Title Page
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Title
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Reported by
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Reported to
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Worksite Supervisor
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Workers on location
- Taila Johnston
- Simon Crocker
- Sharon Farley
- Matthew Leziak
- Matt Madlener
- Evi Waldron
- Ee Hobbs
- Andrew Rouen
- Terry Allen
- Thomas Koehler
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Conducted on
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Location
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Hazard Report
Hazard
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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).
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HAZARD (Add description and take photo)
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If control implemented - provide detail on control implemented.
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Reported by and signature
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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.
