JC-006

• Site conducted

• Conducted on

  Date

• Prepared by

• Location
  Address

• Site

  Media

• Description of Works

• People at Risk From Task

  Select Staff Third Parties Other Contractors Public

  • Staff
  • Third Parties
  • Other Contractors
  • Public

• Revision

PART 1 - STOP POWRA shall be completed at the Point of Work before you start

• YES= (Continue with Task) NO=(Do not continue) N\A=(Ask If unsure)

• Has the Daily activity/safety briefing been delivered?

  Yes

  No

  N/A

• Have you read, understood and signed onto the method statement risk assessment (RAMS) relevant for the task

  Yes

  No

  N/A

• Are their suitable COSHH assessments in place for any hazardous substances associated with the task

  Yes

  No

  N/A

• Do you require a safety document for the task - if yes are you signed onto it?

  Yes

  No

  N/A

• Are you suitably trained on the required plant equipment and specific hazards relating to the task?

  Yes

  No

  N/A

• Are appropriate emergency procedures in place?

  Yes

  No

  N/A

• Do you have the correct tools, plant and equipment to undertake the task Safely?

  Yes

  No

  N/A

• Do you have all the suitable and sufficient training /competence for the task?

  Yes

  No

  N/A

• Do you have the correct personal protective equipment (PPE) for the task?

  Yes

  No

  N/A

• Have you all been briefed on and understand the lift plan relevant to any lifting operations?

  Yes

  No

  N/A

• Are all the working party members clear about your roles and responsibilities for the task? eg Vehicle Marshall, Supervisor

  Yes

  No

  N/A

• Are Temporary works approved and in place?

  Yes

  No

  N/A

• First Aid arrangements in place?

  Yes

  No

  N/A

• Emergency rescue arrangements in place?

  Yes

  No

  N/A

• If you have answered NO to any of the above the required action is to report to your team leader/project manager. All ticked boxes must be completed before starting any Hazard Identification.

PART TWO - THINK Are any of these hazards present and not controlled

• YES = (Present and Controlled - continue with task) NO = (Present but uncontrolled - STOP) N/A = (Non - Applicable)

• Slips Trips and Falls

  Yes

  No

  N/A

• Plant Movements

  Yes

  No

  N/A

• Vehicle Movements

  Yes

  No

  N/A

• Plant Operations

  Yes

  No

  N/A

• Excavations

  Yes

  No

  N/A

• Hot works

  Yes

  No

  N/A

• Working at Height

  Yes

  No

  N/A

• Confined Space

  Yes

  No

  N/A

• Wet/Damp Conditions

  Yes

  No

  N/A

• Trainees

  Yes

  No

  N/A

• Dust

  Yes

  No

  N/A

• Noise

  Yes

  No

  N/A

• Task Lighting

  Yes

  No

  N/A

• Spillages

  Yes

  No

  N/A

• Housekeeping

  Yes

  No

  N/A

• Adverse Weather (Winter/Summer)

  Yes

  No

  N/A

• Lightning Risk

  Yes

  No

  N/A

• Contaminated Waste

  Yes

  No

  N/A

• Overhead Conductor

  Yes

  No

  N/A

• Underground Cables

  Yes

  No

  N/A

• Electrical Plant

  Yes

  No

  N/A

• Site Power Supplies

  Yes

  No

  N/A

• Power Leads

  Yes

  No

  N/A

• Test Equipment

  Yes

  No

  N/A

• Live Working

  Yes

  No

  N/A

• Impressed Voltage

  Yes

  No

  N/A

• Authorisations

  Yes

  No

  N/A

• Trapping or Entanglement

  Yes

  No

  N/A

• Cutting/Severing

  Yes

  No

  N/A

• Crushing

  Yes

  No

  N/A

• Friction/Abrasion

  Yes

  No

  N/A

• Hand Arm Vibration

  Yes

  No

  N/A

• Power Tools

  Yes

  No

  N/A

PART THREE - ACT

• Any information added below must be discussed with your supervisor, and any residual hazards will need to be added to the RAMS, with the RAMS being reviewed by the Site Manager before work starts on the task.

Hazard

• Control Measure

PART FOUR - REVIEW

• Have the tasks created any new hazards?

  Safe

  At Risk

  N/A

• Hazard and Control Measure put in place?

• Lessons learned for next time?

Tick the Correct PPE for the Task

• Ensure you ALL have the correct PPE on and it is fit for the task you are about to carry out

• Hi Viz

  Yes

  No

  N/A

• Safety Gloves

  Yes

  No

  N/A

• Safety Boots

  Yes

  No

  N/A

• Hard Hat

  Yes

  No

  N/A

• Arc Resistant Coveralls

  Yes

  No

  N/A

• Ear Protection

  Yes

  No

  N/A

• Face Mask/Visor

  Yes

  No

  N/A

• Safety Glasses

  Yes

  No

  N/A

• Safety Goggles

  Yes

  No

  N/A

DOCUMENT REFERENCE SECTION

• Please reference any suitable documents relating to the completion of the site works

• RAMs

• Other Documents

Permits To Work

• Permit To work (Electrical)

• Permit to Dig

• Hot Works

• Confined Space

• Third Party Permits

• Permit To Load

• Permit To Work at Height

• Other

Signatures

• All members of the working party must fill their name below, discuss and agree on assessment with the rest of the team. Should changes occur during the day the Point Of Work Assessment must be reviewed and revised. ALL team members must sign on the amended document

• Company

• Signature

  Sign