Information
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Job Title
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Client / Site
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Document No.
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Location
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Conducted on
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Prepared by
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Personnel
JOB
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Job Category
- New Installation
- Repair
- Other
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Job Type
- Light
- Powerpoint
- Fan
- AC
- Hot water
- Sensor
- Switchboard
- Circuit
- Other
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Description
HAZARDS
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Powered Tools
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Falls
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Excavation
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Falling Objects
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Moving plant
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Noise
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Manual handling
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Access / Egress
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Confined Spaces
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Asbestos
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Working in Trenches
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Dust
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Live Parts
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Lone Workers
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Scaffolding
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Ladders
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UV radiation
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Other
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Other hazard:
SWMS
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Working on or near Exposed Energized Electrical Equipment
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Working Near Overhead Powerlines
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Heights
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Plant
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Excavation and Trenching
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Asbestos
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Confined spaces
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Hazardous Substances
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Demolition
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Working on or near a road
PROCEDURES
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Live testing
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Noise Management
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Plant and Equipment
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PPE Management
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Risk Management and Hazard Intervention
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Visual Safety Examination Inspection
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Working in the sun
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Ladders
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Electrical safety (general)
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Inspection of safety equipment
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Isolation Safety Tag and Lockout
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Inspection of Test Instruments
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Testing and Tagging
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Testing of Electrical Equipment & Installation
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Accessing a Pit or Pillar
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CCICR (ceiling, crawling & conductive roofs)
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Hazardous Substances Management
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Housekeeping
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Manual Handling
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Work on Electrical Equipment
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Working in the Vicinity of Exposed Live Parts
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Excavation and Trenching
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Safe working with Asbestos
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Heights
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Heights rescue
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Emergency Preparedness
LiCENCES AND EQUIPMENT
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Competency Records / Licences
- electrical licence
- white card or equivalent
- scaffold > 3m erection licence
- EWP / Boom >11m lift licence
- other
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High Risk Plant / Equipment being used
- EWP / Boom Lift >11m
- Scaffold
- Scissor Lift
- Forklift
- EWP Boom Lift <11m
- Excavator
- Hiab / Crane
- Other
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Other:
RISK ASSESSMENT
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Task
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Task details
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Hazards and Risks
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Initial Risk Level
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Controls undertaken to minimise risk:
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Residual Risk Level
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Risk Likelihood Matrix
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Risk Decision Tree
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If the residual risk is High or Catastrophic, permission must be sought by High Level Management for work to proceed.
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Is the residual risk High or Catastrophic?
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You must contact High Level Management before continuing.
CERTIFICATION
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I certify that the above control measures have been implemented and deemed the site to be safe:
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Additional workers:
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Additional workers:
