do not meet the above requirements, and do these actions comply with
Section 5 of the standard?
6.30 4.1 Do persons who use work platforms understand the requirements?
6.31 4.1 Are there procedures being followed which state the design and construction and
disposal requirements for access equipment?
6.32 4.1 Do persons who design, construct and dispose of access equipment understand the
requirements?
6.33 4.1 Are there procedures being followed which state the use requirements for access
equipment?
6.34 4.1 Are there procedures being followed which state the actions to be undertaken if access
equipment are to be used as a work platform, and do these actions comply with
Section 5 of the standard?
6.35 4.1 Do persons who use access equipment understand the requirements?
6.36 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate before the first use?
6.37 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate at intervals determined by
the operating conditions?
6.38 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate prior to use following
repairs and modifications?
6.39 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate as soon as practicable and
prior to further use following an occurrence that could have affected the stability or
adequacy of the work platforms or access equipment e.g. fire, collision, earthquake,
overloading?
6.40 4.2 Is there a procedure being followed that requires scaffolds be inspected prior to first
use and every 14 days by a licensed and authorised scaffolder?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued:11/07/00
Maintenance Team Leader
Page 35 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
6.41 4.2 Do persons who inspect work platforms and access equipment understand the
inspection requirements?
6.42 4.2 Are records kept of inspections that have been completed?
6.43 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced at intervals determined by the operating
conditions?
6.44 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced where inspections indicate a need?
6.45 4.2 Do persons who service work platforms and access equipment understand the
servicing requirements?
6.46 4.2 Are records kept of services carried out?
6.47 Is there a procedure being followed for the use of mancages and is it in accordance
with Appendix D4 of the standard
6.48 4.3 Are there procedures being followed which state the measures for fall protection for
vehicles, trucks and heavy equipment?
Do these measures comply with the requirements of the standard?
6.49 4.3 Do persons who work on mobile equipment understand the requirements?
6.50 4.3 Is work carried out on mobile equipment in accordance with the site requirements?
6.51 5 Are there procedures being followed which state that where persons are to work in an
area that has no work platform and has been deemed by the risk assessment, to require
controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured
to an appropriate anchorage?
6.52 5 Does this procedure state that PFAE only be used when all other control measures
have been explored and deemed to be inappropriate?
6.53 5 Do persons who work where there is no work platform understand the requirements
for PFRE and PFAE?
6.54 5 Is work carried out in accordance with this requirement?
6.55 5 Are there procedures being followed which state the requirements for anchorage
points? Do these requirements comply with Appendix J of this standard?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued:11/07/00
Maintenance Team Leader
Page 36 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
6.56 5 Do persons who work where there is no work platform understand the requirements
and selection of the appropriate anchorage points?
6.57 5 Are appropriate anchorage points used?
6.58 5.1 Do the site procedures for working on roofs state that prior to working on or accessing
any roof a risk assessment shall be conducted?
6.59 5.1 Do the site procedures for working on roofs state that appropriate control measures
determined by the risk assessment shall be implemented?
6.60 5.1 Are there procedures being followed which state the structural integrity of a roof shall
be determined and confirmed to be sound before:
moving onto it?
storing materials on it?
rigging from it?
6.61 5.1 Are there procedures being followed which state where the integrity of the roof
cladding cannot be determined, but the support structure isappears sound, access onto
the roof shall be by boarding installed by a competent and authorised person?
6.62 5.1 Do persons who are responsible for work on roofs understand the required actions
prior to and whilst persons are working on the roof?
6.63 5.1 Do persons who work on roofs understand the required actions prior to and whilst
working on the roof?
6.64 5.1 Have risk assessment been conducted for work on roofs?
6.65 5.1 Have the required controls arising from risk assessments been implemented whilst
conducting work on roofs?
6.66 5.2 Are there procedures being followed which state PFAE shall be worn and secured to a
static line that extends to the working area?
6.67 5.2 Do persons who supervise or work in shrink stopes understand the requirements?
6.68 5.2 Do persons who work in shrink stopes comply with the standard?
6.69 6 Is there a procedure being followed for using PFRE and PFAE?
6.70 6 Does the procedure include anchorage points?
6.71 6 Does the procedure include static lines?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued:11/07/00
Maintenance Team Leader
Page 37 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
6.72 6 Does the procedure include lanyards?
6.73 6 Does the procedure include inertia reel arrest devices?
6.74 6 Does the procedure include safety harnesses?
6.75 6 Does the procedure include safety climb systems?
6.76 6 Does the procedure include belay systems?
6.77 6 Is there a procedure being followed Is there a procedure for inspecting and servicing
PFRE, PFAE and anchorage points?
6.78 6 Is there a procedure Is there a procedure being followed for keeping records of
acquiring, inspecting, servicing and disposing of PFRE and PFAE (including rescue
equipment)?
6.79 6 Is there a procedure Is there a procedure being followed for ensuring that PFAE
rescue equipment is used only for rescue purposes?
6.80 6 Is there a procedure being followed for keeping records of PFAE rescue equipment
use?
6.81 6 Is there a procedure being followed for ensuring that persons required to use, inspect,
service and dispose of personal equipment are competent and authorised to do so?
6.82 6 Is there a procedure being followed for specifying the age and condition for disposal
for each item of PFRE and PFAE?
6.83 6 Are these procedures readily available to the workforce?
6.84 6 Do persons who are required to use these procedures understand the requirements
contained in them?
6.85 7 Is there a site procedure being followed for working around open holes that states a
risk assessment process shall be used to define the controls required when personnel
are exposed to open holes?
6.86 7 Is there a site procedure being followed for working around open holes that states
where indicated by the risk assessment, access points to an open hole shall have signs
identifying the risk?
6.87 7 Is there a site procedure being followed for working around open holes that states
additional access controls may include barricades and/or the use of PFRE?
6.88 7 Is this procedure readily available to the workforce?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued:11/07/00
Maintenance Team Leader
Page 38 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
6.89 7 Do persons who are required to use this procedure understand the requirements of the
procedure?
Counts
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued:11/07/00
Maintenance Team Leader
Page 39 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
4.7 Maintenance Team Member
No.
Std
Ref
Questions to confirm compliance with the standard
7.1 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for the requirement that risk assessments are conducted only by
competent personnel?
7.2 2 Is there a written procedure being followed that states the site requirements to ensure
work is not undertaken, where there is the risk of falling, without adequate fall
prevention measures in place?
7.3 2 Does the written procedure include measures to ensure that where practicable, the
need to work where there is the risk of a fall is eliminated?
7.4 2 Does the written procedure include measures to ensure that risk assessments are
conducted before the commencement of work and at any time the scope of work
changes or the risk of a fall increases?
7.5 2 Does the written procedure include measures to ensure that appropriate measures are
selected using the hierarchy of controls (Elimination, substitution, redesign,
separation, administrative and personnel protective equipment) ?
7.6 2 Does the written procedure include measures to ensure that all equipment used is fitfor-purpose?
7.7 2 Does the written procedure include measures to ensure that at shift changes, incoming
personnel are aware of the measures being used for work in progress?
7.8 2 Do personnel who are responsible for conducting work at height understand the
required measures?
7.9 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
7.10 3 Are all persons responsible for work carried out at height competent in the site
management systems used for the prevention of falls?
7.11 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) able to participate in a risk assessment of the work?
7.12 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) familiar with the control measures for fall prevention?
NA YES NO Documents that you should be able to access
and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Team Member
Page 40 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
7.13 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) competent in the correct use of control measures?
7.14 3 Are competencies assessed and documented?
7.15 3.1 Is there an SWP procedure being followed which specifies the competency
requirements for emergency services personnel to conduct a ‘rope rescue’?
7.16 4.1 Are there procedures being followed which state the, use requirements for work
platforms?
7.17 4.1 Are there procedures being followed which state the actions to be undertaken if work
platforms do not meet the above requirements, and do these actions comply with
Section 5 of the standard?
7.18 4.1 Do persons who use work platforms understand the requirements?
7.19 4.1 Are there procedures being followed which state the design and construction and
disposal requirements for access equipment?
7.20 4.1 Do persons who design, construct and dispose of access equipment understand the
requirements?
7.21 4.1 Are there procedures being followed which state the use requirements for access
equipment?
7.22 4.1 Are there procedures being followed which state the actions to be undertaken if access
equipment are to be used as a work platform, and do these actions comply with
Section 5 of the standard?
7.23 4.1 Do persons who use access equipment understand the requirements?
7.24 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate before the first use?
7.25 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate prior to use following
repairs and modifications?
7.26 4.2 Is there a procedure being followed that requires scaffolds be inspected prior to first
use and every 14 days by a licensed and authorised scaffolder?
7.27 4.2 Do persons who inspect work platforms and access equipment understand the
inspection requirements?
NA YES NO Documents that you should be able to access
and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Team Member
Page 41 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
7.28 4.2 Are records kept of inspections that have been completed?
7.29 4.2 Do persons who service work platforms and access equipment understand the
servicing requirements?
7.30 4.2 Are records kept of services carried out?
7.31 4.3 Is there a procedure being followed for the use of mancages and is it in accordance
with Appendix D4 of the standard
7.32 4.3 Are there procedures being followed which state the measures for fall protection for
vehicles, trucks and heavy equipment?
Do these measures comply with the requirements of the standard?
7.33 4.3 Do persons who work on mobile equipment understand the requirements?
7.34 4.3 Is work carried out on mobile equipment in accordance with the site requirements?
7.35 5 Are there procedures being followed which state that where persons are to work in an
area that has no work platform and has been deemed by the risk assessment, to require
controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured
to an appropriate anchorage?
7.36 5 Does this procedure state that PFAE only be used when all other control measures
have been explored and deemed to be inappropriate?
7.37 5 Do persons who work where there is no work platform understand the requirements
for PFRE and PFAE?
7.38 5 Is work carried out in accordance with this requirement?
7.39 5 Do persons who work where there is no work platform understand the requirements
and selection of the appropriate anchorage points?
7.40 5 Are appropriate anchorage points used?
7.41 5.1 Do the site procedures for working on roofs state that prior to working on or accessing
any roof a risk assessment shall be conducted?
7.42 5.1 Do the site procedures for working on roofs state that appropriate control measures
determined by the risk assessment shall be implemented?
NA YES NO Documents that you should be able to access
and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Team Member
Page 42 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
7.43 5.1 Are there procedures being followed which state the structural integrity of a roof shall
be determined and confirmed to be sound before:
• moving onto it?
• storing materials on it?
rigging from it?
7.44 5.1 Are there procedures being followed which state where the integrity of the roof
cladding cannot be determined, but appears sound, access onto the roof shall be by
boarding installed by a competent and authorised person?
7.45 5.1 Do persons who work on roofs understand the required actions prior to and whilst
working on the roof?
7.46 5.1 Have risk assessment been conducted for work on roofs?
7.47 5.1 Have the required controls arising from risk assessments been implemented whilst
conducting work on roofs?
7.48 5.2 Are there procedures being followed which state PFAE shall be worn and secured to a
static line that extends to the working area?
7.49 5.2 Do persons who supervise or work in shrink stopes understand the requirements?
7.50 5.2 Do persons who work in shrink stopes comply with the standard?
7.51 6 Is there a procedure being followed for using PFRE and PFAE?
7.52 6 Does the procedure include anchorage points?
7.53 6 Does the procedure include static lines?
7.54 6 Does the procedure include lanyards?
7.55 6 Does the procedure include inertia reel arrest devices?
7.56 6 Does the procedure include safety harnesses?
7.57 6 Does the procedure include safety climb systems?
7.58 6 Does the procedure include belay systems?
7.59 6 Is there a procedure being followed for inspecting and servicing PFRE, PFAE and
anchorage points?
NA YES NO Documents that you should be able to access
and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Team Member
Page 43 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No.
Std
Ref
Questions to confirm compliance with the standard
7.60 6 Is there a procedure being followed for ensuring that persons required to use, inspect,
service and dispose of personal equipment are competent and authorised to do so?
7.61 6 Is there a procedure being followed for specifying the age and condition for disposal
for each item of PFRE and PFAE?
7.62 6 Are these procedures readily available to the workforce?
7.63 6 Do persons who are required to use these procedures understand the requirements
contained in them?
7.64 7 Is there a site procedure being followed for working around open holes that states a
risk assessment process shall be used to define the controls required when personnel
are exposed to open holes?
7.65 7 Is there a site procedure being followed for working around open holes that states
where indicated by the risk assessment, access points to an open hole shall have signs
identifying the risk?
7.66 7 Is there a site procedure being followed for working around open holes that states
additional access controls may include barricades and/or the use of PFRE?
7.67 7 Is this procedure readily available to the workforce?
7.68 7 Do persons who are required to use this procedure understand the requirements of the
procedure?
Counts
NA YES NO Documents that you should be able to access
and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Maintenance Team Member
Page 44 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
4.8 Support Manager
No
Std
Ref
Questions to confirm compliance with the standard
8.1 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for the requirement that risk assessments are conducted only by
competent personnel?
8.2 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for selection of appropriate control measures by the hierarchy of
controls?
8.3 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for compliance with all applicable current statutory and regulatory
requirements
8.4 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for ensuring personnel are not exposed to hazards arising from
working at height?
8.5 1 Do the persons responsible understand their responsibilities?
8.6 2 Is there a written procedure being followed that states the site requirements to ensure
work is not undertaken, where there is the risk of falling, without adequate fall
prevention measures in place?
8.7 2 Does the written procedure include measures to ensure that where practicable, the
need to work where there is the risk of a fall is eliminated?
8.8 2 Does the written procedure include measures to ensure that risk assessments are
conducted before the commencement of work and at any time the scope of work
changes or the risk of a fall increases?
8.9 2 Does the written procedure include measures to ensure that appropriate measures are
selected using the hierarchy of controls (Elimination, substitution, redesign,
separation, administrative and personnel protective equipment) ?
8.10 2 Does the written procedure include measures to ensure that all equipment used is fitfor-purpose?
8.11 2 Does the written procedure include measures to ensure that at shift changes, incoming
personnel are aware of the measures being used for work in progress?
8.12 2 Do personnel who are responsible for conducting work at height understand the
required measures?
NA YES NO Documents that you should be able to
access and actions required
Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Manager
Page 45 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
8.13 2 Have risk assessments been conducted?
8.14 2 Are the required measures identified in the risk assessments implemented on site?
8.15 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities all excavation, construction, operating, modification and
maintenance activities for the foreseeable life of the asset are considered?
8.16 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities, provisions to prevent falls are clearly identified in specifications?
8.17 2.2 Where provisions to prevent falls were contained in purchasing specifications, and
these provisions were changed, were changes made only with the consent of the
originator of the specification?
8.18 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
8.19 3 Are all persons responsible for work carried out at height competent in the site
management systems used for the prevention of falls?
8.20 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) able to participate in a risk assessment of the work?
8.21 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) familiar with the control measures for fall prevention?
8.22 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) competent in the correct use of control measures?
8.23 3 Are competencies assessed and documented?
8.24 3 Has competence been assessed and confirmed by a person qualified and authorised for
the purpose and does their competence include training in workplace competence
assessment?
8.25 3.1 Is there an SWP procedure being followed which specifies the competency
requirements for emergency services personnel to conduct a ‘rope rescue’?
8.26 4.1 Are there procedures being followed which state the design, construction and disposal
requirements for work platforms?
8.27 4.1 Do persons who design, construct, and dispose of work platforms understand the
requirements?
NA YES NO Documents that you should be able to
access and actions required
Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Manager
Page 46 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
8.28 4.1 Are there procedures being followed which state the, use requirements for work
platforms?
8.29 4.1 Are there procedures being followed which state the actions to be undertaken if work
platforms do not meet the above requirements, and do these actions comply with
Section 5 of the standard?
8.30 4.1 Do persons who use work platforms understand the requirements?
8.31 4.1 Are there procedures being followed which state the design and construction and
disposal requirements for access equipment?
8.32 4.1 Do persons who design, construct and dispose of access equipment understand the
requirements?
8.33 4.1 Are there procedures being followed which state the use requirements for access
equipment?
8.34 4.1 Are there procedures being followed which state the actions to be undertaken if access
equipment are to be used as a work platform, and do these actions comply with
Section 5 of the standard?
8.35 4.1 Do persons who use access equipment understand the requirements?
8.36 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate before the first use?
8.37 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate at intervals determined by
the operating conditions?
8.38 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate prior to use following
repairs and modifications?
8.39 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate as soon as practicable and
prior to further use following an occurrence that could have affected the stability or
adequacy of the work platforms or access equipment e.g. fire, collision, earthquake,
overloading?
8.40 4.2 Is there a procedure being followed that requires scaffolds be inspected prior to first
use and every 14 days by a licensed and authorised scaffolder?
NA YES NO Documents that you should be able to
access and actions required
Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Manager
Page 47 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
8.41 4.2 Do persons who inspect work platforms and access equipment understand the
inspection requirements?
8.42 4.2 Are records kept of inspections that have been completed?
8.43 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced at intervals determined by the operating
conditions?
8.44 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced where inspections indicate a need?
8.45 4.2 Do persons who service work platforms and access equipment understand the
servicing requirements?
8.46 4.2 Are records kept of services carried out?
8.47 Is there a procedure being followed for the use of mancages and is it in accordance
with Appendix D4 of the standard
8.48 4.3 Are there procedures being followed which state the measures for fall protection for
vehicles, trucks and heavy equipment?
Do these measures comply with the requirements of the standard?
8.49 4.3 Do persons who work on mobile equipment understand the requirements?
8.50 4.3 Is work carried out on mobile equipment in accordance with the site requirements?
8.51 5 Are there procedures being followed which state that where persons are to work in an
area that has no work platform and has been deemed by the risk assessment, to require
controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured
to an appropriate anchorage?
8.52 5 Does this procedure state that PFAE only be used when all other control measures
have been explored and deemed to be inappropriate?
8.53 5 Do persons who work where there is no work platform understand the requirements
for PFRE and PFAE?
8.54 5 Is work carried out in accordance with this requirement?
8.55 5 Are there procedures being followed which state the requirements for anchorage
points? Do these requirements comply with Appendix J of this standard?
NA YES NO Documents that you should be able to
access and actions required
Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Manager
Page 48 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
8.56 5 Do persons who work where there is no work platform understand the requirements
and selection of the appropriate anchorage points?
8.57 5 Are appropriate anchorage points used?
8.58 5.1 Do the site procedures for working on roofs state that prior to working on or accessing
any roof a risk assessment shall be conducted?
8.59 5.1 Do the site procedures for working on roofs state that appropriate control measures
determined by the risk assessment shall be implemented?
8.60 5.1 Are there procedures being followed which state the structural integrity of a roof shall
be determined and confirmed to be sound before:
moving onto it?
storing materials on it?
rigging from it?
8.61 5.1 Are there procedures being followed which state where the integrity of the roof
cladding cannot be determined, but the support structure isappears sound, access onto
the roof shall be by boarding installed by a competent and authorised person?
8.62 5.1 Do persons who are responsible for work on roofs understand the required actions
prior to and whilst persons are working on the roof?
8.63 5.1 Do persons who work on roofs understand the required actions prior to and whilst
working on the roof?
8.64 5.1 Have risk assessment been conducted for work on roofs?
8.65 5.1 Have the required controls arising from risk assessments been implemented whilst
conducting work on roofs?
8.66 5.2 Are there procedures being followed which state PFAE shall be worn and secured to a
static line that extends to the working area?
8.67 5.2 Do persons who supervise or work in shrink stopes understand the
requirements?Counts
8.68 5.2 Do persons who work in shrink stopes comply with the standard?
8.69 6 Is there a procedure being followed for using PFRE and PFAE?
8.70 6 Does the procedure include anchorage points?
NA YES NO Documents that you should be able to
access and actions required
Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Manager
Page 49 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
8.71 6 Does the procedure include static lines?
8.72 6 Does the procedure include lanyards?
8.73 6 Does the procedure include inertia reel arrest devices?
8.74 6 Does the procedure include safety harnesses?
8.75 6 Does the procedure include safety climb systems?
8.76 6 Does the procedure include belay systems?
8.77 6 Is there a procedure being followed Is there a procedure for inspecting and servicing
PFRE, PFAE and anchorage points?
8.78 6 Is there a procedure Is there a procedure being followed for keeping records of
acquiring, inspecting, servicing and disposing of PFRE and PFAE (including rescue
equipment)?
8.79 6 Is there a procedure Is there a procedure being followed for ensuring that PFAE
rescue equipment is used only for rescue purposes?
8.80 6 Is there a procedure being followed for keeping records of PFAE rescue equipment
use?
8.81 6 Is there a procedure being followed for ensuring that persons required to use, inspect,
service and dispose of personal equipment are competent and authorised to do so?
8.82 6 Is there a procedure being followed for specifying the age and condition for disposal
for each item of PFRE and PFAE?
8.83 6 Are these procedures readily available to the workforce?
8.84 6 Do persons who are required to use these procedures understand the requirements
contained in them?
8.85 7 Is there a site procedure being followed for working around open holes that states a
risk assessment process shall be used to define the controls required when personnel
are exposed to open holes?
8.86 7 Is there a site procedure being followed for working around open holes that states
where indicated by the risk assessment, access points to an open hole shall have signs
identifying the risk?
8.87 7 Is there a site procedure being followed for working around open holes that states
additional access controls may include barricades and/or the use of PFRE?
NA YES NO Documents that you should be able to
access and actions required
Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Manager
Page 50 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
8.88 7 Is this procedure readily available to the workforce?
8.89 7 Do persons who are required to use this procedure understand the requirements of the
procedure?
Counts
NA YES NO Documents that you should be able to
access and actions required
Comments or Further action
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Manager
Page 51 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
4.9 Support Team Leader
No
Std
Ref
Questions to confirm compliance with the standard
9.1 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for the requirement that risk assessments are conducted only by
competent personnel?
9.2 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for selection of appropriate control measures by the hierarchy of
controls?
9.3 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for compliance with all applicable current statutory and regulatory
requirements
9.4 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for ensuring personnel are not exposed to hazards arising from
working at height?
9.5 1 Do the persons responsible understand their responsibilities?
9.6 2 Is there a written procedure being followed that states the site requirements to ensure
work is not undertaken, where there is the risk of falling, without adequate fall
prevention measures in place?
9.7 2 Does the written procedure include measures to ensure that where practicable, the
need to work where there is the risk of a fall is eliminated?
9.8 2 Does the written procedure include measures to ensure that risk assessments are
conducted before the commencement of work and at any time the scope of work
changes or the risk of a fall increases?
9.9 2 Does the written procedure include measures to ensure that appropriate measures are
selected using the hierarchy of controls (Elimination, substitution, redesign,
separation, administrative and personnel protective equipment) ?
9.10 2 Does the written procedure include measures to ensure that all equipment used is fitfor-purpose?
9.11 2 Does the written procedure include measures to ensure that at shift changes, incoming
personnel are aware of the measures being used for work in progress?
9.12 2 Do personnel who are responsible for conducting work at height understand the
required measures?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Leader
Page 52 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
9.13 2 Have risk assessments been conducted?
9.14 2 Are the required measures identified in the risk assessments implemented on site?
9.15 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities all excavation, construction, operating, modification and
maintenance activities for the foreseeable life of the asset are considered?
9.16 2.1 Is there a written requirement that in the design of new facilities and modifications to
existing facilities, provisions to prevent falls are clearly identified in specifications?
9.17 2.2 Where provisions to prevent falls were contained in purchasing specifications, and
these provisions were changed, were changes made only with the consent of the
originator of the specification?
9.18 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
9.19 3 Are all persons responsible for work carried out at height competent in the site
management systems used for the prevention of falls?
9.20 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) able to participate in a risk assessment of the work?
9.21 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) familiar with the control measures for fall prevention?
9.22 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) competent in the correct use of control measures?
9.23 3 Are competencies assessed and documented?
9.24 3 Has competence been assessed and confirmed by a person qualified and authorised for
the purpose and does their competence include training in workplace competence
assessment?
9.25 3.1 Is there an SWP procedure being followed which specifies the competency
requirements for emergency services personnel to conduct a ‘rope rescue’?
9.26 4.1 Are there procedures being followed which state the design, construction and disposal
requirements for work platforms?
9.27 4.1 Do persons who design, construct, and dispose of work platforms understand the
requirements?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Leader
Page 53 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
9.28 4.1 Are there procedures being followed which state the, use requirements for work
platforms?
9.29 4.1 Are there procedures being followed which state the actions to be undertaken if work
platforms do not meet the above requirements, and do these actions comply with
Section 5 of the standard?
9.30 4.1 Do persons who use work platforms understand the requirements?
9.31 4.1 Are there procedures being followed which state the design and construction and
disposal requirements for access equipment?
9.32 4.1 Do persons who design, construct and dispose of access equipment understand the
requirements?
9.33 4.1 Are there procedures being followed which state the use requirements for access
equipment?
9.34 4.1 Are there procedures being followed which state the actions to be undertaken if access
equipment are to be used as a work platform, and do these actions comply with
Section 5 of the standard?
9.35 4.1 Do persons who use access equipment understand the requirements?
9.36 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate before the first use?
9.37 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate at intervals determined by
the operating conditions?
9.38 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate prior to use following
repairs and modifications?
9.39 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate as soon as practicable and
prior to further use following an occurrence that could have affected the stability or
adequacy of the work platforms or access equipment e.g. fire, collision, earthquake,
overloading?
9.40 4.2 Is there a procedure being followed that requires scaffolds be inspected prior to first
use and every 14 days by a licensed and authorised scaffolder?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Leader
Page 54 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
9.41 4.2 Do persons who inspect work platforms and access equipment understand the
inspection requirements?
9.42 4.2 Are records kept of inspections that have been completed?
9.43 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced at intervals determined by the operating
conditions?
9.44 4.2 Are there procedures being followed which state that work platforms, access
equipment and access ways are to be serviced where inspections indicate a need?
9.45 4.2 Do persons who service work platforms and access equipment understand the
servicing requirements?
9.46 4.2 Are records kept of services carried out?
9.47 Is there a procedure being followed for the use of mancages and is it in accordance
with Appendix D4 of the standard
9.48 4.3 Are there procedures being followed which state the measures for fall protection for
vehicles, trucks and heavy equipment?
Do these measures comply with the requirements of the standard?
9.49 4.3 Do persons who work on mobile equipment understand the requirements?
9.50 4.3 Is work carried out on mobile equipment in accordance with the site requirements?
9.51 5 Are there procedures being followed which state that where persons are to work in an
area that has no work platform and has been deemed by the risk assessment, to require
controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured
to an appropriate anchorage?
9.52 5 Does this procedure state that PFAE only be used when all other control measures
have been explored and deemed to be inappropriate?
9.53 5 Do persons who work where there is no work platform understand the requirements
for PFRE and PFAE?
9.54 5 Is work carried out in accordance with this requirement?
9.55 5 Are there procedures being followed which state the requirements for anchorage
points? Do these requirements comply with Appendix J of this standard?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Leader
Page 55 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
9.56 5 Do persons who work where there is no work platform understand the requirements
and selection of the appropriate anchorage points?
9.57 5 Are appropriate anchorage points used?
9.58 5.1 Do the site procedures for working on roofs state that prior to working on or accessing
any roof a risk assessment shall be conducted?
9.59 5.1 Do the site procedures for working on roofs state that appropriate control measures
determined by the risk assessment shall be implemented?
9.60 5.1 Are there procedures being followed which state the structural integrity of a roof shall
be determined and confirmed to be sound before:
moving onto it?
storing materials on it?
rigging from it?
9.61 5.1 Are there procedures being followed which state where the integrity of the roof
cladding cannot be determined, but the support structure isappears sound, access onto
the roof shall be by boarding installed by a competent and authorised person?
9.62 5.1 Do persons who are responsible for work on roofs understand the required actions
prior to and whilst persons are working on the roof?
9.63 5.1 Do persons who work on roofs understand the required actions prior to and whilst
working on the roof?
.64 5.1 Have risk assessment been conducted for work on roofs?
9.65 5.1 Have the required controls arising from risk assessments been implemented whilst
conducting work on roofs?
9.66 5.2 Are there procedures being followed which state PFAE shall be worn and secured to a
static line that extends to the working area?
9.67 5.2 Do persons who supervise or work in shrink stopes understand the
requirements?Counts
9.68 5.2 Do persons who work in shrink stopes comply with the standard?
9.69 6 Is there a procedure being followed for using PFRE and PFAE?
9.70 6 Does the procedure include anchorage points?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Leader
Page 56 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
9.71 6 Does the procedure include static lines?
9.72 6 Does the procedure include lanyards?
9.73 6 Does the procedure include inertia reel arrest devices?
9.74 6 Does the procedure include safety harnesses?
9.75 6 Does the procedure include safety climb systems?
9.76 6 Does the procedure include belay systems?
9.77 6 Is there a procedure being followed Is there a procedure for inspecting and servicing
PFRE, PFAE and anchorage points?
9.78 6 Is there a procedure Is there a procedure being followed for keeping records of
acquiring, inspecting, servicing and disposing of PFRE and PFAE (including rescue
equipment)?
9.79 6 Is there a procedure Is there a procedure being followed for ensuring that PFAE
rescue equipment is used only for rescue purposes?
9.80 6 Is there a procedure being followed for keeping records of PFAE rescue equipment
use?
9.81 6 Is there a procedure being followed for ensuring that persons required to use, inspect,
service and dispose of personal equipment are competent and authorised to do so?
9.82 6 Is there a procedure being followed for specifying the age and condition for disposal
for each item of PFRE and PFAE?
9.83 6 Are these procedures readily available to the workforce?
9.84 6 Do persons who are required to use these procedures understand the requirements
contained in them?
9.85 7 Is there a site procedure being followed for working around open holes that states a
risk assessment process shall be used to define the controls required when personnel
are exposed to open holes?
9.86 7 Is there a site procedure being followed for working around open holes that states
where indicated by the risk assessment, access points to an open hole shall have signs
identifying the risk?
9.87 7 Is there a site procedure being followed for working around open holes that states
additional access controls may include barricades and/or the use of PFRE?
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Leader
Page 57 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
9.88 7 Is this procedure readily available to the workforce?
9.89 7 Do persons who are required to use this procedure understand the requirements of the
procedure?
Counts
NA YES NO Documents that you should be able to
access and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Leader
Page 58 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
4.10 Support Team Member
No
Std
Ref
Questions to confirm compliance with the standard
NA
YES NO Documents that you should be able to access
and actions required
Comments
10.1 1 Does the site have a written policy and procedures for working at height that includes
the responsibilities for the requirement that risk assessments are conducted only by
competent personnel?
10.2 2 Is there a written procedure being followed that states the site requirements to ensure
work is not undertaken, where there is the risk of falling, without adequate fall
prevention measures in place?
10.3 2 Does the written procedure include measures to ensure that where practicable, the
need to work where there is the risk of a fall is eliminated?
10.4 2 Does the written procedure include measures to ensure that risk assessments are
conducted before the commencement of work and at any time the scope of work
changes or the risk of a fall increases?
10.5 2 Does the written procedure include measures to ensure that appropriate measures are
selected using the hierarchy of controls (Elimination, substitution, redesign,
separation, administrative and personnel protective equipment) ?
10.6 2 Does the written procedure include measures to ensure that all equipment used is fitfor-purpose?
10.7 2 Does the written procedure include measures to ensure that at shift changes, incoming
personnel are aware of the measures being used for work in progress?
10.8 2 Do personnel who are responsible for conducting work at height understand the
required measures?
10.9 3 Is carrying out a risk assessment for safe working at height part of the site competence
program for persons who are to work where there is the risk of falling (and their
supervisors)?
10.10 3 Are all persons responsible for work carried out at height competent in the site
management systems used for the prevention of falls?
10.11 3 Are persons who will be required to work where they are exposed to a risk of falling
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Member
Page 59 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
(and their supervisors) able to participate in a risk assessment of the work?
NA
YES NO Documents that you should be able to access
and actions required
Comments
10.12 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) familiar with the control measures for fall prevention?
10.13 3 Are persons who will be required to work where they are exposed to a risk of falling
(and their supervisors) competent in the correct use of control measures?
10.14 3 Are competencies assessed and documented?
10.15 3.1 Is there an SWP procedure being followed which specifies the competency
requirements for emergency services personnel to conduct a ‘rope rescue’?
10.16 4.1 Are there procedures being followed which state the, use requirements for work
platforms?
10.17 4.1 Are there procedures being followed which state the actions to be undertaken if work
platforms do not meet the above requirements, and do these actions comply with
Section 5 of the standard?
10.18 4.1 Do persons who use work platforms understand the requirements?
10.19 4.1 Are there procedures being followed which state the design and construction and
disposal requirements for access equipment?
10.20 4.1 Do persons who design, construct and dispose of access equipment understand the
requirements?
10.21 4.1 Are there procedures being followed which state the use requirements for access
equipment?
10.22 4.1 Are there procedures being followed which state the actions to be undertaken if access
equipment are to be used as a work platform, and do these actions comply with
Section 5 of the standard?
10.23 4.1 Do persons who use access equipment understand the requirements?
10.24 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate before the first use?
10.25 4.2 Are there procedures being followed which state that work platforms and access
equipment shall be inspected to confirm they are adequate prior to use following
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Member
Page 60 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
repairs and modifications?
10.26 4.2 Is there a procedure being followed that requires scaffolds be inspected prior to first
use and every 14 days by a licensed and authorised scaffolder?
10.27 4.2 Do persons who inspect work platforms and access equipment understand the
inspection requirements?
10.28 4.2 Are records kept of inspections that have been completed?
10.29 4.2 Do persons who service work platforms and access equipment understand the
servicing requirements?
10.30 4.2 Are records kept of services carried out?
10.31 4.3 Is there a procedure being followed for the use of mancages and is it in accordance
with Appendix D4 of the standard
10.32 4.3 Are there procedures being followed which state the measures for fall protection for
vehicles, trucks and heavy equipment?
Do these measures comply with the requirements of the standard?
10.33 4.3 Do persons who work on mobile equipment understand the requirements?
10.34 4.3 Is work carried out on mobile equipment in accordance with the site requirements?
10.35 5 Are there procedures being followed which state that where persons are to work in an
area that has no work platform and has been deemed by the risk assessment, to require
controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured
to an appropriate anchorage?
10.36 5 Does this procedure state that PFAE only be used when all other control measures
have been explored and deemed to be inappropriate?
10.37 5 Do persons who work where there is no work platform understand the requirements
for PFRE and PFAE?
10.38 5 Is work carried out in accordance with this requirement?
10.39 5 Do persons who work where there is no work platform understand the requirements
and selection of the appropriate anchorage points?
NA
YES NO Documents that you should be able to access
and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Member
Page 61 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
NA
YES NO Documents that you should be able to access
and actions required
Comments
10.40 5 Are appropriate anchorage points used?
10.41 5.1 Do the site procedures for working on roofs state that prior to working on or accessing
any roof a risk assessment shall be conducted?
10.42 5.1 Do the site procedures for working on roofs state that appropriate control measures
determined by the risk assessment shall be implemented?
10.43 5.1 Are there procedures being followed which state the structural integrity of a roof shall
be determined and confirmed to be sound before:
• moving onto it?
• storing materials on it?
rigging from it?
10.44 5.1 Are there procedures being followed which state where the integrity of the roof
cladding cannot be determined, but appears sound, access onto the roof shall be by
boarding installed by a competent and authorised person?
10.45 5.1 Do persons who work on roofs understand the required actions prior to and whilst
working on the roof?
10.46 5.1 Have risk assessment been conducted for work on roofs?
10.47 5.1 Have the required controls arising from risk assessments been implemented whilst
conducting work on roofs?
10.48 5.2 Are there procedures being followed which state PFAE shall be worn and secured to a
static line that extends to the working area?
10.49 5.2 Do persons who supervise or work in shrink stopes understand the requirements?
10.50 5.2 Do persons who work in shrink stopes comply with the standard?
10.51 6 Is there a procedure being followed for using PFRE and PFAE?
10.52 6 Does the procedure include anchorage points?
10.53 6 Does the procedure include static lines?
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Member
Page 62 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
No
Std
Ref
Questions to confirm compliance with the standard
10.54 6 Does the procedure include lanyards?
10.55 6 Does the procedure include inertia reel arrest devices?
10.56 6 Does the procedure include safety harnesses?
10.57 6 Does the procedure include safety climb systems?
10.58 6 Does the procedure include belay systems?
10.59 6 Is there a procedure being followed for inspecting and servicing PFRE, PFAE and
anchorage points?
10.60 6 Is there a procedure being followed for ensuring that persons required to use, inspect,
service and dispose of personal equipment are competent and authorised to do so?
10.61 6 Is there a procedure being followed for specifying the age and condition for disposal
for each item of PFRE and PFAE?
10.62 6 Are these procedures readily available to the workforce?
10.63 6 Do persons who are required to use these procedures understand the requirements
contained in them?
10.64 7 Is there a site procedure being followed for working around open holes that states a
risk assessment process shall be used to define the controls required when personnel
are exposed to open holes?
10.65 7 Is there a site procedure being followed for working around open holes that states
where indicated by the risk assessment, access points to an open hole shall have signs
identifying the risk?
10.66 7 Is there a site procedure being followed for working around open holes that states
additional access controls may include barricades and/or the use of PFRE?
10.67 7 Is this procedure readily available to the workforce?
10.68 7 Do persons who are required to use this procedure understand the requirements of the
procedure?
Counts
NA
YES NO Documents that you should be able to access
and actions required
Comments
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Member
Page 63 of 64

Major Hazard Audit Protocol
Safe Working at Heights – Self Assessment Questionnaire
** Uncontrolled copy. Printed 5/10/04 **
SAF-MHSAQ-08 Rev 1 Issued: 11/07/00
Support Team Member
Page 64 of 64