Title Page

  • Title

  • Reported by

  • Reported to

  • Worksite Supervisor

  • Workers on location

  • Conducted on

  • Location
  • Hazard Report

  • Hazard
  • A hazard is defined as energy or a substance that has the potential to cause harm to a person. e.g Gravity (fall from height, falling objects, crushing injuries, body stressing, slips and trips) or Sustances i.e. chemical, biological. A hazard may also be Psychosocial e.g. lack of sleep, bullying, work pressure, harrassment and descrimination etc).

  • HAZARD (Add description and take photo)

  • If control implemented - provide detail on control implemented.

  • Reported by and signature

  • GREEN: Minor Hazard - Low risk continue work but but monitor for changes.
    YELLOW: Medium Hazard - Medium risk stop work, consult with workers and apply a control.
    RED: Major Hazard - High risk, STOP WORK! immediately, report and apply a control using the hierarchy of control.

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