Hazard work out PHJones 2015

• Location of RIsk Assment
  Address

• Conducted on start date

  Date

• Expected completion date

  Date

• Prepared by

This form must be completed prior to work commencing form must be sent to contract delivery manager

Identify hazards associated with works to be undertaken please mark potential hazards

• Electrics Please provide socket and see reading

  <1 ohm

  <2 ohms

  <100 ohms

  <200 ohms

  >200 ohms

• Stop all works contact CDM straight away the system is unsafe to continue and a competent electrician needs to rectify before any work continues

• Hot works

  Yes

  N/A

• Can this work be be completed without using a hot working process especially in risk zones, can pipe be fabricated, route altered or can alternative methods of jointing ie compression?

  Yes

  No

• Has assessment of the area where the work is to be carried out been completed?

  Yes

  No

• Have all combustible materials in close proximity of hot works area been moved ?

  Yes

  No

• Have you checked all equipment to be used for hot working prior to commencing work ?

  Yes

  No

• Have materials / structure in close proximity been protected with fire blanket and heat mats ?

  Yes

  No

• Is there a suitable fire extinguisher in the working area ?

  Yes

  No

• Have escape routes been identified from the working area in case of emergency ?

  Yes

  No

• Have the checked the number of persons in the property and advised them of hot works being carried out in the property ?

  Yes

  No

• Are standard hot works related boards and notices in place throughout the property ?

  Yes

  No

• Is there any fire detection equipment in the area of hot works if so will it be affected by hot works ?

  Yes

  No

If you answered no to the above or you feel there is still a risk call contracts manager DO NOT CONTINUE If you are happy there is no risk carry out hot works Be sure to check work area after work. Up to 1 hour and remain on site for a minimum of 1 hour after any hot works.

• Asbestos

  Hazard

  N/A

• Can work be completed any other way without the disturbance of any asbestos

  Yes

  No

  N/A

• Has assessment of the area where work to be carried out been completed?

  Yes

  No

  N/A

• Has the asbestos register been read to identify areas of risk ?

  Yes

  No

  N/A

• Are you aware of and do you understand the asbestos procedures

  Yes

  No

  N/A

• Do you agree to work with in these procedures

  Yes

  No

• Contact Contract Delivery Manager DO NOT COMMENCE WITH WORK

• Cutting / Grinding <br>

  Hazard

  N/A

• Dust

  Hazard

  N/A

• Lifting /carrying

  Hazard

  N/A

• Access,cellar,loft,

  Hazard

  N/A

• Handling waste

  Hazard

  N/A

• Use of ladder/ step ladder / hop up

  Hazard

  N/A

• Roof work

  Hazard

  N/A

• Loose carpets

  Hazard

  N/A

• Earthing /wiring issues

  Hazard

  N/A

• If you are not electrically qualified and you believe you have a potential risk call Contracts Delivery Manager before starting any work .

• Unsafe structure

  Hazard

  N/A

• Scaffold work

  Hazard

  N/A

• Check suitable scaffold tag, carry out inspections if you are not happy call Contracts delivery manager straight away.

• Weather

  Hazard

  N/A

• Any other issues

From hazards identified above please identify from list below controls you will put in place to remove hazard or reduce risk

• Ear muffs plugs

  Yes

  N/A

• Eye protection

  Yes

  N/A

• Safety helmet /bump cap

  Yes

  N/A

• Face mask P3

  Yes

  N/A

• Gloves

  Yes

  N/A

• Hi vis clothing

  Yes

  N/A

• Safety footwear

  Yes

  N/A

• Fire extinguishers

  Yes

  N/A

• Heat mats cool gels

  Yes

  N/A

• Harness / lanyard

  Yes

  N/A

• Lifting straps

  Yes

  N/A

• Ladder anti slip mat

  Yes

  N/A

• Ladder stand off bracket

  Yes

  N/A

• RCD

  Yes

  N/A

• Call in help to remove hazard asbestos removal ,electrician, 2nd man or CDM assistance please indicate in box below i

  Yes

  N/A

• If assistance required call contracts delivery manager straight away before starting any work

• A frames barrier tape rigid barriers

  Yes

  N/A

• Additional lighting

  Yes

  N/A

• Sack barrow

  Yes

  N/A

• Loft boarding

  Yes

  N/A

• Any other actions please record in box below

Areas of concern which could create a potential hazard

• Elderly vulnerable

  Hazard

  N/A

• Disabled

  Hazard

  N/A

• Pets or small children

  Hazard

  N/A

• Confrontation

  Hazard

  N/A

• Property Congested with furniture

  Hazard

  N/A

• Poor hygiene

  Hazard

  N/A

• Any other areas of concern please put in box below

Please identify controls required to prevent hazards from list below

• Walk the job prior to start with customer identifying concerns and job plan

  Yes

  N/A

• Dust sheets

  Yes

  N/A

• Warning signage

  Yes

  N/A

• Stair rods

  Yes

  N/A

• Door Barriers

  Yes

  N/A

• Ask that dogs are shut in a safe area

  Yes

  N/A

• Create a safe area away from works for customer and family

  Yes

  N/A

• Any other precautions please record in box below

All operatives on site to name and sign before work commences

• Installer 1 signature

  Sign

• Installer 2 signature

  Sign

• Installer 3 signature

  Sign