1. LOOK - Do the Job START

2. TELL - My mate if he is being UNSAFE

3. TALK - About the Hazard Controls and Behaviours

Job Name

Onsite Client Representative

Job Number:

TMP Number:

Risk Rating Chart

1. What can harm me?
2. What can harm others?
3. What can harm the environment?

Common Hazards

Good toolbox (site entry procedures), designated site access, other work vehicles well away.

Side friction, speed restriction, additional advanced warning (new seal?)

Good road surface, additional pedestrian lane width, use of driveways

Additional lane width, turning circles, tapers at good length

Additional signage, condition of signage, additional cones, extra sandbags, cable tie signage to poles, additional safety zones

Additional lane width, visibility,shoulders available

Narrow lanes, speed restriction, side friction kerb line of cones, additional safety zones

1.2m wide, cone barrier arms/safety fencing to contain, no trip hazards on route

Placed where good visibility is achievable, out of worksite, TC on site, inside speed restriction

Positive Traffic Management, good delineation, side friction, RGs

Good signage visibility, centreline of cones, side friction, extra safety zone area


Site Specific Hazard

Hazard Description

Likelihood of Harm

Potential Consequences

Risk Rating Before Controls

Hazard Controls (How can we reduce personal and environmental harm here?)

Behaviour/Action to eliminate, isolate or minimise:

Person or Team Responsible
Completed By: (initials)

Signed by All Workers or Visitors to site:

Worker or Visitor
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.