Information
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Project No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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ACTIVITY DESCRIPTION:
DESCRIPTION OF WORKS
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1.1. Division
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1.2. Tasks
HAZARDS
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2.1. Heights
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2.2. Equipment
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2.3. Power Lines
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2.4. Electricity
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2.5. Sharp Objects
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2.6. Slippery / Wet Surfaces
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2.7. Gasses
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2.8. Underground Utilities
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2.9. Overhead Obstructions
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2.10. Hazardous Substances
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2.11. Ignition Sources
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2.12. Manual Handling
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2.13. High Pressure
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2.14. Lifting Equipment
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2.15. Rotating Machinery
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2.16. Ground Openings
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2.17. Entanglement
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2.18. High Voltage
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2.19. Confined Space
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2.20. Weather Conditions
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2.21. Welding
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2.22. Grinding / Cutting
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2.23. Spills
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2.24. Other Hazards
CONTROL MEASURES
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3.1. Lock Out Tag Out
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3.2. Spotters
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3.3. Lighting
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3.4. Respiratory Protection
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3.6. Signage
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3.7. Barricades
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3.8. Fall Arrest
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3.9 Extinguishers
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3.10 Guards
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3.11. Fire Blankets
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3.12. Procedures
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3.14. Competent People
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3.15 Locating Equipment
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3.16. UV Protection
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3.17. Gas Detection
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3.18. Designated Work Areas
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3.19. Supervision of Public
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3.19. Material Data Sheet Review
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3.20. House Keeping
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3.21. Other Control Measures
SIGN OFF
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Team Member
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Team Member
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Team Member
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Team Member
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Authorized Person: I have reviewed this FLRA and agree that it is a fair assessment of the job and I authorize this work to proceed.
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Team Leader
