Title Page
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Scheme or Site Attended
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Attended on
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Attended by
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Location
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(1) STOP and SURVEY your surroundings and identify the hazards
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(2) ASSESS what could go wrong
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(3) Put CONTROL measures in place to minimise the identified hazards
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(4) DO NOT CONTINUE if you think it is unsafe to do so or if you have not had permission to enter scene by the Emergency Services
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(5) STOP, THINK and REASSESS if conditions change
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(6) CONTINUE when safe to do so while checking for new hazards
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(7) FOLLOW Business Incident Process at all times
Hazard Identification
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Hazard Present - Exposure to trauma / death
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What additional control measures are required?
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Hazard Present - Contact with biohazards / bodily fluids
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What additional control measures are required?
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Hazard Present - Fire
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What additional control measures are required?
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Hazard Present - Exposure to toxic chemicals
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What additional control measures are required?
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Hazard Present - Flooding
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What additional control measures are required?
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Hazard Present - Explosive atmospheres
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What additional control measures are required?
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Hazard Present - Inhalation of particulates / asbestos
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What additional control measures are required?
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Hazard Present - Unstable or unsafe structure
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What additional control measures are required?
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Hazard Present - Violence or Hostile Environment
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What additional control measures are required?
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Hazard Present - Risk from falling objects
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What additional control measures are required?
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Hazard Present - Exposure to live electrical connections / cables
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What additional control measures are required?
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Present - Other
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What Other Hazards are present?
Check of Control Measures
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Is it safe to continue with or without additional control measures? If unsure follow Business Incident process and contact those parties listed for relevant guidance and advice BEFORE proceeding.
Liaison with Other Parties
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Are the Emergency Services present?
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Have you obtained permission to enter incident area from relevant authorities if present?
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If permission obtained provide detail as to who provided this permission
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If NO to the above do NOT proceed until permission obtained.
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Have you informed the relevant Broadland Management Team as per the Business Incident process?
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If YES provide details of who you contacted and when.
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If NO do not continue until you have done so.
General Safety
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Have you left your vehicle in a safe location and is the area secure?
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Do you have the required PPE to safely work in the area? If NO do not proceed until PPE obtained.