ALS Take 5

• Project/Job No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Task

1. Think Through The Task

• Work scope and procedures understood?

  Yes

  No

  N/A

• Position of people considered?

  Yes

  No

  N/A

• Permit to work obtained?

  Yes

  No

  N/A

• Correct PPE?

  Yes

  No

  N/A

• Tools/Equipment in good working order?

  Yes

  No

  N/A

Spot The Hazard

Assess The Risk

• 

• Rating

  Extreme

  High

  Medium

  Low

Make The Changes

• Can the hazards be removed and controlled? And how?

• Potential problems discussed?

Reassess The Risk

• Rating

  Extreme

  High

  Medium

  Low

• Can this job be continued safely?

  Yes

  No

Do The Job Safely

• Add signature

  Sign

Notes

• Any additional notes