Title Page

SITE DETAILS:

  • Site Address:

  • Client:

  • EQ / SO Reference:

  • Date:

  • Time:

  • Task:

  • Engineer:

Untitled Page

SECTION 1 - HAZARD ASSESSMENT CHECKLIST:

  • Before attempting this work consider:

  • Are you competent to do the required work?

  • Are your tools & equipment fit for purpose?

  • Will you follow a safe system of work and wear appropiate PPE as in the E-TEC H&S policy?

  • Site Knowledge:

  • Have you completed a site induction?

  • Is the client aware of your planned working activities on site?

  • Have you signed in and do you understand the relevant site safety & environmental controls?

  • Work area condition:

  • Have you surveyed the work area for hazards (eg. acess, lighting, temperature, weather, slip, trip, overhead hazards?

  • IS IT SAFE TO PROCEED?

  • Work area protection:

  • 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?

  • IS IT SAFE TO PROCEED?

  • EMERGENCIES

  • Are you aware of the emergency procedure arrangements in place (e.g. fire, first aid, system failures,spills, assembly point)?

  • Do you understand how to report hazards and/or near misses to the client & E-TEC Head Office?

SECTION 2 - RISKS:

  • Identify which of the following risks may apply during this task.

  • Any additional hazards - please note below.

SECTION 3 - PERSONS AT RISK:

  • Identify those persons at risk from this task.

SECTION 4 - CONTROL MEASURES:

  • What measures below will you put in place to mitigate the hazards you have indentified in section 1-3?

  • Any additional control measures - please note below.

SECTION 5 - METHODOLOGY:

  • Please provide a brief detail of the works to be undertaken.

SECTION 6 - REFERENCED DOCUMENTS:

  • 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:

  • Add signature

SECTION 8 - CLIENT SIGN OFF:

  • Add signature

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.