Hazard Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Environmental Hazards

• Is the work area clean?

  Yes

  No

  N/A

• Air quality

  Safe

  At Risk

  N/A

• Noise levels in work area

  Safe

  At Risk

  N/A

• Weather conditions

  Safe

  At Risk

  N/A

Working at Heights

• Fall protection/Harness required?

  Yes

  No

  N/A

• Others working above or below?

  Yes

  No

  N/A

• Scaffold/bakers/Benches inspected?

  Yes

  No

  N/A

• Elevated platform ground conditions

  Safe

  At Risk

  N/A

• Elevated platform hazards (power lines, curbs, protrusions from structure)

  Safe

  At Risk

  N/A

Ergonomic Hazards

• Repetitive motions?

  Yes

  No

  N/A

• Heavy or awkward lifting?

  Yes

  No

  N/A

Work Environment Hazards

• Slips or trips

  Safe

  At Risk

  N/A

• Limited access

  Safe

  At Risk

  N/A

• Foreign bodies in eyes

  Safe

  At Risk

  N/A

• Exposure to electrical hazards

  Safe

  At Risk

  N/A

• Lighting

  Safe

  At Risk

  N/A

Emergency

• Muster point

  Yes

  No

  N/A

• Evacuation routes identified

  Yes

  No

  N/A

• First aid personnel identified

  Yes

  No

  N/A

Equipment

• Trained/certified to operate lift equipment

  Yes

  No

  N/A

• Trained/certified to operate explosive actuated tools

  Yes

  No

  N/A

Personal Protective Equipment

• Hard hat

  Yes

  No

  N/A

• Safety boots

  Yes

  No

  N/A

• Safety glasses/Gloves/Masks when task requires

  Yes

  No

  N/A

• Face shield

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A