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Field Level Hazard Assessment

Answer the following questions by selecting YES or NO

You can add Media, Notes and Actions as necessary by clicking on the paper clip icon on the upper right corner of the question.
- Upload images through the Add Media option.
- Indicate notes through the Add Note option.
- Assign to another user with a priority level and due date, and they will be notified in real-time via email, text (SMS) or push notification through the Add Action option.

Evaluating Your Work Area and Tasks

Have you walked the area?

Do you have PPE available?

Are you working around live systems?

Does this task require special training?

Are underground utilities located?

Tools and equipment inspected?

Are work permits required?

Tools and material available?

Are evacuation routes established?

Are there previously unidentified safety issues?

Are fire extinguishers and First Aid available?

Is a fall protection plan required?

Have all workers attended the Site Specific Safety Orientation?

Have we co-ordinated activities with other subcontractors?

New/Young Worker on Crew?

New Tools or Equipment?

Adequate Time and Crew Provided to Complete Tasks?

Adequate Tools and Equipment?

Potential Hazard Checklist

Potential Hazard Checklist
Identify the Potential Hazard Checklist by selecting items on the dropdown list:

What other hazard is present?

PPE Required

Check the PPE Requirement if available.

Hard Hat

Hi-Visibility Vest

Safety Boots

Eye Protection

Gloves

Respirators

Face Shield

Ear Protection

RISK ASSESSMENT

RISK ASSESSMENT

RISK ASSESSMENT MATRIX

Risk Scoring matrix.jpg

Risk Assessment:
1-5 is considered Low Risk: work may commence
6-10 is considered Moderate Risk: Action needs to be taken to eliminate or minimize risk prior to work commencing
11-15 is considered High Risk: Immediate action must be taken to eliminate or minimize risk down to a Low to Moderate Risk with controls in place prior to work commencing. If this is not possible then job task cannot commence
16-25 is considered Extreme Risk: Job shutdown, urgent action must be taken to eliminate or minimize risk down to a Low or Moderate Risk with controls in place prior to work commencing. If this is not possible then the job task cannot commence

Click the ADD button to add a TASK
Step 1 - Identify the Task
Step 2 - Identify the Hazards
Step 3 - Conduct Risk Assessment by using the Matrix above
Step 4 - Actions to Eliminate / Control Hazard

Add TASK and identify the HAZARDS

Task

Step 1 Identify Task

Step 2 Identify Hazards

Step 3
Conduct Risk Assessment

Low Risk: work may commence

low.PNG

Moderate Risk: Action needs to be taken to eliminate or minimize risk prior to work commencing

moderate.PNG

High Risk: Immediate action must be taken to eliminate or minimize risk down to a Low to Moderate Risk with controls in place prior to work commencing. If this is not possible then job task cannot commence

high.PNG

Extreme Risk: Job shutdown, urgent action must be taken to eliminate or minimize risk down to a Low or Moderate Risk with controls in place prior to work commencing. If this is not possible then the job task cannot commence

extreme.PNG
Click ADD to SIGN
Worker Full Name and Signature

Field Level Hazard Assessment Checklist

Created by: SafetyCulture Staff | Industry: Construction | Downloads: 164

Use this template to to identify hazards, assess risks and control exposure to them before the tasks for the day begin. The identified controls may require that additional precautions be taken or that certain tasks be prohibited until a safer means to complete the task is made available.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

Download and edit this free checklist

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Field Level Hazard Assessment

Answer the following questions by selecting YES or NO

You can add Media, Notes and Actions as necessary by clicking on the paper clip icon on the upper right corner of the question.
- Upload images through the Add Media option.
- Indicate notes through the Add Note option.
- Assign to another user with a priority level and due date, and they will be notified in real-time via email, text (SMS) or push notification through the Add Action option.

Evaluating Your Work Area and Tasks

Have you walked the area?

Do you have PPE available?

Are you working around live systems?

Does this task require special training?

Are underground utilities located?

Tools and equipment inspected?

Are work permits required?

Tools and material available?

Are evacuation routes established?

Are there previously unidentified safety issues?

Are fire extinguishers and First Aid available?

Is a fall protection plan required?

Have all workers attended the Site Specific Safety Orientation?

Have we co-ordinated activities with other subcontractors?

New/Young Worker on Crew?

New Tools or Equipment?

Adequate Time and Crew Provided to Complete Tasks?

Adequate Tools and Equipment?

Potential Hazard Checklist

Potential Hazard Checklist
Identify the Potential Hazard Checklist by selecting items on the dropdown list:

What other hazard is present?

PPE Required

Check the PPE Requirement if available.

Hard Hat

Hi-Visibility Vest

Safety Boots

Eye Protection

Gloves

Respirators

Face Shield

Ear Protection

RISK ASSESSMENT

RISK ASSESSMENT

RISK ASSESSMENT MATRIX

Risk Scoring matrix.jpg

Risk Assessment:
1-5 is considered Low Risk: work may commence
6-10 is considered Moderate Risk: Action needs to be taken to eliminate or minimize risk prior to work commencing
11-15 is considered High Risk: Immediate action must be taken to eliminate or minimize risk down to a Low to Moderate Risk with controls in place prior to work commencing. If this is not possible then job task cannot commence
16-25 is considered Extreme Risk: Job shutdown, urgent action must be taken to eliminate or minimize risk down to a Low or Moderate Risk with controls in place prior to work commencing. If this is not possible then the job task cannot commence

Click the ADD button to add a TASK
Step 1 - Identify the Task
Step 2 - Identify the Hazards
Step 3 - Conduct Risk Assessment by using the Matrix above
Step 4 - Actions to Eliminate / Control Hazard

Add TASK and identify the HAZARDS

Task

Step 1 Identify Task

Step 2 Identify Hazards

Step 3
Conduct Risk Assessment

Low Risk: work may commence

low.PNG

Moderate Risk: Action needs to be taken to eliminate or minimize risk prior to work commencing

moderate.PNG

High Risk: Immediate action must be taken to eliminate or minimize risk down to a Low to Moderate Risk with controls in place prior to work commencing. If this is not possible then job task cannot commence

high.PNG

Extreme Risk: Job shutdown, urgent action must be taken to eliminate or minimize risk down to a Low or Moderate Risk with controls in place prior to work commencing. If this is not possible then the job task cannot commence

extreme.PNG
Click ADD to SIGN
Worker Full Name and Signature