S ty §=an,4 | DON’T WALK BY S Y ZERO HARM Location: [2\_C. No: () 05 093 [Pater 02 Jio Jona Times O44) [Surervser: VG, Din Sionatre: —(V Recommend 7 Oo Stop Works O FixHazard [{~ Manage Hazard Rating Unsafe Act / Unsafe condition: Dur Praseol ive, Main f towne Yoo Snoiley Ky OSER Vessel, Q pes FOMAL Inshuclsel Lo Weeradditionl aCe. Schiel nek Gane de Nee A Footed clust, rust Wate > CYe voPection , eye. Cantecd With Lhe YUSI rt * Working at height 0 Excavated area Plant / Equipment 1 Scaffolds and Ladders Oo oO Os Trip hazard O Electrical hazar« 0 Barriers EX PPE WA o // — o G Handling (Health Noise O Other WE jategory: 0 A-Potential to result in fatal or major injuries 1 B- Potential to result in minor injuries 1 C- Minimal risk or injury Name of observer: u Russen JonDON’T WALK BY ZERO HARM Date: 09/10/2002: Supervisor: \/ G Time: [3d Signature: iy o Recommend a Fix Hazard Stop Works Hazard Rating Ou am eae Ss 0 ior Prov Proper Hes Cet \nsistee! eo 0 Working at aie O Excavated area O Barriers a Handling | Noise O1 Other Category: 1 A- Potential to result in fatal or major injuries EX B- Potential to result in minor injuries O C- Minimal risk or injury PPE insafe Act / Unsafe condi jope Oorving dhe a of Sree tore arn ith i Fe Cortife i 0 Plant / Equipment 1 Scaffolds and Ladde O Trip hazard O Electrical hazard Wife 7 g h Qo Health Gates (One v lan© sactztciy | PONT WALK BY Site:- ZERO HARM Location: No: 5095 Date: |7 Time: 04 Supervisor: Cie X\\lo/ Signature: Recommend 7 Stop Works & Fix Hazard Manage Hazard Rating Ou om Bue — = | Unsafe ee During Wealey ie Rc book - Poo Vodtor Ja heater AKL bank & a db chein Valve. hepa Cloreat, (errd distity Shut of Wdlun © Chose] drain Nalve of tac tok Properly « Hager s Stip | Waly Warlege « 1 Working at height 0 Excavated area 0 ~Plant/ Equipment O Scaffolds and Ladders Trip hazard O Electrical hazar, O Barriers O PPE IE Yk 1 Handling O Health Oo [Other : Ge 6 = Category: 0 A-Potential to result in fatal or major injuries 1 $#B- Potential to result in minor injuries 0 C- Minimal risk or injury Name of observer: Russel. Tot 2° copy Client Date: \3/lo/22_ 3 copy Worker 1 copy Supervisor = |@ ssuese: DON’T WALK BY ZERO HARM Location: R Ae No: 005096 Date: Time: Supervisor: go Recommend [O stop Works & FixHazard Hazard Rating Ou om Oe Unsafe Act / Unsafe condition: Duswg Preevend WE mandanant aera run tomes Solkw P Pack Iwadet hese on wodiadoy do wesenve Cooknt Tons Flurol Leaking immact itl 4 nodiFea Gha Imecham< omol Sdo? the system (Realace ay g ot 1 Working at height O Excavated area Ende ft Plant / Equipment 0 Scaffolds and Ladders 01 Trip hazard O Electrical haza A 0 #Barriers O PPE ba 0 Handling [4 Health (gal ee | |D1 Noise [4 Other —_ ‘Category: 1 +A-Potential to result in fatal or major injuries [$6 Potential to result in minor injuries 1 C- Minimal risk or injury Name of observer: | Signature: Alum Paws S [copy Supervisor [2 copy client] 3" copy WorkerLocation: QL¢ No: 00: 097 Date: 21 |.0) 2022. Time: 10 Supervisor: J in Py. Lay __ Signature: [\ ty Recommend =) FixHazard >” Manage Stop Works SA | Hazard Rating Unsafe Act / Unsafe condition: Downey Ere C2ePzanon fos UPiwy acd a5) of Nesse\ ~A\- madd -Ay-Alcdnas 4 Foord Ere WER y CO'OYT WAS Missicy| 01 OTe SII Crece and Con®sered Ene Pack Byos wase \BRered Cod erica corvoos COSA aefiieds 1 Working at height Excavated area 1 *~Plant/ Equipment Scaffolds and Ladders oO Oo 0 Trip hazard O Electrical haz: Y, O Barriers O PPE MIA fa Handling CO Health = O Noise Other ZoLkS Category: 1 A-Potential to result in fatal or major injuries Ch Oo B- Potential to result in minor injuries 1 C- Minimal risk or injury Name of observer: ALQN DAS 1" copy Supervisor Signature: 2" copy Client 3" copy Worker