Construction Risk Assessment Form Checklist

Instructions
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1. Answer "Safe", "At Risk", "N/A" for each of the hazards below
2. If "At Risk", follow the questions to identify the likelihood of occurrence, severity and risk rating
3. Include any notes and photos by clicking on the paperclip icon and then "Add Image"
4. Answer the relevant control questions
5. Complete the form by providing the relevant signatures

Confined Space

Likelihood of occurrence

Severity

Risk rating

Confined Space permit received

Enter description of control measures

Working at Height

Likelihood of occurrence

Severity

Risk rating

Working at height permit received

Height safety harness worn

Enter description of control measures

Restricted Access

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Electricity

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Compressed Air

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Uneven/slippery Surfaces

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Hazardous Gases

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Asbestos

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Vehicular movement

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Dust & Airborne particle's

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Working over/near water

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Overhead hazards

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Manual handling

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Fire / Explosion

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Noise

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

UV

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Buried/Covered services

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Lone worker

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Spills / Pollution

Likelihood of occurrence

Severity

Risk rating

Enter description of control measures

Completion

Observations and recommendations

Work completed

Equipment is safe & fit to operate

Customer representative

Construction Risk Assessment Form Checklist

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