Title Page

  • Conducted on

  • Prepared by

  • Location
  • Task Description

Task

  • Does it involve any of the following at a level where there is a risk of injury: -

  • If the answer is yes to any of the above consider remedial action(s) required to reduce the risk to low. e.g. mechanical aids – more rest periods etc..<br>And can you reduce or eliminate.

  • Measure in place
  • Measure

Load

  • Does it involve any
    of the following at a level where there is a risk of injury: -

  • Does it involve any of the following at a level where there is a risk of injury: -

  • If the answer is yes to any of the above consider remedial action(s) required to reduce the risk to low<br>e.g. split the load – mechanical aids – two men working – correct lifting techniques etc..

  • Measure in place
  • Measure

Environment

  • Does it involve any of the following at a level where there is a risk of injury: -

  • If the answer is yes to any of the above consider remedial action(s) required to reduce the risk to low.<br>e.g. improve lighting –Two men working - Mechanical aids.<br>Ensure personnel are aware of the environmental conditions – PPE etc..<br>

  • Measure in place
  • Measure

Assessment sumery

  • Have all measures to reduce risk been implemented where practicably possible.<br>Do you rate the task safe to continue?

  • In my opinion the task is safe to be cared out

  • Task being cared out by
  • I except the conditions of the assessment

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.