Title Page

  • Client / Site

  • Date and Time of Inspection

  • Inspected by

  • Location

General Information

  • Task Description

  • Are there indications that the task is high risk?

  • Select appropriate response

  • Kindly specify

Load weight and lift/carry frequency

  • Risk Rating

    risk.PNG
  • • Note the weight of the load and the repetition rate of the lifting operation.

  • Lift

  • Carry

Hand distance from the lower back

  • • Observe the task and examine the horizontal distance between the operative's hands and their lower back.

  • Lift

  • Carry

Vertical lift region

  • • Observe the position of the operative’s hands at the start of the lift and as the lift progresses.

  • Lift

Trunk twisting/sideways bending

  • • Observe the operative's trunk as the load is lifted.

  • Lift

Asymmetrical trunk/load

  • • Load and hands symmetrical in front of the trunk.

  • Carry

Postural constraints

  • • The movements of the operative are unhindered.

  • Lift

  • Carry

Grip on the load

  • • Containers with well-designed handles or handholds, fit for purpose
    • Loose parts enabling comfortable grip

  • Lift

  • Carry

Floor surface

  • • Dry and clean floor in good condition

  • Lift

  • Carry

Other environmental factors

  • • Observe the work environment and the lifting operation takes place: in extremes of temperature; with strong air movements; or in extreme lighting conditions (dark, bright or poor contrast).

  • Lift

  • Carry

Carry distance

  • • Observe the task and estimate the total distance that the load is carried.

  • Carry

Obstacles en route

  • • Observe the route

  • Carry

Completion

  • Recommendations

  • Inspector's Full Name and Signature

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.