Title Page

  • Conducted on

  • Prepared by

  • Site

  • Task assessed

General

  • Enter description of procedure, task or worksite being assessed

Hazards, Risks and Controls

  • Click Add Hazard (+) after you have observed and identified a hazard

  • Hazard

Hazard

  • Description of hazard

  • Photo of hazard (optional)

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Control Measures

  • Select control measures

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

References

  • Risk Matrix Reference

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Completion

  • Recommendations

Sketch if needed

  • Add drawing

  • Inspector's Full Name & Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.