ASB-SF-002 Risk Assessment Pre-Planning Site Visit.v3

• Job Number:

• Client Reference:

• Site Name / Area

• Conducted on

  Date

• Prepared by

RISK ASSESSMENT

• 01. Working at height (difficult access)

  YES

  NO

• Level of Risk:

  Select Low Risk Medium Risk High Risk Very High Risk

  • Low Risk
  • Medium Risk
  • High Risk
  • Very High Risk

• Control Measures:

• 02. Working alone in a remote area

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  Low Risk

  Medium Risk

  High Risk

  Very High Risk

• 03. Working in a confined / restricted space

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  Select Low Risk Medium Risk High Risk Very High Risk

  • Low Risk
  • Medium Risk
  • High Risk
  • Very High Risk

• 04. Hot works (risk of fire)

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  L

  M

  H

• 05. Excessive noise / dust

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  L

  M

  H

• 06. Obstructed routes and exit

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  L

  M

  H

• 07. Accessible to customers / staff

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  L

  M

  H

• 08. Work involves difficult lifting

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  L

  M

  H

• 09. Isolation of services

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  L

  M

  H

• 10. Isolation of emergency services

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  L

  M

  H

• 11. Electric shock

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  L

  M

  H

• 12. Customers or staff will re-occupy an area where works are unfinished and a return visit is necessary

  YES

  NO

• Significant Hazards:

• Control Measures:

• Level of Risk:

  L

  M

  H

COMPLETION

• Your Name:

  Sign