Professional Documents
Culture Documents
Pera Jackhammer
Pera Jackhammer
SCOPE
This document is to be completed for staff and student use of
machinery, plant & equipment as a part of a school curriculum
activity or program.
Refer to the ITD Guidelines for further staff advice on the risk management process for practical ITD
curriculum activities in schools.
Teachers / Leaders:
Room Locations:
N.B. This assessment can remain active for up to 5 years. However, an annual monitoring & review process
should be undertaken and recorded refer to the last page of this document.
Below are the details of the manufacturing or production processes attributed to this item of equipment categorised
by their assessed inherent risk levels (refer to the Equipment / Process Risk Matrix). The actions required for
approval for each level of inherent risk are mandatory.
Registered teachers with experience, ability and competency in the safe use of this plant / equipment
(indicate one or more of the following):
Specific knowledge of the safe and correct use of this plant / equipment;
Experience (i.e. previous involvement and familiarity) in the safe use of this plant / equipment;
Demonstrated expertise, ability and competency with this plant / equipment;
Documented qualifications relating to the use of this plant / equipment ( e.g. in a staff profile )
OR
An adult staff member or leader, other than a registered teacher, with :
Expertise in the safe and correct use of this plant / equipment;
Documented qualifications that demonstrate experience, ability and competency in the safe use
of this plant / equipment.
Will any ITD staff require initial and/or ongoing training for the safe use of this plant / equipment ?
If yes, give details:
Indicate the Control Measures adopted. Detail their implementation and any additional controls required.
Approved as submitted.
By: Designation:
Signed: Date:
ITD staff members involved in the use of this risk assessment & the associated plant & equipment:
Signature: .. Date:
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Signature: .. Date:
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Signature: .. Date:
Review 1: Yes No
Are allocated risk levels and Actions Required unchanged over the past 12 months ?
Are Minimum Standards and Recommended Control Measures unchanged over 12 months ?
ITD staffing details at this school have remained unchanged over the past 12 months ?
If the responses are NO for any question, record current details here, and list all staff changes (with signatures)
Review 2: Yes No
Are allocated risk levels and Actions Required unchanged over the past 12 months ?
Are Minimum Standards and Recommended Control Measures unchanged over 12 months ?
ITD staffing details at this school have remained unchanged over the past 12 months ?
If the responses are NO for any question, record current details here, and list all staff changes (with signatures)
Review 3: Yes No
Are allocated risk levels and Actions Required unchanged over the past 12 months ?
Are Minimum Standards and Recommended Control Measures unchanged over 12 months ?
ITD staffing details at this school have remained unchanged over the past 12 months ?
If the responses are NO for any question, record current details here, and list all staff changes (with signatures)
Review 4: Yes No
Are allocated risk levels and Actions Required unchanged over the past 12 months ?
Are Minimum Standards and Recommended Control Measures unchanged over 12 months ?
ITD staffing details at this school have remained unchanged over the past 12 months ?
If the responses are NO for any question, record current details here, and list all staff changes (with signatures)