COMPETENCY TO OPERATE - Dangerous Equipment

• Site conducted

  Select

• Client / Site

• Personnel

• Conducted on

  Date

• Prepared by

Person being Assessed

• Name:

• Department:

• Position:

Details of Machinery or Equipment

• Description of machinery/equipment

• Model or Type

• Major risks

Safety Procedures

• Have relevant SAFE OPERATING PROCEDURES (SOP) or a SAFE WORK METHOD STATEMENT (SWMS) been issued to the person being assessed?

  Yes

  No

  N/A

COMPETENCY ASSESSMENT

• PRE OPERATION CHECKS: <br>Rate the person's ability to conduct all the required pre-operation safety checks.

  Not Competent

  Improvement Required

  Competent

  Very Competent

• OPERATING:<br>Rate the person's ability to operate the equipment/machinery safely with no risk of injury to self or others.

  Not Competent

  Improvement Required

  Competent

  Very Competent

• POST OPERATION CHECKS: <br>Rate the person's ability to conduct all the required post-operation safety checks.

  Not Competent

  Improvement Required

  Competent

  Very Competent

APPROVAL

• Do you give approval for the person to operate the equipment or machinery with NO direct supervision?

  Yes

  No

  N/A

• Name of Assessor

  Sign

• Position: