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ANGLOGOLD ASHANTI: Mine Waste Solution CCIX

RISK ASSESSMENT RECORD

RA NO: 003

CONTRACTOR: Fibre-Wound Company (Pty) Ltd DATE: 2013-05-17

BRIEF DESCRIPTION OF WORK/ACTIVITY: Using of Portable Electrical Tools LOCATION: Mine Waste Solution: Stilfontein

RISK ASSESSMENT TEAM:

Initials & Surname Title/Appointment Signature
Contractors: Approved: Yes/ No

Project Manager
Chris Swart Project Coordinator Name: _______________ Signature: __________

Engineering Manager
Andrè Gerber Project Engineer
Name: _______________ Signature: __________
Anton van Zyl CR 6.(6) Safety Officer:

Title/Appointment
Client representative
COMMENTS:
Vaughan Swart
Safety Coordinator

Discipline Coordinator
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REQUIRED AND EXISTING CONTROL MEASURES: (SUBMIT AND ATTACH TO RISK ASSESSMENT)

Available Adequate Changes Remarks

Required
Yes No Yes No Yes No

Scope of work (Logical steps

on how task will be
performed )
Procedures: (W I / SOP / X X X
Vendor spec's)
Training (induction) / X X
Competency certificates/
X
Specific training identified /
Other (Instructions)
Special Permits required X X X
(specify)
Equipment /Tool registers / X X X
others (specify)
Code of Practice: X X X
Other:
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FREQUENCY SCALE SEVERITY SCALE PROBABILITY SCALE

Frequent occurrence / (3) Catastrophi (Many fatalities / > 10 Million damage) (8) Has happened (3)
daily c before

It has happened / (2) Disaster (Fatal injury / > 1 Million damage) (7) Quite possible (2)
monthly

Could occur / yearly (1) Very (Reportable Accident / > R100, 000 (6) Unusual but possible (1)
Serious damage)

Serious (Disability Injury (LTI) / > R100, 000 (5)

damage)

Important (Non-disabling Injury / > R1, 000 (4)

damage)

Of Concern (Minor injury / > R100 damage) (3)

RISK RANKING / PRIORITY FACTOR

If score is 61 to 72 AA Potentially Disaster, action needed immediately
If score is 49 to 60 A Potentially Major, action to be taken within 8 hours – during the shift
If score is 37 to 48 B Potentially Serious, action to be taken within 16 hours – during the second shift
If score is 20 to 36 C Potentially Minor, action to be taken within 7 days
If score is 0 to 19 D Potentially Tolerable, action to be taken within 1 month
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RISK ASSESSMENT

NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIV SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO E MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
1. Responsible  Tools and 3 8 3 72 AA All equipment that Appointed
Sec 6(1) to equipment will are going to be used GMR2.(7)(a)
ensure all tools not be with their registers
and equipment identified shall be checked by
(Personal numbered and the site’s responsible
protective inspected and person and signed off
equipment etc) couldn’t before work shall
to be used are comply with commence (Electrical
identified legal Machinery Reg.9+10
numbered requirements/s & driven Machinery
inspected and ite standards Reg 20 /General
on register which can Safety Reg 14a (5)(b)
result in legal
liability claims. 3 8 3 72 AA Where any
certification is
required this will form Appointed
part of the register to GMR2.(7)(a)
ensure failure of
 People could equipment is kept to
be exposed to a minimum
injury due to
failure of
equipment.
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIV SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO E MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
2. Responsible 6(1) to Appointed
Responsible  Personnel may 3 8 3 72 AA ensure Works GMR2.(7)(a)
Sec 6(1) will be exposed to Instruction WI – 91 –
ensure all hazards not 04 – 2/1 is followed
his/her known to him to the letter.
personnel go
through the Appointed
medical Possible Health 3 8 3 72 AA GMR2.(7)(a)
surveillance related issues will Responsible 6(1) to
and attend not be identified ensure medical
induction that could result in surveillance systems
before work will injury or legal are adhered to
commence liability claims
3. Responsible Exposures to 3 8 3 72 AA Responsible 6(1). to Appointed
6(1) will ensure unknown hazards ensure no job will GMR2.(7)(a)
that all relevant commence before all
permits and  Exposure to necessary permits
clearance to legal liability are obtained and
work will be clearance to work
obtained before  Possible has been given by
the work will process the responsible
commence interruptions person of the section
work is to be
performed (Occ H&S
Act Const Reg 7 )
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIV SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO E MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
4. Responsible  Exposures 3 8 3 72 AA  All Employees Appointed
6(1) to ensure to unknown to sign the GMR2.(7)(a)
risk hazards attendance register
assessment is  Exposures
discussed; to legal liability
understood and
signed prior to  Possible
work is process
commenced interruptions
 People can
be exposed to
injury
 Result in
legal claims
5. Pre-use Electrocution/ 2 8 2 32 C User to inspect Appointed
inspection fires/shock/ before use. Check GMR2.(7)(a)
multiple injuries. plug cord – condition
of body. No
cracks/joints in cable
and earth wire.
Guards in place. Stop
start switch
operational.
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIV SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO E MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
6. Only Untrained / 2 6 2 24 C Supervisors to Appointed
competent incompetent ensure all persons GMR2.(7)(a)
persons to persons may be competent/trained to
operate injured. Hand and use the above
machines. finger injuries. Eye mentioned portable
injuries most electrical equip.
common.
7. Use of  Blades 3 8 2 48 B Inspect for cracks, Appointed
grinders: braking, resulting chips and correct GMR2.(7)(a)
inspect cutting in severe injuries size. Super Flex
and grinding to body, face, blades to be used for
disc and tools hands and cutting. Type eg :
as per step 1. fingers. steel, masonry,
8. Correct PPE  As above 2 5 2 20 C Supervision to verify Appointed
used and before use. Safety GMR2.(7)(a)
available glasses, welding
helmet/visor, gloves,
safety boots, hard
hat, respirator. If
cutting/grinding non-
ferrous materials.
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIV SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO E MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
9. Cutting/  As above 2 6 2 24 C  Never leave Appointed
Grinding multiple injuries grinder running GMR2.(7)(a)
when unattended
and safe position.
No abnormal
postures. Guards in
place. Sparks
contain by using
welding
screens/blankets/bu
ckets. Never pointing
running grinder
towards anybody.
Never cut/grind
when work piece is
not properly secured
or clamped down
10. Using electric  Eye 2 6 2 24 C  PPE required: Appointed
drill. injuries, hands, & safety glasses, GMR2.(7)(a)
fingers. Multiple gloves hard hat and
body injuries. safety shoes. Grip
Burns from drill with both hands.
shavings. Work pieces secured
Electrocution and clamped.
Correct drill bit for
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONSI
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE BLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’S
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIV SIGNATUR
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO E MEASURES E ON
 PROCESS  CONTROL AT
AND WHEN) XF R AND COMPLETI
SOURCE
 MATERIAL CONTROLS ON DATE
 PUT/FOLLOW ARE IN PLACE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
task. Size, steel or
concrete work.
11. Using jig-saw.  As above 2 6 2 24 C  Correct blade for Appointed
with drills. materials like glass- GMR2.(7)(a)
fibre, steel and
wood. No jerking
actions. Cut steady,
beware of blade
cutting on the other
side. Do not cut any
other materials or
items or peoples
hands/body parts
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I _______________________hereby (Print name in full) declare that: the undersigned Responsible

ANGLOGOLD ASHANTI person (appointee)

I have after consultation with my employees as far as reasonably practicable identified and recorded all the significant hazards
and risks associated with the task that I am to perform with regards to this Risk Assessment
I have determined all measures that needs to be in place for this task, including changing the organization of work and design of safe
systems of work, necessary to eliminate, control, minimise, or where the risk still remains provided the necessary personal protective
equipment, and implemented them.
I undertake to periodically review the hazards identified and the risk assessed, to determine whether further elimination, control and
minimization of risk is possible
I have provided every employee as part of this risk assessment with the necessary training, information, instruction or
supervision to enable them to perform their work without risk to his/her Safety and Health.

Signed on the __________ at ANGLOGOLD ASHANTI _________________________

(Date) (Responsible person)

Employed by: FIBRE WOUND SA (Name of Company)

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I / we the undersigned hereby declare that the Responsible person in charge has made us familiar with the work-related hazards and risk
and the measures that must be taken to eliminate, control and minimise those hazards and risks:

PRINT NAME IN FULL SIGNATURE

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