Job Start Up Hazard Assessment

• Audit Title

• Project

• Project number

• Conducted on

  Date

• Assessment team

• Hazard Assessment No.

Housekeeping

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Material handling/storage

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Waste disposal

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Lighting

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Ventilation

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Environmental

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Extreme temperatures

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Ground conditions

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Gas (toxic)

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Flammables

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Dangerous pressure

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Pinch points

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Fire extinguishers

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Hazardous material

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

High risk positioning

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Electrical hazards

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Overhead hazards

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Underground hazards

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Confined space entry

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Excavation

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Restricted egress or access

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Ladders

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Work at heights over 3m

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Scaffolds

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Major lifts

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Vehicles

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Mobile equipment

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

High traffic

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Power tools

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Hand tools

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Permits

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Working alone

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Fatigue

• Severity

  1 - Imminent danger

  2 - Serious

  3 - Minor

  4 - N/A

• Safety hazard and location

• Recommended action

• By whom

• When will controls be put in place?

  Date

Assessment team sign off

Assessment Member

• Name

  Sign

• Supervisor

  Sign