Section 1

GENERAL

  • Does this activity involve Team Lifting?

  • Numbers Involved

  • Does this activity involve Dual Lifting?

  • Does this activity involve Individual Lifting?

  • Use the evaluation below to assist in assessing the degree of risk associated with this practice.

EVALUATION

  • Movement

  • Distance

  • Frequency

  • Duration

  • Load

  • Information

  • Environment

  • Injury Potential

  • Training

  • Experience

  • Suitability

  • Equipment

  • PPE

HAZARDS IDENTIFIED

  • Have any significant hazards been identified during this assessment?

  • If so, please detail below:-

  • a.

  • b.

  • c.

  • d.

CURRENT CONTROLS

  • Describe any control measures currently in place:-

  • a.

  • b.

  • c.

  • d.

RISK RATING

  • Risk Rating Allocated

ACTION REQUIRED

  • Have additional control measures been identified to eliminate or reduce the risk to an acceptable standard?

  • Describe any control measures required :-

  • Who will implement these measures?

  • What is the proposed date for implementation?

  • Can the process continue until then?

COMPLETION & NOTIFICATION

  • HS&S Technician completing this assessment:-

  • Have any serious defects been identified and entered onto the database?

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