Northport Ltd heaLth & Safety procedureS

heaLth aNd Safety procedureS

Procedures

6.1.0 Northport health and Safety policy 6.2.0 Scope & Definitions

INDEX

Northport Ltd Health and Safety Procedures and Forms

1.1.0 Safety Induction Checklist

1.1.1 Staff training record

2.1.1 Hazard Identification Form

2.1.2 Significant Hazard Register

2.1.3 Significant Hazard Training Sheet

2.2.1 Safety audit

2.3.1 Project Job Safety Analysis (JSA) Form (4 Pages)

2.3.1b Job Safety Analysis (JSA) Form (2 pages)

3.1.1 Work Safe Meeting

3.2.1 Company Safety Committee Agenda/Minutes

4.1.1 Accident Register

4.2.1 Serious Harm Notification

4.2.2 Serious Incident Report Form

4.3.2 Pre-employment Questionnaire

4.4.1 Reasonable Cause Impairment Assessment Form

5.4.1 Record of Emergency Drills

5.5.1 Contractor Safety Assessment Form

5.6.1 Traffic Management Sheet

5.7.1 Northport Site Map

Forms

Northport Ltd procedureS

6.1.0 Northport Ltd health and Safety policy

Northport LtdHealth and Safety Policy

1. Northport Ltd is committed to achieving measurable improvement in health and safety management recognising that harm to people, property or the environment is preventable.

2. The Company will provide training resources to ensure all staff understand health, safety and environmental responsibilities.

3. Northport Ltd is committed to complying with relevant health and safety legislation, regional and district planning requirements, regulations, codes of practice, guidelines and safe operating procedures for staff and other Port Users.

4. Northport Ltd recognises and supports the right of employees and their representatives to be involved in safety management and protection of the environment.

5. Northport Ltd is committed to ensuring that all levels of management have process in place that immediately and accurately report and record all safety incidents.

6. Northport will provide required treatment and offer meaningful and safe rehabilitation of staff under the direction of ACC and medical advice if injured or unwell.

i To maintain the current no time loss accident record for staff during the following twelve month period.

ii To work with Port Users to ensure all persons receive safety induction training when entering the Port promotes safety and emergency response readiness.

iii Encourage staff and management to take an active role in the development of safe working practices within the Port though regular tool box and JSA meetings.

Health and Safety Objectives are:

Signed: Chief Executive Office

date:

Next Review Date:

All staff, port users, contractors and visitors to the Port facility are expected to observe the safe work practices, rules and instructions provided by Northport Ltd.

1/08/20131/08/2014

NPL Health and Safety ProceduresNPL health and Safety Procedures relate to Northport Ltd (NPL) staff and contractors business activities for NPL. This documents primary purpose is to describe the processes and procedures required to meet its responsibilities as an Employer and Principal.Port User Company Operating Rules NPL has developed “Port User Company Operating Rules” for all approved operators within the Port, which outlines minimum health and safety requirements that are required to be abided by.Port Users HSE ProceduresTo avoid doubt the NPL Health and Safety procedures are not designed to be used by any party other than NPL to meet health and safety responsibilities. It is the responsibility of Port Users to develop and provide their own health and safety procedures to meet their own operations safety responsibilities.

6.2.0 Scope of NPL Health and Safety Procedures

6.2.1 Terms and Definitions

NpL

NpL Staff

NPL Contractors

Port Access Card

NPL Hot Work Permit

Incident

the port

Port User

Port User Rules

port contractor

Port Visitor

NRC Hot Work Permit

Northport Ltd, which is the owner and operator of Northport facilities. Also referred to as the Company.

An employee of Northport Ltd.

A Contractor of Northport Ltd working relating to Northport facilities.

A card issued by Northport Ltd Security which provides access to the Port for legitimate business only.

A permit issued by Northport Ltd to undertake hot work within the Northport facilities.

Is an event which has or potentially may have harmed a person, the Port, equipment operating within the Port or the environment. Within these procedures an incident also means an accident.

Is the Northport facilities, including land and buildings leased by Northport Ltd.

an operator which has received approval to operate by Northport Ltd or the staff of any enterprise which undertakes work at the Port.

Are the “Port User Company Operating Rules” issued by Northport Ltd and agreed to by Port Users when operating within the Port.

Is a Contractor or subcontractor of a Port User undertaking work within Northport facilities. Port Contractors can also be considered as Port Users.

Any person arriving to the Port with legitimate business within Northport facilities that has not previously received a Port Access Card from Northport Ltd security to enter.

A permit issued by the Harbour Master to undertake hot work on board a vessel alongside a wharf at Northport facilities.

1. The CEO will maintain a Northport Health and Safety Policy and ensure it is displayed within the Administration Office and work places.

2. The CEO is to review the HSE Manager and Safety Committee annual review of safety standards within NPL and the Port prior to making changes and signing a new Health and Safety Policy each year.

3. The CEO is to review individual senior management health and safety performance against company and individual safety roles and objectives which include reporting, investigation, staff involvement and actions taken regarding incidents that occurred under their control.

4. The CEO is to review senior management safety training needs and unless impracticable ensure regular safety management training or refresher training is provided annually.

5. The CEO will provide safety information within monthly reports to the Northport Ltd Board of Directors providing sufficient details to allow an assessment of the progress the company is making in meeting safety objectives.

1. Supervisory staff must ensure that employees are not harmed while at work by establishing safe working

practices within the workplace that conform to appropriate safety regulations and codes of practices.

1.1 Before working or asking others to start work, evaluate the risk associated with that work (Hazard ID & JSA forms are provided for the recording of this within these procedures).

1.2 Ensure personal protective equipment is provided and it is used correctly by all staff. When appropriate, ensure records of the use and issue of safety equipment by individual staff is kept (e.g Safety Boots, Hi-Vision Vest, Hard Hat, Safety Glasses, Approved Gloves, Respiratory Protection, Fall Protection, Lift Jackets).

1.3 Stop work which is believed to be unsafe until it can be made safe.

1.4 Never knowingly expose any person to likely harm from workplace risks (hazards).

2. Ensure all near miss & harm incidents which are more than trivial are recorded in the NPL Accident Register.

6.2.1 Chief Executive Office (CEO)

6.2.3 Supervisor/Leading Hands (include Managers) Responsibilities

1. Ensure these health and safety procedures are available to all staff and Port User companies on request.

2. Ensure emergency readiness and hazard identification control procedures are adequate to meet the operational safety and health needs of the area. This being provided by the use of NPL JSA and Hazard identification procedures.

3. Ensure skilled persons provide new employees supervision and safety training to work safely and complete documented safety assessment training.

4. Ensure all incidents are immediately recorded and an initial investigation occurs as per these procedures.

5. Ensure that appropriate NPL operational and safety procedures are adhered to.

6. Ensure staff are provided with the required Personnel Protective Equipment (PPE) to undertake work safely and make replacements available when minimising significant hazards.

7. Promote hazard identification, tool box meetings and audits to ensure required safety standards are being achieved.

6.2.2 Northport Ltd Managers Responsibilities

3. Help with the investigation of accidents to prevent likely re-occurrence and to identify and evaluate significant hazard.

4. Ensure the CEO is informed immediately of any serious injury accidents within the Port and special procedures relating to serious harm are followed.

5. Continuously monitor workplace safety to identify potential significant hazards and their control to ensure work is carried out safely.

6. Undertake such activities as described within these procedures relating to safety activities which include the running of toolbox meetings, emergency drills, hazard identification process and staff induction training.

7. Monitor Port Users compliance to Port safety standards and take action to address safety concern with anyone not meeting these standards.

6.2.4 Responsibilities of the HSE Manager

1. Manage day-to-day company and Port facility health and safety requirements, ensuring that the highest standard of health and safety performance is achieved.

2. Manage the NPL’s health & safety plan and its legislative requirements including SOP’s, hazard registers and incident investigations.

3. Initiate, develop, improve and implement health & safety objectives and goals specific to NPL needs.

4. Manage the NPL health & safety database (The Vault) and provide assistance to staff to best utilise the database.

5. Manage the reporting mechanisms for workplace incidents and near misses within NPL and the Port facility, ensuring closure of the respective corrective, preventative and improvement actions.

6. Provide leadership, direction and advice in all areas of health & safety and support the activities of NPL managers, their staff and contractors.

7. Provide assistance, resources and advice to staff and Port Users to enable the implementation of company and Port facility health & safety initiatives.

8. Investigate site-wide serious harm accidents or serious incidents and manage the impact on the Port facility’s business.

9. Manage the company’s gradual return to work programme for injured staff and ensure a return to normal work types and patterns at the earliest opportunity.

10. Audit each Port User company or contractor operations ensuring compliance to industry standards, legislation and NPL HSE policies and procedures.

11. Inspect work sites, machinery, equipment, leased and sub-leased properties for hazards, violations, and conformance with government regulations as required.

12. Facilitate and chair the company Health & Safety Committee and the Port Users Health & Safety Committee and ensure promulgation of minutes and action points.

13. Manage the company’s compliance to ACC WSMP processes and standards, arrange for WSMP audits and undertake internal self-assessments.

14. Manage, organise and co-ordinate the necessary training for staff with regard to safe operation of equipment, compliance to legislation, policies and that adequate hazard identification and controls are in place.

15. The HSE Manager is the primary document controller and is responsible for the administration and distribution of the NPL HSE Procedures. Including the maintenance of safety training records and a master copy of all health and safety procedures within the Vault database system.

Northport hSe procedureS

1. NPL visitors are required to report to the Security Gatehouse when entering the Port. Visitors to the Northport Administration building will be required to sign in when arriving but are not required to report to the Security Gatehouse Security if not entering the Port.

2. Visitors must be accompanied by a staff member at all times unless they have completed the appropriate induction process.

3. Visitors must wear safety footwear (preferably safety boots) and hi-vision vest when entering the Port.

4. Persons under the age of 16 are not permitted on site unless strictly supervised and authorisation has been provided by the NPL CEO or HSE Manager.

5. All visitors should be made aware of controls of hazards and what to do in the event of an emergency when visiting.

6.3.1 Reviews

1. The HSE Manager will commission a formal review that includes senior management of health and safety policy, objectives and procedures annually, which will involve all staff or their elected safety representatives to the AS/NZS 4801 Standard.

2. The annual review will specifically examine new identified hazards, present hazard control and reviews, compliance to OSH standards, training needs of employees, and appropriateness of company aims and objectives.

3. The annual review will examine NPL and port user safety management processes over the past 12 months based on the same agenda item associated with normal safety meetings.

4. The decision regarding health and safety goals, objectives and procedures rests with the CEO.

5. NPL may employ the services of external health and safety professional as required, to audit compliance with relevant legislation and help ensure compliance with legislation.

6.2.6 NPL Visitor

1. As an employee of NPL, staff are required to take the time to read and understand NPL and Port safety requirements and operational procedures. Each must recognise their individual responsibility for personal safety and the safety of others while working.

2. Staff are required to be honest and fully apply themselves to gaining sufficient skills during safety induction training and supervision relating to NPL activities that involve significant hazard controls in the Port.

3. Each employee must follow NPL health and safety procedures and observe all Port safe work practices at all times. (Failure to do so is likely to result in serious disciplinary procedures being taken, which could result in termination).

4. Staff must make themselves aware of emergency readiness procedures within all Port areas and immediately report unsafe work conditions to their supervisor, safety representative or NPL management.

5. To immediately report unsafe acts by Port Users, Contractors, visitors, equipment damage, and loss of property to a supervisor and help to complete a incident/accident report.

6. To follow the specific NPL procedures relating to serious harm events to any person.

7. To participate in keeping the workplace safe by contributing to regular toolbox meetings, identifying hazards and recording these, assisting new staff and working with the safety committee to improve health and safety procedures.

6.2.5 All Employee Responsibilities

6.4 Safety Committee

1. NPL has an appointed safety committee consisting of HSE Manager, Senior Management, Supervisory and Staff Representative.

2. The safety committee duties will include, but not be limited to ensuring the promotion of health and safety of all employees and others whilst at work at the Port. The safety committee has the power to co-opt additional temporary members for special purpose and reasons, such as expertise or technical knowledge with consent from the CEO.

3. The safety committee should meet at intervals determined by the committee but not less than 3 monthly. A quorum should consist of a minimum of three members.

4. In the event of a critical event or change in safety procedures the safety committee should meet and review the effectiveness of safety procedures. If urgent or of a serious nature a special safety meeting will be held.

5. The issues and decisions made by the safety committee must be recorded as minutes for all meetings. Copies of such minutes should be posted on notice boards and circulated to all members of the safety committee and Company. The safety committee is to be responsible for issuing and return of health and safety manuals within the workplace.

6. The safety committee is responsible for reviewing new materials and equipment being considered for purchase by the company to establish safe work practices regarding identified significant hazards. It is not for the safety committee to investigate or question the business aspects of the decision making process of the purchase itself.

7. Employee members of the safety committee will be given adequate training in the relevant company safety procedures in order that they may carry out their responsibilities and meet their functions within the committee. This training should be recorded on their training record.

8. Once a year the safety committee will undertake a review of company safety procedures to monitor their effectiveness as described within these procedures.

9. The function of this group is to act as a “watchdog” which will be monitoring the safe working environment, ensuring facilities are safe; processes are working and actively suggest new ways for improvement of safety within the Port.

10. Paid training leave will be provided to staff which are safety representatives as established within the Employment Relations Act and HSE Amendment Act 2002.

HSE representative meeting agenda is required to cover:

- minutes of the previous meeting- outstanding issues - last meeting- changes to legislation/compliance issues- accidents and incidents reports- tool box meetings minutes- review of completed Hazard Id forms- use of JSA forms- ACC/serious injury/rehabilitation reports- Port User safety issues- safety audits - issues identified- safety review of new equipment- contractors and sub-contractors issues- general safety business- date of next meeting.

Annual HSE review by HSE Manager to cover:

- Review of safety committee minutes- health and safety management performance

against objectives - recommendations- hazard management effectiveness and

coverage- compliance with legislation- review of accidents and incidents data- serious injury review and injury management

issues- internal self-assessment audit results- review of contractors and sub-contractors

safety management procedures- annual training needs and requirements

highlighted review of bring up system

Northport hSe procedureS

6.5.1 Internal Induction Training Process

1. The key part of this safety induction training is to ensure as a new employee they are aware of significant hazards they may face or could create for themselves or others. NPL asks staff to be honest and open in explaining their skill level and experience.

2. New staff are significantly more likely to be involved in serious incidents and it is vital sufficient time is made available and to ensure these staff understand NPL Health and Safety Procedures and requirements.

3. NPL safety induction is designed to confirm staff have understood training in safe work practices regarding significant hazards identified as part of activities they will undertake and that they have shown an understanding of this training.

4. The safety induction training process is to consist of the following process:

6.5 recording of Safety training

1. The health and safety training of NPL staff will be recorded and managed using the Vault computer system.

2. The Vault system is to be used to record individual safety training achievements of staff and the need for any associated refresher or re-licensing requirements regarding that training.

3. A loss of licence or qualification to operate equipment must be immediately reported by staff to their manager and recorded within the Vault system. Staff are not to operate equipment that requires a licence unless they have that current licence to do so.

4. The NPL will require proof by way of a photocopy of certificates, licences and qualifications, which are to be scanned and held within the Vault system.

5. The company will identify internal and external trainers with appropriate safety experience, qualifications and skill will be employed to train staff. A list of these will be be held within the Vault, administrated by the hSe Manager.

6. Staff that are specifically involved with the management and training of other staff relating to significant hazards will be required to demonstrate sufficient skill and experience to instruct others.

7. Senior NPL staff leading hazard management are to undertake ongoing training to increased their experience and skills in this field at least every 2 years. Such training may include the review of other Port User and/or Port hazard management systems.

Print two copies of the staff induction book - one will be retained by NPL as evidence of the status of the employees safety induction and the other is for the employee’s ongoing reference.

• The HSE Manager is responsible for new employee safety induction training which will start with the Port Security Induction and being issued with their Port Security Pass. (No NPL employee should be given access to the Port without a current site pass).

• The HSE Manager and new employee are to complete a short tour of the Port and discuss NPL safety standards and hazards. During this tour special attention is to be given to hazards within the Port such as heavy equipment hazards and cargo handling in restricted areas.

• The HSE Manager is to review and plan the training needs of the new employee with the employees manager.

• Once the relevant Significant Hazard Training Sheets have been identified, training is to be scheduled and a relevant trainer identified.

• The new employee’s manager is responsible for ensuring training occurs and that the new employee is provided sufficient skilled supervision until assessed as being trained to work safely unsupervised.

• Once training is completed for any of the Significant Hazard Training Sheets, the NPL Office is to be notified and a signed sheet provided as evidence.

1. By using the Hazard Identification form 2.2.1, enter identified hazards and the degree of likely risk associated with the activity, machine or process. Determine the severity and frequency:

2. Enter likely ways to reduce the likely risk of an accident occurring and degree of possible injury.

3. Determine if the hazard is a significant hazard (risk).

4. Actions relating to the hazard are determined based on the effects to people, environment and equipment.

5. Systematic hazard identification and assessment will be carried out evaluating the workplace by area, or by following the manufacturing process step by step, or both, inclusive of all work and standards of safe work practices being undertaken:

6. For each identified hazard, risk and severity will be determined, with the company ensuring sufficient information is provided to make accurate and informed judgement. If required, specialised advice will be obtained from a skilled source as to the most appropriate controls to be put in place, such as the industry association, govt safety agency, safety consultant and the manufacture or supplier.

7. A matrix has been developed to help staff with this process to help determine hazard significance.

8. All identified hazards will be assessed to determine their potential to cause serious harm.

A Significant Hazard means a hazard that is an actual or potential cause or source of: Serious harm; or• Harm, more than trivial, the severity of whose effects depend on the extent or frequency of exposure to the hazard; or • Harm that usually is not easily detectable, until a significant time after exposure to the hazard.

6.6.1 Hazard Identification & Assessment

6.6 Hazard Identification & Management

The following procedures have been developed to achieve:

1. A Systematic identification of hazards.

2. The assessment of hazards to determine significance, then determination an appropriate hierarchy of control - elimination, isolation or minimisation.

3. The identification of new hazards on an on-going basis before employees, or other Port Users might be exposed to these.

4. A process for management and employee representatives to monitor the company Accident Register and associated investigation to further identify significant hazards and evaluate controls.

5. Training and/or supervision that is appropriate in establishing safe work practices and procedures, thus preventing likely harm from significant hazards.

6. A process allowing changes to procedures by the HSE Manager and Safety Committee which is clearly documented and in consultation with staff representatives. (The NPL HSE procedures themselves follow closely the requirements of law and changes must be made with care).

8. A process which undertakes a hazard identification process when undertaking work for the first time or using newly purchased equipment.

Note NPL is not responsible for the safety management of hazards directly associated with other Port User

activities as an employers but will attempt to make the Port as safe as practicable given the limited scope of control and knowledge of such activities.

1. Actions prior to the significant hazard joining the Significant Hazard Register

• Elimination must be considered as the first method for control

• Isolation from employees will be considered where elimination is not practicable

• Where both elimination and isolation are not practicable the company will minimise the hazard to employees and manage the on-going risk.

2. The manager will monitor significant hazard controls by regular reviewing of the workplace to standards within company SOPs.

3. Daily visual inspection of equipment and review of activities should be undertaken by supervisors to ensure employee safety.

4. Employees should visually check all equipment safety before use and use appropriate PPE made available by management.

5. Special consideration will be given to the control of significant hazards when staff are introduced to hazards for the first time.

6. Supervisors are to ensure staff undertaking the supervision and instruction of safety procedures controlling hazards have adequate skill and experience themselves.

1. The company is to hold specific information on the required controls relating to identified hazards that related to regulations, codes of practices and other safety standards.

2. The safety committee as part of its review of hazards it’s to ensure such information is available and understood by staff.

3. Workplace audits will evaluate the level of information available to staff regarding specific controls and compliance to standards no less than 3 monthly.

4. A review of the information provided to staff is to be reviewed as part of the annual review process for hazards by the safety committee.

5. Part of the hazard review process for changes to the workplace is to include legislative requirements and the amount of relevant information required to be provided within the workplace.

1. The following steps should be taken to reduce the risk of harm to employees when minimising a significant hazard:

2. All employees should have information about the hazard and the methods of control employed.

3. When appropriate staff are to be issued with protective clothing and suitable safety equipment (PPE) when exposed to significant hazards, with training in the fitting, correct use and maintenance and replacement of that equipment.

4. The company will have a system in place for the issue, renewal and maintenance of PPE and other safety equipment required relating to significant hazards.

5. Where appropriate, environmental monitoring of the hazard will be undertaken.

6. Where appropriate, health monitoring of exposed employees will be used to ensure effectiveness and compliance of controls.

7. Emergency procedures will deal with any likely situations arising from the hazard.

6.6.2 Where Hazards are Significant:

6.6.3 Hazard Evaluation

6.6.4 Hazard Minimisation

1. Staff and management will undertake regular reviews of company hazard management effectiveness no less than every 3 months as part of safety committee duties as established with its agenda.

2. The company will undertake an annual hazard management review of all listed significant hazards and effectiveness of safe operational procedures.

3. The safety committee may commission an independent auditor with appropriate specialised skills to undertake monitoring, reviews and reports on the hazard management effectiveness.

4. In the event of a critical situation, the CEO will ensure a review of hazard management controls is undertaken and that appropriate procedures are in place immediately and that actions taken are reviewed under “serious injury review” at the following safety committee meeting. If sufficiently serious a special meeting of the safety committee will be held to discuss and take appropriate steps/action to prevent a re-occurrence.

1. Prospective new employees will be provided with a pre-employment health questionnaire, requesting health related information. Depending on the position offered, a further medical physical examination from the company medical provider may be requested prior to employment.

2. Monitoring of the individual health of injured staff will be reviewed by the safety committee. Post critical event that may require health monitoring to occur will be provided on medical practitioner’s advice. This may include the company requesting a drug test for illegal drugs and testing for specific exposure to hazards.

3. The company will only undertake testing for hazard exposure if the employee consent to the testing and each person has a right to decline health monitoring.

4. Exit health testing will be provided on full time staff at the CEO’s discretion, generally after employment over 12 months, unless a recent health medical is available.

5. The medical practitioner will keep all medical records and they will be responsible for the reporting and managing of sub-optimal results in association with the HSE manager.

6. In the event of a sub-optimal result the medical provider will be asked to contact the individual directly and offer assistance or referral of information to the individuals GP.

7. The company will request the medical provider informs it of all sub-optional tests in a manner that ensures steps can be taken to prevent ongoing harm and protects the individuals privacy.

6.6.5 Hazard Reviews

6.6.6 health Monitoring

6.7 Accident Reporting, Investigation & Rehabilitation

The terms incidents and accidents, in this context, include all “near miss” or “near hit” events, work-related illness and injury events, that harmed or might have harmed any employee, and others, during the course of their work on-site.

All employees are required to report accidents/incidents to the HSE Manager and their immediate supervisor immediately after they occur and have the event recorded:

• In the company Accident Register

• If Serious Harm, in the Serious Harm Accident Register

Northport hSe procedureS

6.7.1 Non-Serious Harm

procedure

1. Supervisory staff are to ensure that sufficient first aid staff are available and a person records all accident and incidents within the accident register, completing an initial investigation of accidents/incidents.

2. The HSE Manager is the designated accident investigator (or appointed person) and is to review as soon as practicable each reported incident to check it is correctly recorded and take any immediate steps required to make the workplace safe and stop a re-occurrence. All actions are to be documented and attached to the accident report or review by the safety committee at its next meeting.

3. Actions and controls identified as a result of an accident/incident are to be the responsibility of the HSE Manager. The HSE Manager will ensure all collated accident data is presented to the safety committee for sign-off by providing a copy of the accident register report at the meeting.

4. If corrective actions are required the accident report (or as an attachment) must show the work required, immediate steps taken, the names of any persons reasonable for doing the work and the specific time frame required to have it completed. That when work is completed it is dated and signed off by the safety committee.

5. Induction training must ensure employees are provided with specific instructions regarding incident/accident recording procedures. Unless it is impracticable to do otherwise, employees are not to record their own accidents within the accident register or solely carry out an investigation.

6. The safety committee will regularly review all accidents/incidents recorded within the workplace and discuss rates. Data relating to workplace injury will be posted within the workplace as part of the safety committee minutes or charts. The safety committee will review the overall accident data for a 12 month period as part of the annual review when setting new objectives and safety promotional activities.

1. First priority is to provide medical assistance. Control or move items at the scene only if necessary to:

2. In the event of serious harm, the HSE Manager (or in their absence, an appointed person) is to be informed immediately. The HSE Manager will confirm that serious harm has occurred and arrange to notify the appropriate government agency, as soon as practicable.

3. Staff are not to interfere with the scene of a serious harm accident. The HSE Manager can request work continuation from a warranted Safety Inspector after a designated company investigator has recorded all relevant information. For example: photographs, measurements, staff interviews, contractors and other witnesses testimony that confirm activities leading up to event.

4. The HSE Manager is to notify appropriate authority in writing on the prescribed “Serious Harm Notification” form within seven (7) days of the event.

5. The company has a serious incident report form which should be completed in the event of a serious harm accident. This includes injury to any visitor or contractor involving a company activity including Port Users and vessel crew. All information associated with the investigation of an accident is for company use only.

6. Only the CEO is authorised to speak on behalf of the company or make documentation available to any other person.

• Save life, prevent harm and relieve suffering• Maintain access for essential services• Prevent serious damage or loss of equipment

6.7.2 Serious Harm Accident Procedure

6.7.3 Practical Guidelines for Investigation

1. Much of the evidence at a serious accident scene is of a fleeting nature and may not last for very long. Samples should be taken where appropriate and photographs, sketches and measurements taken to help with later reconstruction of events.

2. Interviews should be taken as soon as possible. Eyewitnesses are strongly influenced by each other and news media may change their view of the event. Witnesses may become hostile for various reasons, so keep interviews low key and focused on the events surrounding the accident. Ask open-ended questions.

3. Follow the questions described within the company safety procedures. They will provide a sound structure to obtaining the information required. Ask additional relevant questions.

4. Allow the person being interviewed to explain their answer in their own words. Ensure accurate notes are made. Let the staff person review and sign the interview note. If requested allow a family or staff representative to be present.

5. Do not interview staff in groups. Look for the underlying reasons for an accident. Not all causes of accidents are work related. Follow common sense and respect the privacy and rights of the injured and others involved in the investigation.

6. A designated safety professional and trained accident investigator, may be called, at the CEO’s discretion, in the event of serious injury.

6.7.4 Rehabilitation

1. Given the varied nature of rehabilitation needs management is to seek appropriate additional information and advice when reviewing company rehabilitation involvement and return to work programs including ACC and Occupational Theorists (OT’s).

2. If an injury requires professional medical treatment the company will assist staff in seeking medical treatment. While the company has no legal requirement to pay for treatment it may do so on a case-by-case basis.

3. No payment will be made to employees for costs associated with medical treatment unless the injury was reported to the company as per accident reporting and investigation procedures and it has been agreed to in advance.

4. Employees are required to report back to the company immediately after receiving treatment from the medical provider to complete company safety procedures and continue work if practicable.

5. The employee must provide the company with a copy of the ACC Certificate and Medical Accident Treatment Certificate from the medical provider as soon as practicable to help the company to establish the extent of injury, any limitation in work capacity and help plan appropriate rehabilitation.

6. For serious injury, rehabilitation will commence once appropriate documented plans have been developed with ACC and signed off by the employee, their representative, the person controlling the day-to-day work of the employee – normally the HSE Manager.

7. Rehabilitation will be offered to employees for non-work related injury and sickness on case-by-case bases.

8. The company will assist rehabilitation by allowing work trials of employees at ACC request and cost.

Northport Safety forMS

Identified By: Date:

Hazard Identification Form - 2.1.1

DESCRIBE THE HAZARDS / SAFETY ISSUE IDENTIFIED

Describe Adverse Effect or Harm Created

Describe Any Immediate Actions Taken

SUGGEST ONGOING CHANGES OR ACTIONS REQUIRED

People / Work Methods / Training / Equipment / Planning / Design / Maintenance

Area/Machinery/Process/Location/Organisations/Person

Safety Audit - 2.2.1NPL MANAGEMENT / SAFETY REVIEW

Reviewed By: Date:

Other Issues Raised / Considered

Ref Number:

Actions To be Taken

Safety Rep. Sign-Off Date

Person to be Responsible

Proposed Completion Date Actual Completion Date

Manager Sign-Off Date

ESTABLISH RISK SCORES (Set a priority of action based on the following potential outcomes)

POTENTIAL CONSEQUENCES PROBABILITYPeople Job/Equipment Environment

Slight health effect or minor injury - FAC, MTC

Slight impact or damage less than $500 cost

Single event with slight on site effects

Repeated minor health effects orinjury

Minor disruptionand cost up to$1,000

Minor event withboth on and offsite effects

Health effect or injury resulting in LTI (Full day off work)

Site disruptionand cost up to$5,000

Local nuisanceand potentialRMA action

Irreversible healthor injury effect- Serious Harm

Major businessdisruption with losses up to $10,000

Widespread nuisance or likely risk of explosion

Fatility - potential multiple Serious Harm

Extensive damage, loss of business with costs over $50,000

Persistent effect and severe damage, fines over $10,000

Improbable(hasn’t occurred

yet)

AUnlikely

(has occurred in industry)

BPossible

(has occurred)

CLikely

(happens regularly in industry)

DProbable

(Likely to happenin company)

E

5

Monitor

5

Monitor

5

Monitor

5

Monitor

4

Review Controls

5

Monitor

5

Monitor

5

Monitor

3

Establish Controls

4

Review Controls

4

Review Controls

4

Review Controls

4

Review Controls

2

Controls ASAP

2

Controls ASAP

4

Review Controls

3

Establish Controls

2

Controls ASAP

2

Controls ASAP

1

Stop & Control

3

Establish Controls

2

Controls ASAP

2

Controls ASAP

1

Stop & Control

1

Stop & Control

(4801) (9001) (1401)

X

XX

XX

X

Hazard Inspection

Date:

EX = Excellent Standard

AC = Acceptable Standard

CA = Corrective Action

ICA = Immediate CA

NA = Not applicable

Work Place:

Assessed by:

Assessment Area

Operational/Port User Review

General Work Place Significant Hazards

EX AC CA ICA NA

Noise & Lighting

Work Hours/Stress

Electrical Safety

Machinery Guarding

Toilets and Rest Areas

Port Signs

Assess & Egress

Housekeeping

NPL Issue/Use of PPE

Fall Protection

Comments/Other areas reviewed

Comments/Other areas reviewed

Safety Audit - 2.2.1

Dry Goods

Chip Loader

Wharf/Gantry

Cargo Area

Weight Bridge

Security

Vehicles

Drains/Roads

Tractor/Forklift Checks

Workshop

Vessels (SSM)

Administration

EX AC CA ICA NA

Safety Management Review

Emergency Equipment Review

Comments

Comments

Electrical Compliance/Maintenance

Fire Alarms - checked

Extinguishers - in test/checked

First Aid Kits - monitored

Resulting Actions Person responsible

Signed off by person responsible

Signed off by Management

Attach additional Sheets

NPL Staff

NPL Contractors

Port Users

EX AC CA ICA NA

HSNO Test Certificates current

Signage & Evac. Point - clearly marked

Emergency/Fire Wardens trained

Port User Emergency readiness

NPL HSE Manual Available to Staff

Formal Safety Rep/Management Meetings

JSAs & Safety Hazard Meeting Completed

Incidents Recorded and Investigated

Tool Box Meetings Held

Site hazard identification Recorded

Evidence of SOPs in Use

1. Minutes of last meeting (check actions have been completed and signed off)

2. Hazard management (review hazard Id 2.1.1 reports & controls 2.1.3 and SOP’s)

3. Conformance with legislation (Review changes to HSE law, new safe work practices and procedures)

4. Safety review of new equipment (involving staff - use separate sheet if required)

5. Port User safety and emergency readiness

Company Safety Committee Agenda/Minutes - 3.2.1

Location:

Date:

Names Present/Initials

Apologies

Other Business/Issues

6. Accidents and incidents (review accident register and data)

7. Serious injury review (or in the event of a serious incident involving staff - use separate sheet)

8. Internal and external audit reports (self-assessment audit results)

9. Contractors and sub-contractors (including post-contract evaluation)

10. Training needs (Include review of Vault – bring-up system)

Incident/Accident Register - 4.1.1 Location

Surname

Given Names

Home Address

Phone Number:

Date of Birth

Male Female

Personal Details of Injured

Date Reported

Time: AMPM

Location or Work Area:

Identify the Parts of the Body Harmed:

Treatment Given:

RECORD THE NATURE OF INJURY:

DEGREE OF INJURY:

Employee

Self Employed

Contractor Employee

Visitor, Customer, Other

Number of hours since arrival to work

Occupation / Position:

Period of Employment Years Months

If Shift Work, the shift:

Serious Harm Medical Treatment

Time Loss First Aid

Restricted Duties Near Miss

Amputation

Burns

Crushing

Cuts

Disease

Fractures

Strains / Sprains

Eye Injury

Poison / Chemical

Head Injury

Multiple Injury

Other

Reference Number

Person Recording the Injury/Near Miss

Date:Immediately

Email Address:

Details of Other Company/Non-Employee Involved

Address

Contact: Phone Number:Email Address:

Date of Accident

Position:

Degree of Incapacity (if able to be determined):

Able to return to all duties immediately

Able to return to some duties

Able to only return on other/alternative duties

Unable to return on any duties at the time of this report

Details of Injury

Details of Accident / Harm

Part of the Body Harmed

Activity:

What happened?

New and Significant Hazards can be assessed and managed using the Hazard Identification Form within HSE Procedures

Management to confirm the Action required to be taken:

Start by: Finished by:

This Accident Register is available from Work Injury Care Ltd by email to wic@xtra.co.nz

Person Responsible for Actions:

Authorised by:

Date:

Position:

Signed:

List all new hazards & known Significant Hazards below

List the key people/equipment involved:

How did it happen?

What can prevent a future recurrence?

Staff/Safety Rep:

Additional Training / Capital / Equipment required:

Manager: Date:

Position:

Initial Investigation

Management Actions

Signed-off as Completed by Management & Staff Representatives

Accident Date:Name of Injured Person:

A. What happened?

Notes:

B. Where it happened?

C. When it happened?

D. How it happened?

E. Why it happened?

What should be done to prevent a recurrence?

Serious Incident Report Form - 4.2.2

LocationAccident Register Ref.

Activity:

Should any disciplinary action be taken?

Notes:

Should any training/re-training be implemented?

Who should take corrective action and by when?

Review of Company Health and Safety Procedures as a result of this Critical Event:

List Additional Hazards Identified (Attach Any Associated 2.1.1 Forms )

SIGNIFICATION HAZARDS LIKELY HARM

Signed by Manager/Investigator:

Signed off by Owner: (If different to Manager)

Signed off by Staff Representative:

Date:

Date:

Date:

Attach Support Material and Statements

Employee Name: DOB:

Address: Contact No. ( )

To help the company assess your health relative to the type of work you will be required to do, we ask you to complete this questionnaire. Please provide additional information in the areas provided that the company should be aware of.

Please answer all the questions honestly and sign the form at the end.

HAZARD

Repetitive processes

Heavy lifting

Shift work

Others (please specify)

HAZARD

Repetitive work

Heavy lifting

Chemicals/dust

BODY PART

Hands & fingers

Arms & shoulders

Wrists & elbows

Chest, lungs

Ears

Nose

Eyes

Head & neck

Hips & thighs

Back & spine

Ankles & knees

List any associated ACC Claims

Asthma

Diabetes

Heart disease, high blood pressure

Epilepsy or other causes of unconsciousness

Stroke

O.O.S. / R.S.I.

Back pain

Allergy or reaction to chemicals

Skin disorder e.g. Rashes, Eczema.

Never Regularly Continuously COMMENTS

Never Regularly Continuously COMMENTS

YES NO COMMENTS

Date of Injury Length of incapacity Current Status

YES NO COMMENTS

If requested, are you willing to provide from ACC your personal claim history report? YES NO

Pre Employment Questionnaire - 4.3.2

Q2. Do you have any physical condition that could be affected by exposure to any of the following?

Q1. Have you regularly been exposed to any of the following workplace hazards within the last 24 months?

Q3. Do you now have or have you had any injuries or medical condition that affects the use of any of the following?

Q4. Have you suffered from the following:

Q5. Is there any reason you cannot wear the following personal protective equipment?

EQUIPMENT TYPE

Safety boots/shoes

Rubber boots

Breathing protection (mask)

PVC coats/trousers

Safety Glasses

Gloves/Hand protection

Q6. Have you ever been off work through illness for longer than two weeks in the past 2 years?

(If yes, please give details of when and type of illness/injury and date/s)

YES NO COMMENTS

YES NO

Q7. Do you smoke?

(If yes, how many per day and what sort?)

YES NO

Q8. Do you drink alcohol?

(If yes, how much per week – amount and type?)

YES NO

Q9. Do you do any form of regular exercise?

(If yes, how often per week and doing what?)

YES NO

Q10. Do you take any regular medications, supplements?

(If yes, what are they?)

YES NO

Please provide any other significant medical history or information you believe relevant:

CONSENT FOR COLLECTION OF INFORMATIONI declare the information I have given above is accurate to the best of my knowledge. I understand that giving any deliberately misleading information on this form or with any future claim with the company will be treated as sufficient cause to enact serious disciplinary procedures, which may lead to a termination in employment.

I understand that this information will be kept at the company office under the control of the Manager and that I am entitled to ask for a copy.

Signed: Date:

ANNUAL EMERGENCY EQUIPMENT AND DRILLS

EMERGENCY DRILL RECORDS (ATTACHED A LIST OF PERSONNEL AT EACH DRILL)

Date: Time Taken:

Points Raised

Action Taken

SIGNED OFF BY MANAGER

EMERGENCY DRILL RECORDS (ATTACHED A LIST OF PERSONNEL AT EACH DRILL)

Date: Time Taken:

Points Raised

Action Taken

SIGNED OFF BY MANAGER

HOSE REELSClear? In good condition?

(6 month) YES / NO

(12 month) YES / NO

FIRE ALARMSBells/sirens working? Mains power supply healthy? Indicator board lamps all working? Fire brigade or central station connections in order?

(6 month) YES / NO

(12 month) YES / NO

EXTINGUISHERSAll present and correct? Not obstructed? In good order?

(6 month) YES / NO

(12 month) YES / NO

MAINTENANCEAny temporary wiring? Any damaged electrical fittings?

(6 month) YES / NO

(12 month) YES / NO

SMOKINGAre smoking rules observed?

(6 month) YES / NO

(12 month) YES / NO

FLAMMABLE LIQUIDSExcessive quantities in working area? Any damaged/loose earthing and bonding straps? Any accumulations of empty containers? Any accumulation of soiled rags or waste?

(6 month) YES / NO

(12 month) YES / NO

GAS CYLINDERSAny idle cylinders in buildings? Any cylinders not secured? Any damage to fittings or hose?

(6 month) YES / NO

(12 month) YES / NO

HOUSEKEEPINGAny accumulation of rubbish in buildings or yard? Any area untidy or congested? Any sprinkler heads obstructed? Any combustibles adjacent to switchgear, heaters or battery charging?

(6 month) YES / NO

(12 month) YES / NO

FIRST AID EQUIPMENTIs it available and appropriate?

(6 month) YES / NO

(12 month) YES / NO

Annual Record: Drills and checks are required every six months:(Monthly inspection under fire emergency readiness monitoring contract – Fire service requested to be on site for 6 monthly evacuation drills)

Record of Emergency Drills - 5.4.1

Port Activity/Work Location:

Are you a Self Employed Person? (you have no employees or subcontractors) YES / NO

Name of NPL Contractor

Address

Are you approved under the ACC Work Safety Management Practices (WSMP) Scheme: YES / NO

If Yes the level achieved: Primary Secondary Tertiary Last Audit Date: .................................

Contractor Safety Assessment Form 5.5.1

Do you undertake Job Safety Analysis (JSA) for new work you do? (if yes, provide completed examples)

Have you clearly defined health and safety management responsibilities?

Have you systematically identified hazards? (if yes, provide evidence)

Do you have a health and safety review process?

Do you have a significant hazards register? (if yes, provide evidence)

Do you review significant hazard controls or Safe Work Practices (SOP)? (if yes, provide evidence)

Can you provide a list of Significant Hazards you may create while at the Port? (if yes, provideevidence)

Do you have a written health and safety policy statement and procedures? (if yes, provide a copy)

Date:

Company Manager:.................................................. Date:.................................

The following questionaire is to be completed by all NPL contractors working within the Port. All sections must be completed. If you have any difficulties understanding the requirements please contact the NPL HSE Manager.

If an Employer please complete the following: (Y for Yes - N for No - please attach all support documentation request-

Management Commitment

Hazard Management

Job Safety Analysis

Training and Supervision Do you discuss safety with staff before work starts? (if yes, provide evidence)

Are you aware of the Port Induction process?

Have you determind your employees’ training needs? (if yes, describe this process)

Can you provide documented evidence of training required to work on site? (if yes, provide evidence)

Accident & IncidentsDo you record all incidents in an accident register? (if yes, describe the process regarding the Port)

Do you investigate incidents that occur? (if yes, describe this process)

Do you have special procedures for serious harm events and notification?Emergency Readiness

Will you have trained First Aid staff? (if yes, please list staff)

Do you have first Aid kits available to your staff working at the Port? (if yes, describe this process)

Do you have an emergency plan relating to the work you will be undertaking? (if yes, please describe)

Sub-Contractor SafetyWill you be employing sub-contractors at the Port? (if yes, list)

If using subcontractors are they to operate under your health and safety management system?

Are you aware of the significant hazards subcontractors may create? (if yes, please provide)

Do you record all incidents in an accident register? (if yes, describe the process regarding the Port)

Can you describe the significant hazards you may create? (if yes, provide evidence)

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6.1

DOL Serious Harm Notification - 4.2.1