• Take 5 No.

  • Name

  • Date

  • Location

  • Address
  • Task

  • Risk Evaluation Matrix

    DNRME Risk Matrix.png

Hazard Checklist

  • 01. Do I understand the task/work?

  • 02. Am I trained, competent and authorised to do this task?

  • 03. Are tools/equipment fit for purpose and task/work?

  • 04. Can I be injured by nearby activities or can my activities injure others nearby?

  • 05. Can I strain or over exert myself?

  • 06. Can I slip or trip on anything?

  • 07. Can I fall onto, into or from anything?

  • 08. Can something fall on me or can I cause something to fall onto someone else?

  • 09. Can I come into contact with or be exposed to something that may harm me?

  • 10. Does anything need to be isolated and tested for dead? (e.g. electrical, hydraulics, gas)

  • 11. Can I spill or pollute something?

  • 12. Can weather conditions or work environment affect job safety? (e.g. poor lighting, tidal zones, excessive heat or cold, storms, etc.)

  • 13. Will communications reception be limited while doing the task?

  • 14. Is there a safer way I can do the task?

  • 15. Do I need to report into Field Ops (eg. 3 Messaging) while this task is being done?

  • 16. Are there any other hazards that need to be accounted for?

  • 17. Have I got the required PPE/provisions?

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.