Minteq Stop Card - duplicate

• Document No.

• Task description

• Photograph of task area.

  Media

• Client / Site

• Conducted on

  Date

• Prepared by

Are any of the following hazards present and are they controlled?

• Pinch points

  Safe

  At Risk

  N/A

• Sharp Edges

  Safe

  At Risk

  N/A

• Hot Surface

  Safe

  At Risk

  N/A

• Lifting Objects

  Safe

  At Risk

  N/A

• Heat (Dehydration)

  Safe

  At Risk

  N/A

• Chemicals

  Safe

  At Risk

  N/A

• Mobile Equipment

  Safe

  At Risk

  N/A

• Slip / Trip / Fall Hazard

  Safe

  At Risk

  N/A

• > 4ft Height without Fall Prevention or Fall Protection

  Safe

  At Risk

  N/A

• Energized Equipment

  Safe

  At Risk

  N/A

• Confined Space

  Safe

  At Risk

  N/A

• Noise

  Safe

  At Risk

  N/A

• Electrical

  Safe

  At Risk

  N/A

If any hazard is selected, STOP and address mentioned hazard before starting work.

If all hazards are safe, then GO proceed with your work.