Information

  • Document No.

  • Audit Title and/or Job Description and/or Task Description.

  • Site/Location

  • Conducted on

  • Prepared by

  • Location

Job Information

  • Person in charge of work.

  • Persons involved

Break Tasks Into Steps

  • Task

  • Step 1

  • Hazards Associated with Step 1

  • Risks Associated with Step 1

  • Media.

  • Safe Work Procedures / PPE for step 1

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Step 2

  • Hazards associated with Step 2

  • Risks Associated with Step 2

  • Media

  • Safe Work Procedures / PPE for step 2

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Step 3

  • Hazards associated with Step 3

  • Risks Associated with Step 3

  • Media

  • Safe Work Procedures / PPE for step 3

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Is there another step??

  • Step 4

  • Hazards Associated with Step 4

  • Risks Associated with Step 4

  • Safe Work Procedure / PPE for Step 4

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

  • Is there another step??

  • Step 5

  • Hazards Associated with Step 5

  • Risks Associated with Step 5

  • Safe Work Procedure / PPE for step 5

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

  • Is there another step??

  • Step 6

  • Hazards Associated with Step 6

  • Risks Associated with Step 6

  • Safe Work Procedure / PPE for step 6

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

  • Is there another step??

  • Step 7

  • Hazards Associated with Step 7

  • Risks Associated with Step 7

  • Safe Work Procedure / PPE for step 7

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

  • Is there another step??

  • Step 8

  • Hazards Associated with Step 8

  • Safe Work Procedure / PPE for step 8

  • Risks Associated with Step 8

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

  • Is there another step??

  • Step 9

  • Hazards Associated with Step 9

  • Risks Associated with Step 9

  • Safe Work Procedure / PPE for step 9

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

  • Is there another step??

  • Step 10

  • Hazards Associated with Step 10

  • Safe Work Procedure / PPE for step 10

  • Risks Associated with Step 10

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

  • Is there another step??

  • Step 11

  • Hazards Associated with Step 11

  • Risks Associated with Step 11

  • Safe Work Procedure / PPE for step 11

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

  • Is there another step??

  • Step 12

  • Risks Associated with Step 12

  • Hazards Associated with Step 12

  • Safe Work Procedure / PPE for step 12

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

Jobsite and Task Checklist

  • Are permits required? (Permit to work, hot work, confined spaces, etc.)

  • Is the permit complete? DO NOT PROCEED WITHOUT A PERMIT

  • Is special training needed? (Forklift, Scaffold, Powder Actuated Tool)

  • Do the people involved have the appropriate training / licences?

  • Can weather conditions affect safety?

  • Consider posponing the job until the weather improves.

  • Is lighting a problem?

  • Consider if additional lighting is required.

  • Contact with acids, toxic or caustics? (Material Safety Data Sheet)

  • Wear PPE and refer to Material Safety Data Sheets on company 'L' drive.

  • Will there be exposure to dust, fumes or mist? (Material Safety Data Sheet)

  • Wear a dust mask appropriate to the risk. SEEK ADVICE TO ENSURE YOU HAVE THE CORRECT MASK.

  • Is the employee working with sharp or rough materials that require PPE?

  • Wear correct hand protection appropriate to the task. SEEK ADVICE TO ENSURE YOUR PPE IS APPROPRIATE.

  • Can the worker slip, trip or fall?

  • Ensure the work area is free from hazards. Wear a safety harness, Clean slippery surfaces.

  • Do tools, machines or equipment present any hazards?

  • Ensure you are competent to use the equipment. Ensure the equipment is safe to use.

  • Can any body part get caught in, struck by or caught between objects? THIS INCLUDES HANDS, THINK BEFORE YOU REACH

  • Isolate and lock of plant using personal padlocks if you will be at risk of mechanical entrapment. LOCK OUT, TAG OUT, TRY OUT.

  • Can pushing, pulling, lifting, bending or twisting cause strain?

  • Use correct manual handling.
    Source equipment to reduce risk.

  • Is there danger from falling objects?

  • Check area overhead and remove the risk before starting work.

  • Is excessive noise or vibration a problem?

  • Wear ear defender, hearing protection.
    Carry out a Hand Arm Vibration Risk Assessment.
    Use Anti Vibration Gloves. SEEK ADVICE.

  • Are there flammable, explosive or electrical hazards?

  • Ensure area is purged of fumes.
    Engage electrician to remove electrical hazard.

  • Fall hazard from one level to another or same level?

  • Use a harness, fall arrestor, lanyard.

  • With all the Hazards & Risks assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

Signatures

  • Person completing Task Hazard Analysis & SSOW

  • Employee 2

  • Employee 3

  • Employee 4

Comments/Discussion

  • Comments/Discussion

  • Add media

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.