TAKE TIME TAKE CHARGE - Surface

Type of TTTC: Individual Group Time / Date:

Work Location:

Task Description:

IDENTIFY THE HAZARDS / ENERGY SOURCES PRESENT

1. Gravity 2. Chemical 3. Mechanical

4. Noise & Vibration 5. Biological 6. Thermal

7. Motion 8. Manual Handling 9. Radiation

10. Vehicle Interaction 11. Electrical 12. Pressure

Other - Please list

CONTROLLING ENERGY SOURCES - Document below high risk items (maximum 4)

Remove - the Energy Source (Elimination / Substitution) Prevent - the Release (Redesign / Separation)
Protect - People from the Release (Separation / Admin / PPE)

Energy No Controls in Place or to be Implemented

Olympic Dam Document No. 114531 V.1 Page 1 Issued: 12 April 2013
Name/s:

Do you have functioning radio Communications? Yes No NA

Safety Shower Accessible and Operational Yes No NA

Fire Extinguisher Accessible and in date Yes No NA

SIMULTANEOUS OPERATIONS (SIMOPS)

if present this hazard is being controlled by;
Will there be SIMOPS YES NO
PTW THA
Does your work instruction or THA cover the hazards above?
YES - Continue with task NO - Contact your Supervisor N/A - Not Applicable

IS MY AREA CLEAN AND SET UP FOR ME TO COMPLETE THIS TASK SAFELY

I can rectify myself (Complete work and start task)

YES NO
I need additional support (Contact your supervisor)

AM I FIT FOR WORK & ADEQUATELY TRAINED FOR THIS TASK?

YES Continue with task NO Contact your Supervisor

RISK ASSESSMENT – After implementing controls can I work safely?

YES Continue with task NO Contact your Supervisor

AREA RE-ENTRY OR REPEATED TASK

Reviewed TTTC and confirmed conditions are unchanged for area and task. Energy
sources and controls reviewed and are deemed suitable and functioning as designed.

Time

Initial

Supervisor Sign Off:

Supervisor:
Name Signature Date

Signed (IN FIELD) Signed (End of Shift)

Supervisor shall sign TTTC’s daily either at the worksite or at the end of shift
For any further actions an Event Notification will be raised in Fpe by the Supervisor

Event Notification /SAP Notification #

Olympic Dam Document No. 114531 V.1 Page 2 Issued: 12 April 2013