Title Page
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Equipment
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Asset/Equipment No. (Scan QR code)
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Job/Task
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Task Type
- Breakdown
- Corrective
- Project
- Planned Preventative Maintenance
- Other
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Prepared by
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Conducted on
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Department
Before You Start
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Individual Risk Assessments must be completed by RMET (or SRMET for team tasks) before commencing the assigned work. Any risks indentified as MEDIUM or HIGH risk must have a mitigation strategy put in place and re-assessed
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1. Do you have relevant skills and training for the task?<br><br>2. Are you familiar with any relevant work instructions ?<br><br>3. If required, do you have the correct documents / permits for the task? <br><br>4. Do you have the correct PPE for the task?<br><br>5. Do you have the correct tools for the task?<br><br>6. If required, have you completed a pre-use inspection on all access equipment?<br><br>7. Have you isolated the area to prevent unauthorised access?
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PLEASE REPORT DIRECTLY TO YOUR MANAGER BEFORE CONTINUING
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Does this task require LOTO?
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Do you have the right LOTO equipment for the task?
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PLEASE REPORT DIRECTLY TO YOUR MANAGER BEFORE CONTINUING
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*Is all equipment isolated for the entire task?
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Does this task meet the requirements of the live working standard? https://policy.a2z.com/docs/90711/publication
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PLEASE REPORT DIRECTLY TO YOUR MANAGER BEFORE CONTINUING
Risk Assessment
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The work instruction may have been created some time ago and conditions may have changed. Select any of the following hazards that may be apparent during this task and identify what controls you will put in place to mitigate the risk then re-assess.x
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Risk to others from your work?
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Safety control measures
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Slips, Trips and Falls
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Safety control measures
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Falls from Height
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Safety control measures
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Falling Objects
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Safety control measures
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Risk of objects being projected
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Safety control measures
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Objects Overturning/Collapsing
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Safety control measures
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Manual Handling Heavy Objects
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Safety control measures
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Sharp Objects Present?
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Safety control measures
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Hazardous Substances
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Safety control measures
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Heat, Fire or Explosion
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Safety control measures
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Asphyxia or Drowning
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Safety control measures
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Entanglement/Entrapment
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Safety control measures
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Electric Shock
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Safety control measures
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Stored Energy/Unsecure load
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Safety control measures
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Vehicles
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Safety control measures
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Dust Inhalation
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Safety control measures
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Noise Exposure
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Safety control measures
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Vibration
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Safety control measures
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Inadequate Lighting
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Safety control measures
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Additional risk?
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Specify Risk
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Safety Control measures
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Insert Control measure
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For the highlighted hazards above, do the selected control measures sufficiently control the risk?
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A continued risk exists, or the safety measures are insufficient!
Do not start working and inform your manager! Further approval is required!
Review
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Did this task require LOTO?
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Please upload LOTO evidence
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Please insert the APM WO number
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1. Is there a quicker/simpler way of completing the task? <br><br>2. Did the work create any additional / unforeseen hazards? <br><br>3. Are there any lessons learnt for next time?
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Does the current embedded risk assessment require updating based on your findings?
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Sign Off
