Title Page
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Task Description
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Completed by
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Location
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• The task / work to be completed is understood?
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• A safe operating procedure or SWMS is available and understood?
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• All team members are trained, competent and fit to do the task?
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• Correct number of team members available to complete the task?
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• There are safe access and exit paths / points?
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• The correct and required PPE is available?
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• All equipment, plant, tools has been checked and is working correctly?
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• All permits required to do the task have been completed and issued?
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• STF
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• Manual Handling ….
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• All required services and equipment have been isolated?
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• Are there plant, equipment, or people nearby that can be impacted?
Identified Hazards
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• Hazards were identified, controls agreed and implemented?
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List details of how you or others could be injured (hazards):
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List details of what you or others can do to keep everyone safe (controls):
Control
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• All team members are aware and understand the hazards identified?
Proceed
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• Can the task be done safely?
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• A risk assessment is required before the task can continue?
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• Safety issues have been escalated to Supervisor / Manager?
