Rail Safeworking Pre-Start Brief Site Compliance
Scope of Works
Client
Date
-
Day
-
Month
Year
Date
24hr time Minutes
Network Control
Please Select
Central 9274 9787
Eastern 9274 9797
EGR 9274 9790
Midwest 9274 9727
Northern 9274 9770
Picton 9274 9747
South 9274 9757
Southwest 9274 9767
NCO 9326 2345
ECO 9326 3333
ICO 9326 2038
Protection Officer
Please Select
Eben Liebenberg 0436 001 522
Jason Purdy 0448 487 274
Jaxon Thomas 0428 284 935
Kahurangi Corene Coopper 0439 996 269
Lukas Pretorius 0436 890 500
Vince Belladonna TBC
Wesley Pothas 0484 818 572
First Aider
First Aid Location
Please Select
Crib room
Site office
Vehicle
Muster Point
Please Select
Crib room
Designated Safe Place
Site Entry Gate
Site office
Vehicle
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Site Specific Hazards
Adopted Control Measures
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Next
Briefer
Please Select
Richard Akera
Vince Belladonna
Kahurangi Corene Cooper
Gary Ellard
Eben Liebenberg
Trent Murdoch
Wesley Pothas
Lukas Pretorius
Jason Purdy
Mark Roberts
Jaxon Thomas
Rami Ziino
Briefer's Signature
Location
Time
First name
Surname
BAC
Please Select
0.00
Fail
Signature
First name
Surname
BAC
Please Select
0.00
Fail
Signature
First name
Surname
BAC
Please Select
0.00
Fail
Signature
First name
Surname
BAC
Please Select
0.00
Fail
Signature
First name
Surname
BAC
Please Select
0.00
Fail
Signature
First name
Surname
BAC
Please Select
0.00
Fail
Signature
First name
Surname
BAC
Please Select
0.00
Fail
Signature
First name
Surname
BAC
Please Select
0.00
Fail
Signature
First name
Surname
BAC
Please Select
0.00
Fail
Signature
First name
Surname
BAC
Please Select
0.00
Fail
Signature
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Next
Select box to confirm task completed. If not applicable leave box empty.
Site Access
Point of Entry communicated
Designated Parking Area communicated
Required Exemption forms held
Accreditation Checks completed
OLE Conditions
Power Status communicated
Exclusion distance communcated
Correct accreditation Level held
Isolation / Permit to Work forms completed
Worksite
Site Limits communicated
Designated Safe Place communicated
Adjacent Line Protection held
All required Safeworking Forms held
Rail Conditions
Track Speed comunicated
Directions of Travel communicated
Network Possession Notice held
Pre-work Safety Assessment completed
Communication
Site Channel communicated
Control Channel communicated
Network controllers details held
Check of radios warning devices completed
Track Vehicles
Limit of Authority communicated
Ontrack location communicated
Correct accreditation level held
Vehicles travel path plan completed
External Factors
Other work groups communicated
Environmental factors communicated
Rail safety Management Plan held
Required booking on procedures completed
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Worksite Protection Plan
Protection Officer
TAP
Please Select
24418
13813
24241
406
21128
19293
23515
22576
27793
12934
22936
20607
R/W
Please Select
20-00192231
20-00075941
20-00125003
20-00064204
20-00064204
20-00080769
20-00250784
20-00128082
20-00289378
20-00073199
20-00245701
20-00000623
Protection Officer Signature
Network
Please Select
Arc
PTA
Accreditation
Region / Line
Location
Track
Please Select
Bi-Directional
Both Mains
Down Main
Up Main
Scope
Site From
Kilometers
Site To
Kilometers
Protection Method
Please Select
2001 WDZ
3001 LPA
3005 WOTA
3013 LW
3019 TV
Date
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