Information
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Job #:
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On Site Supervisor:
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Conducted on
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Job location?
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Standard Locating job?
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Job Description:
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Where is the nearest First Aid kit?
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Emergency Evacuation assembly area?
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Emergency evacuation assembly area?
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Site PPE requirements?
- Transit NZ compliant Dayglow top and long sleeves
- Pants. (Legs must be covered on site!)
- Steel capped Safety Boots
- Safety Glasses (Clear or tinted? Depending on the conditions )
- Sun Hat
- Hard Hat
- Fire Retardant Overalls
Hazards Identified
Hazard Identification
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Hazards Identified
Hazards
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Hazards Identified?
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Eliminate or Minimise
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Controls implemented/Comments?
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Work in the Road Corridor?
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Eliminate or Minimise
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Has Temporary Traffic Management been implemented? Always maintain a vigilant eye on the vehicles and pedestrians in the vicinity. Never turn your back on the live lane. If necessary, use a spotter to increase your safety.
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Slips, Trips and Falls.
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Eliminate or Minimise
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Always watch your footing, be careful on uneven ground. Maintain a good situational awareness at all times. Wear appropriate protective footwear.
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Smoking.
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Eliminate or Minimise
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Smoking is prohibited on site by LoKate Services personnel.
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Weather.
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Eliminate or Minimise
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Cold weather?
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Wear appropriate PPE clothing for cold/wet conditions. If you are getting too cold retire to the vehicle as extreme cold affects your decision making abilities.
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Warm Weather?
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Wear appropriate warm weather PPE, (Sun Hat, Sunscreen, Neck flap on Hard hat). Have you applied your sunscreen? Drink plenty of liquids to avoid dehydration. Dehydration affects your ability to make decisions!
Personnel on Site
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Personnel on Site
Personnel
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Name
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Task/Responsibility or Site visitor?
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Initials and Sign on time.
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On Site Supervisor Signature.
