Title Page
SITE DETAILS:
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Site Address:
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Client:
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EQ / SO Reference:
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Date:
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Time:
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Task:
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Engineer:
Untitled Page
SECTION 1 - HAZARD ASSESSMENT CHECKLIST:
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Before attempting this work consider:
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Are you competent to do the required work?
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Are your tools & equipment fit for purpose?
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Will you follow a safe system of work and wear appropiate PPE as in the E-TEC H&S policy?
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Site Knowledge:
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Have you completed a site induction?
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Is the client aware of your planned working activities on site?
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Have you signed in and do you understand the relevant site safety & environmental controls?
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Work area condition:
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Have you surveyed the work area for hazards (eg. acess, lighting, temperature, weather, slip, trip, overhead hazards?
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IS IT SAFE TO PROCEED?
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Work area protection:
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Will you erect barriers and warning signage to ensure other personnel are warned and/or prevented from accessing the area in or under which you are working as required?
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IS IT SAFE TO PROCEED?
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EMERGENCIES
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Are you aware of the emergency procedure arrangements in place (e.g. fire, first aid, system failures,spills, assembly point)?
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Do you understand how to report hazards and/or near misses to the client & E-TEC Head Office?
SECTION 2 - RISKS:
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Identify which of the following risks may apply during this task.
- ELV Electrical
- LV Electrical
- HV Electrical
- Energised Systems
- Temperature
- Abestos
- Ventilation
- Lighting
- Manual Handling
- Noise
- Dust / Fumes
- Vibration
- Vechilce Movement
- Fragile Surface
- Slips / Trips / Falls
- Wastes
- Lone Working
- Working at Height
- Confined Spaces
- Access & Egress
- Biological / Chemical
- Radition
- Lift / Moving Machinery
- Cutting /Grinding
- Working near water
- Adverse Weather
- Vermin
- Welding
- Fire
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Any additional hazards - please note below.
SECTION 3 - PERSONS AT RISK:
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Identify those persons at risk from this task.
- Employees
- Contractors
- Client
- Young / Vulnerable Workers
- Public
SECTION 4 - CONTROL MEASURES:
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What measures below will you put in place to mitigate the hazards you have indentified in section 1-3?
- Survey / crawl boards
- Earthing & LOTO
- Harness / Lanyard
- Access permit
- PPE / Protection
- 2 Person Working
- Inspection Record
- Permit to Work
- Guarding / Protection
- Securing Access Equipment
- EffectiveMeans of Communication
- Lone Working Arrangements
- Pre-use Check
- Lifting Aids
- Asbestos Register
- Spill Control
- Document Control
- Authorised Access
- Hygiene / Welfare
- Flotation Device
- Task Lighting
- Forced Ventilation
- Housekeeping
- Switch Plan
- Fire Protection
- First Aid
- COSHH
- SAP
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Any additional control measures - please note below.
SECTION 5 - METHODOLOGY:
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Please provide a brief detail of the works to be undertaken.
SECTION 6 - REFERENCED DOCUMENTS:
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Please provide a list of standard documents referenced (e.g. RAMS, HSPs, MHA, COSHH Assessments) along with any Permits relating to the above works.
SECTION 7 - E-TEC SIGN OFF:
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Add signature
SECTION 8 - CLIENT SIGN OFF:
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Add signature