Information
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Task
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Document No.
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Name
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Date & Time
STOP
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Do I have the required Skills & Knowledge
THINK
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Doi I have the Correct PPE & Tools
ASSESS
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I have identified the Hazards in my Workplace
CONTROL
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I have implemented effective controls so myself and others will be safe
COMMIT
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I will continue to work safely
STOP & REVIEW
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STOP & REVIEW your Take 5 if something CHANGES from original plan
REVIEW
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Hazard Identified
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Effective Controls Implemented
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Notes / Comments
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No task is so important that it cant be done SAFELY