Hazard Identification Form

• Client / Site

• Location
  Address

• Conducted on

  Date

• Prepared by

• Describe the nature of work

Personal Protective Equipment

• PPE available and needed to protect employees against hazards

  Select Full face shields Safety goggles Safety boots Work gloves Ear plugs Or ear muffs Respirators High visibility vests Fall Protection devices (harness and lanyards) Hard hats Others

  • Full face shields
  • Safety goggles
  • Safety boots
  • Work gloves
  • Ear plugs Or ear muffs
  • Respirators
  • High visibility vests
  • Fall Protection devices (harness and lanyards)
  • Hard hats
  • Others

• Other PPE used

Hazard Identification

• NOISE:<br>Will the work create higher noise levels? Consider the need for hearing protection in the work area.

  ✔

  ✖

  N/A

• MANUAL HANDLING:<br>Consider if the work tasks contain any Manual Handling Risks.

  ✔

  ✖

  N/A

• EXCAVATION:<br>Consider if the work requires an excavation to be dug.<br>Do you need to check for services prior to excavation?

  ✔

  ✖

  N/A

• WORKING AT HEIGHTS:<br>Consider if personnel are working at height during this task. <br>Are they trained to perform the task?

  ✔

  ✖

  N/A

• SLIP & TRIP HAZARDS:<br>Consider if any slip / trip hazards are present at the worksite.<br>Will equipment to be used form a trip hazard?

  ✔

  ✖

  N/A

• REFERENCE: Wet surfaces labeled with proper warning sign to avoid slips and trips
  [This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections]

  

• SITE SECURITY / EMERGENCY PREPAREDNESS:<br>Prevent unauthorized access to the work site at all times.<br>Ensure site emergency planning has occurred.

  ✔

  ✖

  N/A

• WORKING OUTDOORS:<br>Consider the ambient conditions / associated hazards.<br>Consider precautions to prevent exposure to heat/cold.

  ✔

  ✖

  N/A

• TRAFFIC MANAGEMENT:<br>Consider how construction traffic will access and egress the workplace in a safe manner.

  ✔

  ✖

  N/A

• CUTS AND ABRASION:<br>Is there a risk of cuts / abrasion? Consider control measures such as task separation or adequacy of PPE

  ✔

  ✖

  N/A

• HAZARDOUS SUBSTANCES:<br>Will work task involve contact with any Hazardous Substances? Refer to MSDS and consider specialized PPE / precautions.

  ✔

  ✖

  N/A

• PLANT AND MACHINERY:<br>Is the plant work area delineated away from other works?<br>Operator ticketed/licensed to operate this type of equipment?

  ✔

  ✖

  N/A

• FALLING OBJECTS:<br>Will personnel be working above where others may pass? Will personnel be working below others?

  ✔

  ✖

  N/A

• LIFTING:<br>Consider if work task involves crane lifts.<br>Ensure a lift study has been conducted.

  ✔

  ✖

  N/A

• FIRE / IGNITION SOURCES:<br>Consider if hot work is being conducted in the work area. Consider containment / testing requirements.

  ✔

  ✖

  N/A

• ENVIRONMENTAL IMPACTS:<br>Is there potential to release pollutants to drain’s / marine environment / waterway’s / ground / atmosphere; Vibration / noise emission beyond the project perimeter; generation of dust or disposal of hazardous waste?

  ✔

  ✖

  N/A

• DECONTAMINATION OF PLANT AND EQUIPMENT:<br>Plant, Equipment, and PPE must be decontaminated at the end of each day and or when exposed equipment is to leave the asbestos area

  ✔

  ✖

  N/A

• VIBRATION:<br>Consider the need for vibration monitoring from demolition process, especially when working near heritage type buildings.

  ✔

  ✖

  N/A

• HAZARDOUS SUBSTANCE STORAGE / SPILLS PREVENTION:<br>Consider if any potential spill sources exist in the work area.<br>Consider the need for bunds, drip trays, spill blankets, absorption etc

  ✔

  ✖

  N/A

• WASTE DISPOSAL:<br>Consider if work task creates wastes prescribed wastes requiring special disposal e.g Asbestos

  ✔

  ✖

  N/A

• CUSTOMER AND SURROUNDING PROPERTY:<br>Consider the potential risk to neighbours’ property Consider potential damage to customer property nearby.

  ✔

  ✖

  N/A

• ASBESTOS:<br>Consider if personnel may be exposed to asbestos during this task? If unsure, check the Asbestos Register/Scope of Works for known sources.

  ✔

  ✖

  N/A

• WORKING ON ELECTRICAL EQUIPMENT

  ✔

  ✖

  N/A

• SAFE ISOLATION PROCEDURE

  ✔

  ✖

  N/A

• ACCESS & EGRESS

  ✔

  ✖

  N/A

• ACCESS TO HIGH RISK ESTATES

  ✔

  ✖

  N/A

• HAND TOOLS / POWER TOOLS

  ✔

  ✖

  N/A

• NEARBY WORK:<br>Consider if any work will be occurring nearby.<br>Consider if there is any impact of your work on others.

  ✔

  ✖

  N/A

• Are there other hazards identified?

  ✔

  ✖

  N/A

• Other hazards identified

Overall summary

• Write observerations here

• Overall Assessment

  Safe

  At Risk

Completion

• Full Name and Signature of engineer

  Sign