On Site Task Specific Risk Assessment 403(01)D

• Part 1.
  This form must be completed by SPC/Site supervisor before any task is undertaken and followed in conjunction with relevant Method Statement, Task Methodology sheet and generic risk assessments.
  
  Prior to commencement of any works, task and area must be assessed and findings recorded below. For example:-
  
  Identify and note tool/equipment to be used for the task, check what test records are available to make sure it is in good working order.
  
  Identify any hazardous substances to be used and make sure COSHH assessments are available.
  
  Identify necessary PPE required for the task to be carried out.

• Part 2.
  If hazards identified on the site are not covered by generic Risk Assessments, part 2 of this form must be completed.
  
  In the table below list specific hazards your team and other parties can be exposed to. Control measures must be put in place and strictly followed. Work group must be briefed on all arrangements prior to commencement of any work.
  

Part 1.

• Related Task Methodology sheet No. Method statement ref No.

• Site location:

• Task to be carried out:

• Applicable Generic Risk Assessment Nos.

• Plant/tools/equipment to be used

details

• Type of equipment:

• In good working order?

  Yes

  No

• Details:

• COSHH assessments available Yes/No

type of substance

• Type of substance.

• COSHH assessments available?

  Yes

  No

• Show action taken to remove COSHH RISK.

• Is there a risk of fire?

  Yes

  No

• Fire point set up

  Yes

  No

• Warning safety signs displayed.

  Yes

  No

• Site safety briefing given to all operatives.

  Yes

  No

• Additional PPE identified for the task.

Part 2.

• Additional Site Specific Hazards Identified.

• Persons affected

  Select Operatives Public Visitors Other parties

  • Operatives
  • Public
  • Visitors
  • Other parties

• Activity/hazards

activity

• Activity:

• Hazard:

• Actual risk

  High*

  Medium

  Low

• Control measures in place **

• Risk after control measures.

  High*

  Medium

  Low

• Have work group been briefed on new hazards and control measures

  Yes

  No

• * (H,M,L) high, medium and low risk
  
  ** control measures put in place must reduce risk to 'as low as reasonably practicable '

• Completed by:

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