Is a task involves a hazard of potential dropped or falling objects. this form must be completed before commencing this task.
Can you eliminate the hazard by doing the task at ground level?
If NO, Complete a Risk assessment and a housekeeping check of the area you are working in before you start the task.
Rubber tool grommets
Covering gaps in flooring, opening & grid mesh with appropriate material (e.g. safety mats, blankets, boards)
Toolboxes / Tool bags with lids / Tool Bags
Barrier Safety Mesh on handrails
Storage area (suitable bins, buckets, cages etc.)
Secure/Tie-down of equipment/objects and tools in windy conditions or inclement weather
OTHER; (please specify)
Danger Tape with Information Tags
Exclusive Control Zone
"Working Above" signs
OTHER (please specify)
Is your work area "Drop Zone" barricaded - Every 4 meters up in height must be a minimum of 2 meters out from direct vertical drop to allow for deflection?
Have you checked and have communication with persons working above, below or in close proximity of each other?
NOTE: On completion of the task, conduct a thorough housekeeping and equipment check to ensure no loose items with the potential to fall are left at the work area.
Work Group Supervisor:
As workgroup supervisor I have verified that the above controls are in place and are effective in controlling the risk of dropped and falling objects.