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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 />

8.41 4.2 Do persons who inspect work pl<strong>at</strong>forms and access equipment understand the<br />

inspection requirements?<br />

8.42 4.2 Are records kept of inspections th<strong>at</strong> have been completed?<br />

8.43 4.2 Are there procedures being followed which st<strong>at</strong>e th<strong>at</strong> work pl<strong>at</strong>forms, access<br />

equipment and access ways are to be serviced <strong>at</strong> intervals determined by the oper<strong>at</strong>ing<br />

conditions?<br />

8.44 4.2 Are there procedures being followed which st<strong>at</strong>e th<strong>at</strong> work pl<strong>at</strong>forms, access<br />

equipment and access ways are to be serviced where inspections indic<strong>at</strong>e a need?<br />

8.45 4.2 Do persons who service work pl<strong>at</strong>forms and access equipment understand the<br />

servicing requirements?<br />

8.46 4.2 Are records kept of services carried out?<br />

8.47 Is there a procedure being followed for the use of mancages and is it in accordance<br />

with Appendix D4 of the standard<br />

8.48 4.3 Are there procedures being followed which st<strong>at</strong>e the measures for fall protection for<br />

vehicles, trucks and heavy equipment?<br />

Do these measures comply with the requirements of the standard?<br />

8.49 4.3 Do persons who work on mobile equipment understand the requirements?<br />

8.50 4.3 Is work carried out on mobile equipment in accordance with the site requirements?<br />

8.51 5 Are there procedures being followed which st<strong>at</strong>e th<strong>at</strong> where persons are to work in an<br />

area th<strong>at</strong> has no work pl<strong>at</strong>form and has been deemed by the risk assessment, to require<br />

controls to prevent falls, persons should wear fall-restraint equipment (PFRE) secured<br />

to an appropri<strong>at</strong>e anchorage?<br />

8.52 5 Does this procedure st<strong>at</strong>e th<strong>at</strong> PFAE only be used when all other control measures<br />

have been explored and deemed to be inappropri<strong>at</strong>e?<br />

8.53 5 Do persons who work where there is no work pl<strong>at</strong>form understand the requirements<br />

for PFRE and PFAE?<br />

8.54 5 Is work carried out in accordance with this requirement?<br />

8.55 5 Are there procedures being followed which st<strong>at</strong>e the requirements for anchorage<br />

points? Do these requirements comply with Appendix J of this standard?<br />

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

access and actions required<br />

Comments or Further action<br />

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

Support Manager<br />

Page 48 of 64

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