OSCA 2018 - Take 5

• Your Full Name and description of task: Example John McCorkle / Manual Handling

• Department

  Light Vehicle

  Truck Shop

  CHPP

  Dragline Maint.

  ROM

• Conducted on

  Date

• Prepared by

• Location
  Address

• Others involved in the task:

• Time Take 5 Checklist completed

  Date

STOP

• Is this task a simple, one person task?

  No

  Yes

  N/A

• A Take 5 isn't suitable as your risk assessment. You must complete a JSA.

THINK

• Is there a work instruction or SOP for this task / activity?

  No

  Yes

  N/A

• Is this task free of any immediate hazards to others nearby?

  No

  Yes

  N/A

• Am I trained to do this task?

  No

  Yes

  N/A

• Are you 'FIT FOR WORK'?

  No

  Yes

  N/A

IDENTIFY

• Have I communicated with other work groups any hazards that may affect them or me?

  Yes

  No

  N/A

• Are there hazards are around me "here and now"?

  No

  Yes

  N/A

• Hazards?

  Select Working at Heights Electrical Vehicle Interaction Hazardous Chemicals Slips or Trips Manual Handling Hot surfaces Falling Objects Pinch Points Toxic Contaminants Atmospheric Hazards Ergonomic Issues High ambient temperature Noisy Other

  • Working at Heights
  • Electrical
  • Vehicle Interaction
  • Hazardous Chemicals
  • Slips or Trips
  • Manual Handling
  • Hot surfaces
  • Falling Objects
  • Pinch Points
  • Toxic Contaminants
  • Atmospheric Hazards
  • Ergonomic Issues
  • High ambient temperature
  • Noisy
  • Other

• List other:

• CONTROL MEASURE/S

• List all control measures you need to put in place to manage the hazards you identified.

PLAN

• Do I have all the permits required for this task?

  No

  Yes

  N/A

• Do I have the correct tools & equipment?

  No

  Yes

  N/A

• Is the equipment isolated and I applied my personal isolation locks & tags (if required)

  No

  Yes

  N/A

PROCEED

• Name & Signature

  Sign