OHS007 Site Specific Risk Assessment 4.3

• Client

• Site Address:
  Address

• Date

  Date

• Prepared by

• Personnel

• SWMS Employed on this site:

  Select OHS006a Domestic Premises OHS006b Emergency and Exit Lights OHS006c Workplace Test and Tag OHS006d Working from Ladders OHS006e Elevated Work Platforms OHS006f Fire Services OHS006g Working Alone Working in Isolation

  • OHS006a Domestic Premises
  • OHS006b Emergency and Exit Lights
  • OHS006c Workplace Test and Tag
  • OHS006d Working from Ladders
  • OHS006e Elevated Work Platforms
  • OHS006f Fire Services
  • OHS006g Working Alone Working in Isolation

Possible Hazards

• Traffic

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Mobile plant & equipment

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Working at heights/ladders

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Weather

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Housekeeping/Workplace Layout

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Lighting

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Electrical

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Manual handling

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Site access

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Select Extreme High Moderate Low No Risk

  • Extreme
  • High
  • Moderate
  • Low
  • No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Noise

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Domestic premises

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

• Other

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• 

• Risk Assessment Rating Prior to Control (as per OHS008)

  Extreme

  High

  Moderate

  Low

  No Risk

• Control Measures

• Initialled by Responsible Person

  Sign

• Other Workers Consulted

  Yes

  No

  N/A

• Control Measure Assessed as Sufficient

  Yes

  No

Authorisation

• The authorisation of this site specific risk assessment is an acknowledgement of Jim's Test & Tag's commitment to all aspects of work/occupational health and safety and is authorised by:

  Sign

• This is to verify that having conducted works in accordance with the SWMS indicated above, the controls have been found to provide adequate protection and that no other safety issues have been identified. If the controls have been found to be inadequate the Divisional Franchisors are to be notified via the feedback form on the Intranet. If a high risk has been identified, the Divisional Franchisors are to be contacted immediately.

  Sign

• Additional controls required?

• Client signature to acknowledge receipt of this site specific risk assessment

  Sign