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

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Major Hazard Audit Protocol<br />

<strong>Safe</strong> <strong>Working</strong> <strong>at</strong> <strong>Height</strong>s – <strong>Self</strong> <strong>Assessment</strong> <strong>Questionnaire</strong><br />

** Uncontrolled copy. Printed 5/10/04 **<br />

No.<br />

Std<br />

Ref<br />

Questions to confirm compliance with the standard<br />

5.56 5 Do persons who work where there is no work pl<strong>at</strong>form understand the requirements<br />

and selection of the appropri<strong>at</strong>e anchorage points?<br />

5.57 5 Are appropri<strong>at</strong>e anchorage points used?<br />

5.58 5.1 Do the site procedures for working on roofs st<strong>at</strong>e th<strong>at</strong> prior to working on or accessing<br />

any roof a risk assessment shall be conducted?<br />

5.59 5.1 Do the site procedures for working on roofs st<strong>at</strong>e th<strong>at</strong> appropri<strong>at</strong>e control measures<br />

determined by the risk assessment shall be implemented?<br />

5.60 5.1 Are there procedures being followed which st<strong>at</strong>e the structural integrity of a roof shall<br />

be determined and confirmed to be sound before:<br />

moving onto it?<br />

storing m<strong>at</strong>erials on it?<br />

rigging from it?<br />

5.61 5.1 Are there procedures being followed which st<strong>at</strong>e where the integrity of the roof<br />

cladding cannot be determined, but the support structure isappears sound, access onto<br />

the roof shall be by boarding installed by a competent and authorised person?<br />

5.62 5.1 Do persons who are responsible for work on roofs understand the required actions<br />

prior to and whilst persons are working on the roof?<br />

5.63 5.1 Do persons who work on roofs understand the required actions prior to and whilst<br />

working on the roof?<br />

5.64 5.1 Have risk assessment been conducted for work on roofs?<br />

5.65 5.1 Have the required controls arising from risk assessments been implemented whilst<br />

conducting work on roofs?<br />

5.66 5.2 Are there procedures being followed which st<strong>at</strong>e PFAE shall be worn and secured to a<br />

st<strong>at</strong>ic line th<strong>at</strong> extends to the working area?<br />

5.67 5.2 Do persons who supervise or work in shrink stopes understand the<br />

requirements?Counts<br />

5.68 5.2 Do persons who work in shrink stopes comply with the standard?<br />

5.69 6 Is there a procedure being followed for using PFRE and PFAE?<br />

5.70 6 Does the procedure include anchorage points?<br />

5.71 6 Does the procedure include st<strong>at</strong>ic lines?<br />

NA YES NO Documents th<strong>at</strong> you should be able to<br />

access and actions required<br />

Comments<br />

SAF-MHSAQ-08 Rev 1 Issued: 11/07/00<br />

Maintenance Manager<br />

Page 30 of 64

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