DTZ UTAKE 5

• Document No.

• Client / Site

• AREA:

• Conducted on

  Date

• TASK:

• Entered by:

• Location
  Address

• UTAKE 5 completed by:

  Group

  Individual

• UTAKE 5 completed when:

  Start of Job

  Random check

  Changes to the job

Step 1. STOP AND LOOK

• Observe work area and surroundings

  Yes

  No

Step 2. THINK THROUGH THE TASK

• Work scope / Procedures / JHA or JSA understood and in use

  Yes

  No

• Correct permit requirements obtained and in use

  Yes

  No

• Correct PPE obtained and in use

  Yes

  No

• Correct Tools / Equipment used and in good order

  Yes

  No

Step 3. IDENTIFY THE HAZARDS

• Look close

• Look wide

• Look for the hidden

• Hazard Details - List or take a picture(s) of the hazards you identified - Hazards identified are:

• Add media

  Media

Step 4. CONTROL AND COMMUNICATION

• Hazard Control Details - List or take a picture of how the hazard(s) will be controlled to protect you:

• Add media

  Media

• Hazards controlled before the task is started

  Yes

  No

• Share learnings with others in crew / team - Do the people working with you understand the hazards and controls in the same way you do?

  Yes

  No

Step 5. DO THE TASK SAFELY

• Control - Hazards must be controlled before the task is started - Can the job be done safely? (If no, STOP and contact your Supervisor)

  Yes

  No

• AFTER A BREAK - STOP, LOOK, AND REVIEW YOUR UTAKE 5
  Complete and send this document to your Supervisor