Service Stream Version: 8.
2
Job Safety Environmental Analysis (JSEA) Issue Date:
SSFC (all nbn Contract Types) CCD-P-TMP-SSFC-193 7/08/2024
Date: 20 3 2024 Time: 9 30 AM Project:
Unity Services
Contracting Company: Value Services Job Location: UNIT 3, 249 PRESTON POINT RD BICTON, W
Emergency Evacuation Point: Area on Front of house Closest Medical Facility: Boorqgoon Medical Center
If the work activity or conditions change, you must review the hazards and controls
HAZARDS CONTROL MEASURES TAKEN
(If “Y” must have controls in place & recorded below prior to
IS THE RISK APPLICABLE TO THE WORK TO BE CONDUCTED?
commencement of any work)
(circle ‘Y’, ’N’ or ‘NA’)
All members of the work crew been inducted into the SWMS Yes All members have signed JSEA
Asbestos Containing Materials No must be licensed to remove or disturb ACM
Fire, explosive, ignition, spark (hot work) sources Yes Fire extinguisher in hand
Excessive noise Yes Ear muffs worn when using hammer drill
Hazardous Chemicals (substances and/or dangerous goods) Yes SDD on hand
Poor lighting conditions (dusk, night work, within building) Yes Head Lamp
Adverse weather conditions - (heat, cold, rain, natural disasters) No Monitor weather forecast, incorporate forecast, sha
Geographically remote location No
Working in isolation N/A
Slips, trips, falls Yes Uneven surface, visual inspection
Exposure to laser / UV / direct sunlight Yes Safety goggles, sunscreen
Presence of potentially dangerous animals (dogs, snakes, insects) No Confirm with customer about dogs or other animals
Biological hazards (syringes, unhygienic work environment) Yes Use sharps kits
Is everyone fit for work i.e., free from the effects of drugs and Note: Maximum worktime shall not exceed 12 hours (does not
alcohol, have minimum 10-hour break from the time of your last include shift handover and travel time) and shall not extend
work shift. Yes beyond 14 hours, without completing the Individual Fatigue
Management – Risk Assessment Worksheet.
Does the work impact Vehicle Traffic and/or Pedestrians? Y / N If yes, complete this section
Impact (incl. where a work vehicle/mobile plant may be placed or in
use) to restricted/no-standing zone, parking clearway, bus stop, No Contact Field Supervisor Engage Traffic Management
tramway, hospital, school, childcare centre, shopping centre, etc Provider
Will parking of a vehicle reduce the available road width to less than
6m for two-way traffic or 3m for one-way traffic? Contact Field Supervisor Engage Traffic Management
No Provider
Will the worksite impact a driveway or access to a property? No Contact Field Supervisor Inform occupants at the property
Will the worksite clearance to vehicle traffic be less than 1.2m? No Refer to TGS Card selection flowchart
Will the worksite vehicle traffic be greater than 60kph? No Posted Speed Limit: Refer to TGS selection flowchart
Will the vehicle traffic volume be greater than 40 vehicle per hour? No Refer to TGS Card selection flowchart
Will approaching vehicle traffic have at least 100m of clear line Refer to TGS Card selection
of site to the worksite? Yes flowchart
Will the clearance for pedestrian traffic be less than 1.2m wide? No Refer to Pedestrian selection flowchart
Will pedestrians be required to use the other side of the road? No Refer to Pedestrian selection flowchart
If TGS Card implemented for site, what TGS card is selected? 1 Traffic Management Provider -
Does the work involve accessing / working in/on pits or manholes? Y / N / NA If yes, complete this section
Confined space (Telstra Special Work Location SWL) N/A
Confined space (Telstra Temporary Hazard Location THL) N/A Do Not access. Contact Service Stream Supervisor
Contaminants (sediment, water, gas detection) N/A
Unsafe access (ladder condition etc.) N/A
Remediation of pits, manholes, ducts N/A
Gas Readings: O2: CO: H2S: LeL: Gas Readings: O2: CO: H2S: LeL:
Does the work involve working at height (pole/aerial work, accessing roof)? Y / N / NA If yes, complete this section
Risk of fall greater than 2m (consider inspection of PPE/Equipment) Yes Use gutter guard, 3 point contact, 4:1 ladder
Pole access – pole has been inspected as safe to climb No
Work involving use of an EWP No
Work at height (for pole work – check Asset Owner Accreditation) No Slide tiles
Work at height (roof access – check with Field Supervisor) No Contact Field Supervisor
Electrical hazards (roof space, overhead, NO-GO/Exclusion Zones) Yes Consider install method of ntd
Work being undertaken above (Exclusion Zone, falling objects) No LOTO spotter at power box
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nbn Contract Types: retain and/or upload completed JSEA onto relevant system (e.g., ETA, as necessary)
Service Stream Version: 8.2
Job Safety Environmental Analysis (JSEA) Issue Date:
SSFC (all nbn Contract Types) CCD-P-TMP-SSFC-193 7/08/2024
Does the work require access to roof / ceiling or underfloor space? Y / N / NA If yes, complete this section
Fragile structure/surface/manhole/suspended ceiling Yes Visual inspection
High temperature inside roof / ceiling space No Put EA plans, use spotter for regular contact
Electrical hazards Yes isolate energy sources
Restricted space Yes Wear Head Protection
Poor ventilation Yes Keep manhole open for 5 min to let the airflow
Recently sprayed chemicals (insecticides / pesticides) No Visual Inspection
Does the work involve drilling into building materials cavities? Y / N / NA If yes, complete this section
Services inside building walls / cavities (gas, electricity, water, other) - must confirm location of services using wall scanner, camera
Electrical hazards - isolate energy sources
Does the work involve any manual handling hazards? Y / N / NA If yes, complete this section
Extensive bending / twisting Yes Use pit key, knee bends
Sustained or awkward postures over a long duration N/A
Lifting, lowering or sudden forces N/A
Whole body or hand & arm vibration (jackhammer etc.) Yes Use hammer drill with PPE
Pushing or pulling Yes Use proper technique to haul
Does the work involve any environmental hazards? Y / N / NA If yes, complete this section
Spills or contaminated soil or water (hazardous materials) N/A
Stormwater or sediment controls / bunding N/A
Dewatering - Ceiling Space hold points(stop)
Air quality or dust emissions -
Disturbance to flora or fauna Yes Wear Masks
Noise or vibrations Yes Use ear muffs during power drills
Cultural heritage & archaeology, native title -
Waste generation, management, and disposal (incl. materials, water) Yes Collect waste and put it on bin
Spreading of weeds and pests N/A
Use of pesticides / insecticides N/A
Fire or bushfire prevention Yes Isolate power sources
Other N/A
List any additional identified hazards and controls (If any hazards identified are not listed on the SWMS or HSEMP, must contact Supervisor)
Required safety equipment
PPE (Overalls, Safety Boots, Hearing Protection, Safety Glasses, Fire Extinguisher (checked within last 6
Long Sleeve Hi-Vis Shirt, Work Gloves, P1 or P2 Rated Dust Mask) Yes months) Yes
Electrical Equipment (tested & tagged) No First Aid Kit (checked within last 6 months) Yes
Fall Prevention PPE/Equipment (ladder, harness, ropes, lanyard in Plant/equipment (Authorisation Certificate,
good condition, within expiry date) Yes pre-start check completed, good condition) Yes
REMEMBER: Any member of the work party has the authority to stop work if unsafe. Work must not recommence until all persons are satisfied the
worksite is safe. If the workplace hazards cannot be effectively eliminated or minimised so the work can be performed safely, the work activity must not
start until additional controls are implemented. If in doubt, please contact Service Stream Supervisor prior to starting work.
All members of the work crew have reviewed this JSEA and understand their role in the safe completion of the work. ✔ YES NO
Prior to signing all workers must be aware of the risks involved in performing the task and the control measures in place; have been consulted in the
identification of worksite hazards; and are satisfied that all foreseeable risks have been controlled and documented.
ALL visitors are to be inducted to this JSEA and sign off as acknowledgement of their understanding of site hazards and controls.
NAME ROLE SERVICE STREAM ID # SIGNATURE
Asfand Yar Akram Tech
Mark B FS
Page 2 of 3
nbn Contract Types: retain and/or upload completed JSEA onto relevant system (e.g., ETA, as necessary)
Service Stream Version: 8.2
Job Safety Environmental Analysis (JSEA) Issue Date:
SSFC (all nbn Contract Types) CCD-P-TMP-SSFC-193 7/08/2024
Does the work involve excavation, trenching, horizontal boring?
Excavations – Specific Risk Controls Standard Controls Y N/A
Ground Surface penetration (excluding pot holing) which involves:
a. Use of any powered equipment or machinery to penetrate or excavate by any means
(excluding use of a vacuum truck for potholing purposes)
b. Use of a grundomat or directional drill rig ServiceStream CCD-C-FRM-2276
c. Installation of an earth stake Authority to Work - Locating
d. Installation of star pickets to a depth exceeding 30cm/300mm Underground Services authorisation
e. Hand digging to a depth exceeding 50cm/500mm (except when removing/replacing
an existing telco pit)
f. Vacuum extraction/hydrovac to any depth greater than 150cm/1500mm
g. Where the asset owner requires you to be authorised under a/their permit or where
is required
✔
their representative will be on site. Note: When the asset owner’s cover letter/plans
contain Critical Assets requiring either work permits or permissions, asset owner
approval or to be present on site – Adhere to the ATW permit conditions and contact
your Service Stream Supervisor.
Any other ground surface penetration including but not limited to:
a. Use of a concrete saw, grinder, jackhammer, or other electrical/air operated/petrol
powered equipment to breakout /Cut materials such as asphalt or concrete The work authorisation process below
b. Hand digging to a depth less than 50cm/500mm
c. Installation of star pickets to a depth less than 30cm/300mm
d. Vacuum extraction/hydrovac to a depth less than 150cm/1500mm
must be completed BEFORE work
commences ✔✔
Note: at least one of the above must be selected as Yes and the required work authorisation process put in place.
Other Ground Surface Penetration Work Authorisation Y N/A
BYDA and/or other equivalent plans are on site, continuously available and have been reviewed?
A visual inspection of the area around the proposed excavation for buried service markers has been conducted e.g., visual indicators,
ground depressions/repairs, service pits, valve covers, control cabinets?
Residents, tenants, or owners have been consulted on location of services for works on private property? Where planned work may
risk striking underground services, Service Stream has consulted with the Client to identify possible alternatives to excavating near
the service.
All underground services are positively identified for all services that intersect or run parallel to the path of excavation.
This includes potholing at a frequency that predictably shows depth and alignment.
Service location and a Service sweep of the area has been completed by a worker who has completed RIICCM202D - Identify, locate,
and protect underground services training? ✔
Services identified on the above plans and through visual inspection have been positively located by vacuum excavation or hand
digging (potholed) and marked out? ✔
If potholing is not achievable or permitted – has the Supervisor / Senior Supervisor been consulted for alternate methods / controls? ✔
Non-energised electrical circuits such as timer-controlled lights, pumps & power points were
considered, and a visual search has been conducted. Where identified they have been energised and located?
Materials/equipment to protect identified services are available for use where the excavation or ground disturbance is required
adjacent to these existing buried services? ✔
Workers have been briefed on the type and location of the buried services?
Only insulated hand tools will be used?
Demo saw cutting concrete - Low Voltage Gloves (electrical) are worn where electrical assets are present or their presence has not been eliminated. ✔
I hereby confirm that the above measures have been completed prior to the commencement of work. I understand and accept the conditions and
precautions detailed and am satisfied that all precautions and risk control measures are in place and are effective in reducing the risk to an acceptable
level and all services have been positively identified.
Crew Supervisor name: Signature: Time:
Additional Sign off section
NAME ROLE SERVICE STREAM ID # SIGNATURE
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