ANGLOGOLD ASHANTI: Mine Waste Solution CCIX

RISK ASSESSMENT RECORD

RA NO: 002

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

BRIEF DESCRIPTION OF WORK/ACTIVITY: ON and Off loading of vehicles and trucks LOCATION: Mine Waste Stilfontein

RISK ASSESSMENT TEAM:

Initials & Surname Title/Appointment

Contractors: Signature Approved: Yes/ No

Chris Swart Project Coordinator Project Manager :

Name: _________________ Signature: _____________

Project Engineer Engineering Manager :

Andre Gerber Name: ________________ Signature: ______________

Anton van Zyl Safety Officer

Title/Appointment Comments:
Site representative

Vaughan Swart Safety Officer

Discipline Coordinator

REQUIRED AND EXISTING CONTROL MEASURES: (SUBMIT AND ATTACH TO RISK ASSESSMENT )
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 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 X
Competency certificates/
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 Concern , action not to be taken during work

ANGLOGOLD ASHANTI Mine Waste Solution CCIX Risk Assessment

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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONS
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE IBLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK P REVENTATIVE S
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES AND SIGNATU
 PROCESS  CONTROL AT
AND WHEN) XF R CONTROLS ARE RE ON
SOURCE
 MATERIAL IN PLACE COMPLET
 PUT/FOLLOW ION DATE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
1. Responsible Tools and 3 8 3 72 AA All equipment that is Appointed
6(1) to ensure equipment not going to be used with GMR2.(7)(a)
all tools and identified, their registers shall
equipment to numbered and on be checked by the
be used are register couldn’t site’s responsible
identified, comply with legal person and signed off
numbered and requirements/site before work
on register. standards which commences.
can result in legal (Electrical machinery
liability claims 3 8 3 72 AA reg. 9+10 & driven
machinery reg. 20/
general safety
People could be reg.14a (5)(b)
exposed to injury Where any
due to failure of certification is
equipment required this will form
part of the register to
ensure failure of
equipment is kept to
a minimum
2. Responsible Person may be 3 8 3 72 AA Responsible 6(1) to Appointed
6(1) will ensure exposed to ensure works GMR2.(7)(a)
all his/her hazards not instruction from the
/conversion/tmp/activity_task_scratch/755698784.doc 4
NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONS
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE IBLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE S
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES AND SIGNATU
 PROCESS  CONTROL AT
AND WHEN) XF R CONTROLS ARE RE ON
SOURCE
 MATERIAL IN PLACE COMPLET
 PUT/FOLLOW ION DATE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
personnel go known to him 3 8 3 72 AA client is followed to
through the the letter.
medical Possible health
surveillance related issues will Responsible 6(1) to
and attend not be identified 2 5 3 30 C ensure medical
induction that could result in surveillance systems
before work will injury or legal are adhered to.
commence. liability claims
Responsible
6(1) to ensure Certificate of
all his/her Incompetent competency to be
personnel is personnel can produced for all
certified lead to injury or labour.
competent for property damage
the tasks they
are to perform,
and legally
appointed.
3. Responsible Exposures to 3 8 3 72 AA Responsible 16.2 to Appointed
6(1) to Ensure unknown Hazards ensure no job will GMR2.(7)(a)
all relevant Exposures to legal commence before all
permits and liability the necessary
clearance to Possible process permits are obtained
work are interruptions and clearance to
obtained before People can be work has been given
/conversion/tmp/activity_task_scratch/755698784.doc 5
NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONS
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE IBLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE S
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES AND SIGNATU
 PROCESS  CONTROL AT
AND WHEN) XF R CONTROLS ARE RE ON
SOURCE
 MATERIAL IN PLACE COMPLET
 PUT/FOLLOW ION DATE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
the work will exposed to Injury by the responsible
commence, Result in Legal person of the section
where required. Claims where work is to be
performed
4. Responsible Exposures to 3 8 3 72 AA All Employees to sign Appointed
6(1) to ensure unknown hazards the attendance GMR2.(7)(a)
risk Exposures to legal register
assessment is liability
discussed; Possible process
understood and interruptions
signed prior to People can be
work is exposed to injury
commenced Result in legal
claims
5. Driver to park Damage to 2 5 2 20 C Supervisor to ensure Responsible
vehicle next to equipment, that the driver is 2.1
area where injuries, trucks licensed, handbrake
equipment is to overturning from applied and chock
be loaded/off- unstable/ wheels if necessary
loaded and unbalanced loads
surface as level and runaway
and stable as vehicles
possible
6. Loading/off-  Damage to 2 6 2 24 C Supervisor to ensure Responsible
loading of property or loads that only trained 2.1
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONS
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE IBLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK P REVENTATIVE S
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES AND SIGNATU
 PROCESS  CONTROL AT
AND WHEN) XF R CONTROLS ARE RE ON
SOURCE
 MATERIAL IN PLACE COMPLET
 PUT/FOLLOW ION DATE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
loads to be when loading/off- riggers and assistants
done by loading do the loading/off-
trained and  Injury and loading with the
competent lacerations to correct lifting
workers workers equipment
7. When using a  Damage to 2 6 2 24 C  Supervisor to Responsible
forklift or property or loads ensure that forklift is 2.1
mobile crane when slewing set for size before
for loading/off-  Injuries to loading/off-loading
loading workers struck or and only colour
barricade area caught by loads coded lifting
off equipment is used
when using mobile
crane. Only licensed
operators are
allowed to do the
work and that all
equipment is on
register and checked
daily
8. When  Damage 2 5 2 20 C  Supervisor to Responsible
loading/off- caused by falling ensure that area is 2.1
loading secure loads and injuries properly barricaded
load first before caused by caught and that enough
/conversion/tmp/activity_task_scratch/755698784.doc 7
 NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONS
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE IBLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE S
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES AND SIGNATU
 PROCESS  CONTROL AT
AND WHEN) XF R CONTROLS ARE RE ON
SOURCE
 MATERIAL IN PLACE COMPLET
 PUT/FOLLOW ION DATE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
lifting or between and spotters are set out
lowering struck by to guard the
loading/off-loading
area
9. When  Damage 2 7 2 28 C  Supervisor Responsible
loading/off- to load if driver to ensure that the 2.1
loading with cannot see reverse hooter is
a forklift the where he is working and pre-
driver must driving use inspection
drive with the  Injuring or was done on the
load in a killing workers forklift
lowered when struck by
position forklift
10. When  Damage 2 5 2 20 C  Supervisor Responsible
lowering or caused by and operator to 2.1
lifting the falling loads ensure that only
load to and injuries the required
load/off-load caused by workers are in the
it must be caught barricaded area
done slowly between and
and struck by
/conversion/tmp/activity_task_scratch/755698784.doc 8
 NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONS
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE IBLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE S
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES AND SIGNATU
 PROCESS  CONTROL AT
AND WHEN) XF R CONTROLS ARE RE ON
SOURCE
 MATERIAL IN PLACE COMPLET
 PUT/FOLLOW ION DATE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
controlled
11. Use of  See R.A. 2 4 2 16 D  See R.A. 37 Responsible
ladders may 37 2.1
be needed to
reach loads
12. When drivers  Injuries 3 3 3 27 C  Supervisor Responsible
of vehicles caused by the to notify drivers 2.1
get out of loading/off- before entering
their vehicles loading of the site the P.P.E.
when loads requirements
loading/off-
loading they
must have
the required
P.P.E.
available
13. Rigger  Failure of 2 7 2 28 C  Supervisor Responsible
assistants to equipment or to ensure that 2.1
attach the accidental rigger check
lifting release of load before lifting the
equipment load
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 NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONS
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE IBLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE S
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES AND SIGNATU
 PROCESS  CONTROL AT
AND WHEN) XF R CONTROLS ARE RE ON
SOURCE
 MATERIAL IN PLACE COMPLET
 PUT/FOLLOW ION DATE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
and guide
ropes to the
load that is
loaded/off-
loaded
14. Position  Swinging 2 6 3 36 C  Rigger to Responsible
crane hook load can injure give clear signals Rigger
vertically workers and to crane drivers
above lifting damage while blowing his
point of load equipment whistle to worn
and pick up the workers of the
the slack on lift
the slings.
15. Check all  Can 3 6 3 54 B  Rigger to Responsible
equipment cause load to give clear signals Rigger
for kinks and suddenly to crane drivers
twists while swing/jerk or while blowing his
lifting slide causing whistle to worn
multiple the workers of the
injuries and lift
damage
/conversion/tmp/activity_task_scratch/755698784.doc 10
 NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONS
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE IBLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE S
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES AND SIGNATU
 PROCESS  CONTROL AT
AND WHEN) XF R CONTROLS ARE RE ON
SOURCE
 MATERIAL IN PLACE COMPLET
 PUT/FOLLOW ION DATE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
16. Make sure  Load can 3 6 3 54 B  Rigger to Responsible
that the swing and pull ensure that the Rigger
guide rope the rigger guide ropes is the
operator is in assistant into correct length to
a safe or against control the load
position and objects or without
flagmen are struck other endangering co-
keeping workers on workers.
workers elevated level
away from
the danger
area
17. When the  As all 3 6 3 54 B  Rigger to Responsible
correct above and the ensure that he is Rigger
position is crane boom in such a position
reached, the slewing into where he can
load will be position clearly see the
lowered into assistant rigger
position and crane driver
simultaneously
for giving signals
/conversion/tmp/activity_task_scratch/755698784.doc 11
 NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONS
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE IBLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE S
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES AND SIGNATU
 PROCESS  CONTROL AT
AND WHEN) XF R CONTROLS ARE RE ON
SOURCE
 MATERIAL IN PLACE COMPLET
 PUT/FOLLOW ION DATE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
18. Load to be  Uncontrol 2 7 2 28 C  Rigger to Responsible
collected and led shifting of ensure that he is Rigger
placed into load can cause in such a position
position by damage to where he can
the workers equipment and clearly see the
injuries to assistant rigger
workers and crane driver
simultaneously
for giving signals
19. Lower the  Falling of 2 7 2 28 C  Rigger to Responsible
crane hook lifting ensure that no Rigger
to ground equipment and workers is in the
level before slings can barricaded area
removing the injure workers when lowering
lifting receiving it the cane hook
equipment
and guide
ropes
20. Check lifting   Riggerto report Responsible
equipment to the store man if Rigger
and slings for any deviations
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NO LIST TASK WITH POTENTIAL AND PROB SEV OF FREQ SCO RISK PREVENTATIVE PERSON RESPONS
ALL TASK EXISTING HAZARDS OF OCCUR OF RE RANK / MEASURES AND RESPONSIBLE IBLE
STEPS  INJURY OCCU 3/4/5/6/ OCCU TOTA PRIORI CONTROLS TO ENSURE PERSON’
(WHO WILL DO R 7/8 R L TY  ELIMINATE RISK PREVENTATIVE S
 HEALTH
WHAT, WHERE 1/2/3 1/2/3 PXS FACTO MEASURES AND SIGNATU
 PROCESS  CONTROL AT
AND WHEN) XF R CONTROLS ARE RE ON
SOURCE
 MATERIAL IN PLACE COMPLET
 PUT/FOLLOW ION DATE
 ENVIRONMENT
PROCEDURE
 PROVIDE PPE
visual were found
damage and
hand in at
the store.

I the undersigned Responsible person (Appointee) _______________________ hereby

(Print name in full)
declare that:

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
/conversion/tmp/activity_task_scratch/755698784.doc 13
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 __________/20…. at ANGLOGOLD ASHANTI _____________________

(Date) (Responsible person)

Employed by FIBRE WOUND SA

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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