Title Page

  • Conducted on

  • Document Reference

  • Location
  • Area

  • Prepared by

  • Task

  • Take photo of the area

  • Description of the task

  • Untitled 12.png
  • Guide line for completed audit score.
    20% and below Green
    20% to 65% Amber ( Resolve all issues)
    65% to 100% Red ( implement immediate actions before continuing with the task)

  • what category of manual handling is the task

  • Are there indications that the task is high risk

  • Please comment on the task.

  • A . LOAD WEIGHT.

    Untitled 1.png
  • A .What is the Load weight and lift/carry frequency score

  • Suggested action
  • Untitled 1.png
  • B . What is the hand distance from lower back score

  • Suggested action
  • Untitled 3.png
  • CARRY

    Untitled 13.png
  • C .What is the Vertical lift region score

  • Suggested action
  • Untitled 4.png
  • D . Torso twisting/ sideways bending Asymmetrical torso/load carrying

  • Suggested action
  • Untitled 5.png
  • E . Postural constraints

  • Suggested action
  • Untitled 6.png
  • F . Grip on load

  • Suggested action
  • Untitled 7.png
  • G . Floor surface

  • Suggested action
  • Untitled 8.png
  • H . Other environmental factors

  • Suggested action
  • Untitled 10.png
  • H . ( CARRY ONLY)carry distance

  • Suggested action
  • Untitled 9.png
  • I . Obstacles en route (carrying only)

  • Suggested action
  • J . Communication and co ordination (team handling only)

  • Please comment on the issues with communication and co ordination

  • Any further comments

  • When the assessment was completed

  • Assessment completed by

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.