Information
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Document No.
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Client / Site
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AREA:
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Conducted on
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TASK:
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Entered by:
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Location
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UTAKE 5 completed by:
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UTAKE 5 completed when:
Step 1. STOP AND LOOK
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The action of stepping back and observing is a good habit to get into
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Observe work area and surroundings
Step 2. THINK THROUGH THE TASK
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Have a clear plan in your mind on how to do the task safely.
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Work scope / Procedures / JHA or JSA understood and in use
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Correct permit requirements obtained and in use
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Correct PPE obtained and in use
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Correct Tools / Equipment used and in good order
Step 3. IDENTIFY THE HAZARDS
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Just because it hasn't happened doesn't mean it won't happen
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Look close
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Tool condition Chemical handling
Working at heights Equipment handling
Slips, trips and falls Manual handling
Lacerations Noise
Untidy housekeeping Missing machine guards -
Look wide
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Conflicting tasks Spills and leaks
Pedestrian & vehicle traffic Blocked access & egress
Emergency exits Emergency equipment
Poor lighting Damaged vehicles
Work environment Ergonomics -
Look for the hidden
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Products & chemicals Thermal (hot & cold)
Electricity Heat stress
Compressed gases Biological
Vapors inside Toxic/asphyxiating gases
Confined spaces Physical / weight
Corrosion Body position -
Hazard Details - List or take a picture(s) of the hazards you identified - Hazards identified are:
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Add media
Step 4. CONTROL AND COMMUNICATION
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Hazard Control Details - List or take a picture of how the hazard(s) will be controlled to protect you:
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Add media
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Hazards controlled before the task is started
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Share learnings with others in crew / team - Do the people working with you understand the hazards and controls in the same way you do?
Step 5. DO THE TASK SAFELY
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Control - Hazards must be controlled before the task is started - Can the job be done safely? (If no, STOP and contact your Supervisor)
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AFTER A BREAK - STOP, LOOK, AND REVIEW YOUR UTAKE 5
Complete and send this document to your Supervisor
