FLHA - Field Level Hazard Assessment

• Conducted on

  Date
• Worksite:
  Address

• Prepared by

  Select Branislav Repka Jiri Koncinsky Lukas Kyncl Marian Simko Matej Česka Ondrej Polivka

  • Branislav Repka
  • Jiri Koncinsky
  • Lukas Kyncl
  • Marian Simko
  • Matej Česka
  • Ondrej Polivka

• A field level hazard assessment should be performed at the beginning of each shift and during
  task execution. The FLHA process can be expressed in the diagram below:

  

General

• Description of work/task to be completed

• Toolbox talk

• Weather

• Safety documentation in place/reviewed/signed

  Yes

  No

  N/A

• Evacuation routes established

  Yes

  No

  N/A

• Muster Point

• PPE

  Select Safety helmet Hi-vis vest Safety footwear Safety glasses Protective gloves

  • Safety helmet
  • Hi-vis vest
  • Safety footwear
  • Safety glasses
  • Protective gloves

• PPE available & inspected

  Yes

  No

  N/A

• Have all workers attended Site Specific Safety Orientation

  Yes

  No

  N/A

• MSDS reviewed and available to all workers for the review

  Yes

  No

  N/A

• Adequate time and crew provided to complete tasks

  Yes

  No

  N/A

• Adequate tools and equipment to complete the task

  Yes

  No

  N/A

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• Subcontractors/other trades on site?

  Yes

  No

  N/A

• Have you coordinated activities with other trades present on the job site?

  Yes

  No

  N/A

• Material storage identified

  Yes

  No

  N/A

• Waste properly managed

  Yes

  No

  N/A

Environmental Hazards

• Work area clean/ housekeeping

  safe

  control measures

  at risk

  N/A

• Extreme (low/high) temperatures

  safe

  control measures

  at risk

  N/A

• High Winds

  safe

  control measures

  at risk

  N/A

• Wet or slippery conditions

  safe

  control measures

  at risk

  N/A

• Excessive noise

  safe

  control measures

  at risk

  N/A

• Dust/Mist/Fumes

  safe

  control measures

  at risk

  N/A

• Poor visibility/ low light

  safe

  control measures

  at risk

  N/A

• Uneven ground

  safe

  control measures

  at risk

  N/A

• Vehicle traffic

  safe

  control measures

  at risk

  N/A

• Open excavations

  safe

  control measures

  at risk

  N/A

• Wildlife/insect/vegetation

  safe

  control measures

  at risk

  N/A

• Open water

  safe

  control measures

  at risk

  N/A

• High sun exposure

  safe

  control measures

  at risk

  N/A

Access/Egress Hazards

• Emergency Rescue procedure in place

  Yes

  No

  N/A

• Confined/Restricted space entry permit required

  Yes

  No

  N/A

• Ladders tied off

  Yes

  No

  N/A

• Aerial lift/Swing stage inspected

  Yes

  No

  N/A

• Scaffold inspected/tagged

  Yes

  No

  N/A

Rope access Hazards

• Exclusion zoning in place/ signs, pylons, danger tape

  Yes

  No

  N/A

• Anchor points identified

  Yes

  No

  N/A

• All ropes reaching the ground

  Yes

  No

  N/A

• Knots at the end of the ropes

  Yes

  No

  N/A

• Rigging equipment inspected

  Yes

  No

  N/A

• All carabiners are loaded on the major axis, with the gate closed and sleeve locked

  Yes

  No

  N/A

• Y-hang angle ≤ 90°

  Yes

  No

  N/A

• Deviation angle

  Yes

  No

  N/A

• Proper ROPE PROTECTION in use

  Yes

  No

  N/A

• All tools are tied-off

  Yes

  No

  N/A

• Use of fall arrest/restraint system within 6ft of the unprotected edge

  Yes

  No

  N/A

• Buddy checks

  Yes

  No

  N/A

• Pre-use tool and RAT kit inspection completed

  Yes

  No

  N/A

Overhead + Electrical Hazards

• Low overhead clearance

  Yes

  No

  N/A

• Falling objects

  Yes

  No

  N/A

• Moving suspended loads

  Yes

  No

  N/A

• Working on/near energized equipment

  Yes

  No

  N/A

• Electrical cords/tools condition

  Yes

  No

  N/A

• Fire extinguisher/ fire procedures in place

  Yes

  No

  N/A

• Powerlines

  Yes

  No

  N/A

• Radio/micro towers

  Yes

  No

  N/A

Personal Limitations/Hazards

• Procedure available for task

  Yes

  No

  N/A

• Work tasks and instructions are clear?

  Yes

  No

  N/A

• All workers have training for specific tasks or tools to be used on site?

  Yes

  No

  N/A

• First time performing the task?

  Yes

  No

  N/A

• Working alone?

  Yes

  No

  N/A
Signature

• Signature Supervisor

  Select Branislav Repka Jiri Koncinsky Lukas Kyncl Marian Simko Matej Česka Ondrej Polivka

  • Branislav Repka
  • Jiri Koncinsky
  • Lukas Kyncl
  • Marian Simko
  • Matej Česka
  • Ondrej Polivka

• Signature Lead

  Select Branislav Repka Jiri Koncinsky Lukas Kyncl Marian Simko Matej Česka Ondrej Polivka

  • Branislav Repka
  • Jiri Koncinsky
  • Lukas Kyncl
  • Marian Simko
  • Matej Česka
  • Ondrej Polivka

• Signature Technician

  Select Branislav Repka Jiri Koncinsky Lukas Kyncl Marian Simko Matej Česka Ondrej Polivka

  • Branislav Repka
  • Jiri Koncinsky
  • Lukas Kyncl
  • Marian Simko
  • Matej Česka
  • Ondrej Polivka

Media summary