Information

DNRME Take 5 - Generic v 2018.03.22

  • Take 5 No.

  • Name

  • Date

  • Work Description

  • Location

  • Address

Risk Evaluation Table

  • Risk Evaluation Table

    DNRME Risk Matrix.png

Hazard Checklist

For the following questions, document hazards, controls and risk levels in the applicable Add Notes section and take photos as required. (may need to click on the "paper clip" icon) Once the Take 5 is complete: * If in mobile reception, email to yourself and/or manager * If out of mobile reception, save the audit and email on return to the office.

Is the task/work a change from a current process, procedure or design?

  • If Yes, you need to contact you supervisor/manager to obtain approval.<br>Once approval is obtained, undertake all required documentation before proceeding.

01. Do I have the required permits to do this work?

  • If No do not proceed with the work until the required permits are in place.

02. Can I be injured by being in, on or between anything?

  • Pinch points, rotating machinery, conveyors, vehicles, beams, etc.

  • Have the hazard/s been managed?

03. Can I slip or trip on anything?

  • Steep, slippery or uneven surfaces, poor housekeeping, tools, cables, debris, etc.

  • Have the hazard/s been managed?

04. Can I fall onto, into or from something?

  • Work above 1.8 m, fall onto objects, from machinery, water, etc

  • Have the hazard/s been managed?

05. Can something fall on me and/or can I cause something to fall onto someone else?

  • Falling tools, equipment, people working above or below me, vegetation, debris, etc.

  • Have the hazard/s been managed?

06. Can I be struck by any moving objects?

  • Vehicles, machinery, boat, projectiles, debris, etc.

  • Have the hazard/s been managed?

07. Can I strain or over exert myself?

  • Repetitive movements, pushing, pulling lifting, awkward posture, sustained posture, etc.

  • Have the hazard/s been managed?

08. Can I come into contact with or be exposed to something harmful?

  • Heat, gases, electricity, oil, grease, acid, pneumatic, hydraulic, etc.

  • Have the hazard/s been managed?

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

  • People working above or below me, dust, fumes, noise, sparks, projectiles, boats, cables, etc.

  • Have the hazard/s been managed?

10. Can I spill or pollute something?

  • Spill or release oil, fuel, chemical, poison, etc. onto me or into waterways

  • Have the hazard/s been managed?

11. Does anything need to be isolated and tested for dead?

  • Electricity, water, pneumatic, hydraulics, etc.

  • Have the hazard/s been managed?

12. Could there be uncontrolled movement?

  • Ground failure, wall failure, roof failure, run away vehicle, flowing water, etc.

  • Have the hazard/s been managed?

13. Can weather conditions, work environment, fatigue, speed or poor lighting affect job safety?

  • Temperature (cold/hot), humidity (low/high), storm, inadequate lighting, unrealistic schedule, rushing, lack of rest or sleep, etc.

  • Have the hazard/s been managed?

Do I have the required PPE?

  • Eyes, ears, face, head, hands, feet, body, etc

15. Are there any other hazards present that weren't accounted for?

  • If "At Risk" then document the hazards, controls and risks. Include photos if required

  • Have the hazard/s been managed?<br>(Document the risk rating and what controls were used or why no controls were required.)

Signature

  • Sign here

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