Title Page
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Conducted on
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Prepared by
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Location
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Foreman Signature
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Foreman Contact Information
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Customer / Department Signature
ENSURE PPE REQUIREMENTS
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Complete FLRA card PRIOR to start of task or change in condition. Review the listed hazards with crew at the site, ONLY check the items which apply to the job. Document the hazards and identify the level of risk and controls for each.
Ensure PPE Requirements
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Hard hat
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Safety glasses
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Coveralls (nomex) (Arc Flash Rated)
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Gloves (kevlar / leather / electrical)
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CSA Boots – electrically rated
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Hearing Protection
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Arc Flash PPE
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Fall Prevention / Protection equipment
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Additional PPE required
List of Hazards. Tick the ones that apply and answer the series of questions below it.
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Environmental Hazards
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Solid Non-Haz Waste to be generated
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Hazardous Waste to be generated
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Waste plan identified
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Liquid Spill Potential
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Gas Release Potential
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Refrigerant Release potential
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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High Temp / Cold Temp outdoor work
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Weather conditions
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Excavation permit required
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Hole covering required
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Other
Other Environmental Hazard
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Describe Hazard
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Ergonomics Hazards
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Awkward body position / tight space
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Excessive reaching
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Prolonged twisting bending motion
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Kneeling / Squatting or sitting on ground
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Lift too heavy / awkward lift
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Parts of body in line of fire
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Repetitive motion
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Hands not in line of sight
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Working above your head
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Other
Other Ergonomics Hazard
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Describe Hazard
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Access / Egress Hazards
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Working from Ladders (inspected)
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Slippery path
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Congested path / Housekeeping Issues
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Vehicle traffic area
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Hoisting (tools, equipment)
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Lighting Levels (low/ flashing / bright)
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Evacuation complicated (alarms, routes)
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Other
Other Access/Egress Hazard
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Describe Hazard
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Electrical Hazards
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Lockout required (complete JSA)
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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GFI test
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
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Please STOP inspection and notify your supervisor about this hazard.
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Troubleshooting energized equipment
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
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Electrical cords condition
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
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Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
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Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
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Electrical tools condition
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
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Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
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Voltage (>50v)
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
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High Voltage >240V
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
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Near Exposed electrical conductors
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
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Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
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Electrically classified area (explosion proof)
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Other
Other Electrical Hazard
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Describe Hazard
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Working at Heights Hazards
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Scaffold (inspected and tagged)
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Ladders (inspected and tied off)
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Powered Mobile Equipment in use
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Roof top access (permit required?)
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Retractable Lifeline used
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Anchor Point
Risk Assessment BEFORE Control Measures/Methods
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Probability / Likelihood BEFORE Control Measures/Methods
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Severity / Consequence BEFORE Control Measures/Methods
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Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Working within 15 ft / 3 m of edge
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Working above / near water
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Falling items
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Others working overhead / below
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Barricades and signs in place
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Other
Other Working at Heights Hazard
-
Describe Hazard
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Rigging Practices Hazards
-
Lift study required
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Critical lift permit
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Crane used (3rd party)
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Equipment inspection missing
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Slings required (rope / nylon / steel)
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Hoisting or moving loads overhead
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Temporary lift equipment (chainfall / winch)
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Out of sight load
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Multiple Signalers required
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Large or heavy load (>100 kg)
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Other
Other Rigging Practices Hazard
-
Describe Hazard
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Hazardous Work Permits
-
Hot Work - flame
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Hot Work Sparks / excess heat
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Line Breaking – (hot / gas / chemical)
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Live Electrical work
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Confined Space - permit required
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Confined Space – non-permit required
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Other
Other Work Permits Hazard
-
Describe Hazard
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Personnel Hazards
-
Procedure not available for task
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Confusing work / task instructions
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Not Trained to use tool
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
First time performing task
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
First time on site
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Distractions (noise, workers)
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
-
Excess hours (>12)
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
Worker
-
Is the worker working alone?
-
Other
Other Personnel Hazard
-
Describe Hazard
Risk Assessment BEFORE Control Measures/Methods
-
Probability / Likelihood BEFORE Control Measures/Methods
-
Severity / Consequence BEFORE Control Measures/Methods
-
Risk Assessment BEFORE Controls?
-
Control Measures/Methods to mitigate risks. Click on the paperclip icon, create an action, and assign it to who should action the Control.
Risk Assessment AFTER Control Measures/Methods
-
Probability / Likelihood AFTER Control Measures/Methods
-
Severity / Consequence AFTER Control Measures/Methods
-
Risk Assessment level AFTER Controls?
-
Please STOP inspection and notify your supervisor about this hazard.
OTHER QUESTIONS
OTHER QUESTIONS
-
Are there hazards remaining?
-
Are permits closed out?
-
Area cleaned at end of job/shift?
-
Warning ribbon removed?
Names
-
Worker
Name