NGM - Dropped Objects

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Critical Controls: Actions and conditions that must be in place and functioning 100% of the time, without fail, to protect people when working in potentially significant risk situations.
  
  Instructions: For each critical control, select Controlled, AtRisk, or NA (Not Applicable or not observed). See Assessment below for definitions. If something is marked AtRisk, immediately Pause the work until the missing protections are put in place. Write the corrective action taken in the notes box below

• Critical Controls

• Have you completed a Team Risk Assessment prior to starting the job?

  Controlled

  At Risk

  N/A

• Has a workplace inspection been completed? (remove fall hazards, tripping hazards, loose tools, etc.)

  Controlled

  At Risk

  N/A

• The proper tools are used for the task at hand. (Tetheres toold, rope line, buckets)

  Controlled

  At Risk

  N/A

• Exclusion zones are set up to prevent entry. Barriers, spotters and signager are in place

  Controlled

  At Risk

  N/A

• Ensure all materials are secure

  Controlled

  At Risk

  N/A

• Employees are clear of the drop zone

  Controlled

  At Risk

  N/A

Assessment

• CONTROLLED The presence of this control is verified and effective

• AT RISK This control is missing or ineffective

• NA / NO Not Applicable to this exposure situation or Not Observed