Plant and Equipment Risk Assessment Template WHS-PRO-TEM-002b
Electronic copies of this checklist are current. All other copies are uncontrolled and currency can only be assured at the time of printing

This template is designed to be used prior to purchasing a piece of equipment. To assist in completing this template the WHS Unit have provided a sample completed Plant and Equipment Risk Assessment Template which can be found at this link.
Name of Item:
Manufacturer / Make / Model:
Supplier:
Division:
Proposed use:
Assessment Team:	Signature:	Date:
Assessment Team:	Signature:	Date:
Assessment Team:	Signature:	Date:

Design and manufacture:

Is the plant designed and manufactured in accordance with a relevant standard (e.g. Australian Standard) / competent person?

☐ No	☐ Yes	☐ N/A	Standard name / number:
Competent person:

Registration / certification:

Is the plant registered / certified, if required?

List of plant requiring registration in accordance with the WHS Regulations Part 2 Schedule 5 https://www.legislation.qld.gov.au/view/html/inforce/current/sl-2011-0240#sch.5

☐ No	☐ Yes	☐ N/A	Details:

Modifications:

Has the plant been modified in any way? ☐ Yes ☐ No (if no, go to question 4)

List Modifications:
Qualifications of person modifying item of plant?
Certification number / engineering report for modifications:	☐ Yes Number / Date of report:
Do these modifications add WHS risks?

Second hand plant:

Is the plant second hand? ☐ Yes ☐ No (if no, go to question 5)

Is a written notice outlining the condition of the plant, any faults identified available (from supplier)?
Have faults been repaired / made safe?
Has plant safety been assessed by a competent person? Who is the competent person

Documentation:

☐ Design safety documentation
☐ Manufacturers installation, operation and maintenance manual
☐ Approved plans / calculations
☐ Safety data sheets
☐ Certifications

Licensing / Qualification / Competency Requirements:

☐ Installation
☐ Operating
☐ Maintenance / Servicing
☐ Repair

Identify the hazards and control:	Detail the controls for each applicable risk:

Hazards	Yes	No	Controls
Can anyone be crushed due to: material falling off the plant? uncontrolled or unexpected movement of the plant? lack of capacity for the plant to be slowed, stopped or immobilised? the plant tipping or rolling over? parts of the plant collapsing? coming into contact with moving parts of the plant during testing, inspection, operation, maintenance, cleaning or repair? being thrown off or under plant? being trapped between the plant and materials or fixed structures? other factors not mentioned?	☐	☐
Can anyone be stabbed or punctured due to: coming in contact with sharp or flying objects? coming in contact with moving parts during testing, inspection, operation, maintenance, cleaning or repair? the plant, parts of the plant or work pieces disintegrating? work pieces being ejected? the mobility of the plant? uncontrolled or unexpected movement of the plant? other factors not mentioned?	☐	☐
Can anyone’s body parts be sheared between two parts of the plant, or between a part of the plant and a work piece or structure?	☐	☐
Can anyone be struck by moving objects due to: uncontrolled or unexpected movement of the plant or material handled by the plant? the plant, parts of the plant or work pieces disintegrating? work pieces being ejected? mobility of the plant? other factors not mentioned?	☐	☐
Can anyone come into contact with fluids under high pressure, due to plant failure or misuse of the plant?	☐	☐
Can anyone be injured by electrical shock or burnt due to: the plant contacting live electrical conductors? the plant working in close proximity to electrical conductors? overload of electrical circuits? damaged or poorly maintained electrical leads and cables? damaged electrical switches? water near electrical equipment? lack of isolation procedures? other factors not mentioned?	☐	☐
Can anyone be injured by explosion of gases, vapours, liquids, dusts or other substances, triggered by the operation of the plant or by material handled by the plant?	☐	☐
Can anyone be injured due to: poorly designed seating? poorly designed operator controls? high forces? repetitive movements? awkward body posture or the need for excessive effort? vibration? other factors not mentioned?	☐	☐
Can anyone be injured due to unexpected start-up, unexpected over-run/over-speed (or similar malfunction) from: failure/disorder of the control system(e.g. a hydraulic system)? restoration of energy supply after an interruption? external influences on electrical equipment? other environmental factors (gravity, wind, etc.)? errors in the software? errors made by the operator?	☐	☐
Can anyone be injured due to: noise (greater than 85dB, interferes with communication)? inadequate or poorly placed lighting? entry into any confined spaces of the plant? failure to select plant that is suitable for its intended use? contact with hot or cold parts of plant? exposure to hazardous chemicals, radiation or other emissions released by the plant? exposure to biological substances? lack of operator competency? other factors not mentioned?	☐	☐

Servicing / Maintenance requirements (including calibration):

☐ Added to maintenance schedule (as per manufacturers recommendations)
☐ Modifications to manufacturers recommendations for servicing / maintenance
☐ Issues:

JCU Inspection requirements specific to this item of plant:

Are there any inspections requirements for this plant (separate to maintenance inspections identified above)?	☐ Yes ☐ No

Safe work procedure (SWP):

Is a safe work procedure / safe operating procedure required?	☐ Yes ☐ No

Person responsible for developing SWP?
Completion date:

Consultation: