Information

  • Document No.

  • Site Address / Block Name

  • Postcode

  • Client

  • Conducted on

  • Prepared by

  • Location
  • Personnel Onsite

Risk Assessment

Working at Heights

  • 1.1. Fall risks of 2m or more? (including voids, pits, and trenches)

  • Add notes and pictures

  • Add Notes

  • 1.2. Lack of edge protection?

  • 1.3. Unsafe or incomplete edge protection?

  • Are you able to complete height work safely

Cable Pulling And Work Area

  • Are You Able To Complete Task Safely

  • Have You Tested All Chambers For Gas

  • Can All Chambers Be Guarded With 4 Sided Guards

  • Have You Setup Chapter 8

  • Base Of Ladders Guarded

  • Work Area Guarded

  • Photo Of Work Area

Plant and Equipment

  • 2.1. Unsafe or damaged plant/equipment? (including missing or damaged guards)

  • 2.2. Incorrect plant /equipment for job? (e.g. grinding discs for cutting)

Harness and Equipment

  • 5.1. Unsafe or damaged harness or equipment?

  • 5.2. Incompatible hooks/equipment?

  • 5.3. Unlabelled or does not meet AS?

  • 5.4. Unsafe or uncertified anchor points?

  • 5.5. Lack of inspection protocol for equipment?

  • 5.6. Lack of or inadequate formal training for operators?

Ladders

  • 6.1. Unsafe or damaged ladders?

  • 6.2. Unsafe positioning of ladders?

  • 6.3. Ladder not properly secured?

  • 6.4. Ladder unsuitable for job? (e.g. metal ladder used for electrical work)

  • 6.5 Is There Unsafe Ground

Hazardous Manual Tasks

  • 7.1. Lack of identification hazardous manual tasks?

  • 7.2. Lack of assessment of hazardous manual tasks?

  • 7.3. Inadequate risk controls? (examples: no job rotation, lighter loads, trolleys, lifting equipment, etc)

  • 7.4. Lack of training in risk controls and safe lifting/ team lifting techniques?

Hazardous Chemical (including fuel and oil)

  • 8.1. Unsafe storage location? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)

  • 8.2. Incompatible chemicals stored near each other?

  • 8.3. Inadequate spill containment equipment?

  • 8.4. Safety Data Sheets not accessible on site?

  • 8.5. Lack of emergency procedures for injury/spills/fire etc?

  • 8.6. Excessive quantities stored on site or in vehicles?

  • 8.7. Insufficient ventilation?

  • 8.8. Insufficient, or incorrect, PPE?

  • 8.9. Unsuitable storage containers? (unlabeled or stored in food containers)

Personal Protective Equipment (PPE)

  • Do You Have All PPE Items

  • Please add a note

  • Hard Hat With Chin Strap

  • Safety Harness Equipment

  • Ear Defenders

  • Goggles

  • Gloves

  • 11.1. Lack of, or inadequate PPE (including sun protection)

  • 11.2. Lack of system to issue, inspect, replace and monitor PPE?

  • 11.3. Lack of training in safe use, clean-up and inspection of PPE?

Work Environment

  • 12.1. Lack of/or inadequate amenities? (toilets, wash areas, lunch rooms, etc)

  • 12.2. Insufficient lighting?

  • 12.3. Inadequate housekeeping?

  • 12.4. Lack of, or inadequate noise/ vibration control?

Environmental Hazards

  • 14.1. Lack of/or inadequate Environmental Management plan (EMP)?

  • 14.2. Lack of/or inadequate, dust suppression system?

  • 14.3. Lack of/or inadequate systems to prevent contaminants entering stormwater drains?

  • 14.4. Lack of water re-use systems?

Welfare Information

  • Is There A Welfare Unit Onsite

  • Local Toilet Facilities
    http://www.mcdonalds.co.uk/ukhome/Restaurants/restaurant_locator.html

  • Local A&E Hospital
    http://www.nhs.uk/service-search

Additional Hazards

  • List additional Hazards

Corrective Actions

  • Enter any corrective actions that will be undertaken

Sign Off (to be signed by all crew onsite

  • Persons onsite

  • Persons onsite

  • Persons onsite

  • Persons onsite

  • Persons onsite

  • Persons on site

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.