Per-Start Risk Assessment

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

ALL SITE MANAGERS/SUPERVISORS ARE REQUIRED TO:

• Assess the hazards in the immediate work area on a DAILY basis for each task and complete this form

  Yes

  No

  N/A

• Discuss the Hazards and Controls with their team and verify understanding

  Yes

  No

  N/A

• Put in place extra precautions and controls, as necessary

  Yes

  No

  N/A

• Check throughout the day that the precautions and controls are being followed by the team and are working effectively

  Yes

  No

  N/A

GENERAL ASSESSMENT

• Have all personnel been adequately trained?

  Yes

  No

  N/A

• Is all plant and machinery in working order?

  Yes

  No

  N/A

• Do all personnel have adequate P.P.E?<br>

  Yes

  No

  N/A

• Is the site in a safe condition for working?

  Yes

  No

  N/A

• Has a safe pedestrian access been established?

  Yes

  No

  N/A

• Is vehicular traffic management in place?

  Yes

  No

  N/A

• Has a toolbox talk taken place?

  Yes

  No

  N/A

• NOTE : all 'Possible Hazards' listed should be checked to determine if they are applicable to the works. Add any additional hazards identified to the list and put controls in place. Controls MUST be put in place to achieve a Residual Risk score of 5 or 6 for each hazard.

Hazard Assessment checklist

• Others working nearby?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Others working below?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Pedestrians and Public access?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Obstructions or Projections?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Manual handling?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Working at heights?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Danger of Slips, trips, falls?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Noise and Vibration?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Power tools?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Hand Tools?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Excavations and openings?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Vehicles?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Vehicles in restricted spaces?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Sharp edges?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Alternate power supply?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Welding activities?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Poor Lighting?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Confined spaces?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Chemicals, adhesives, oils?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Welding fumes, dust, gases?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Mechanical lifting?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Access to worksite?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Climatic conditions?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Underground services?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Overhead power lines?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

• Live cables?

  Yes

  No

  N/A

• Risk score

• Control Measures

• Residual risk

I have been briefed in my role and understand the hazards contained in this risk assessment and will comply with the control measures to the best of my ability to reduce the risk of injury.

• Signed by

  Sign

• Signed by

  Sign

• Signed by

  Sign

• Signed by

  Sign

Risk Assessment Prepared By:

• Add signature

  Sign

Visitors to the site

• Visitors on site?

  Yes

  No

  N/A

• Oranisation

• Arrival Time

• Departure Time

• More visitors on site?

  Yes

  No

  N/A

• Oranisation

• Arrival Time

• Departure Time

• More visitors on site?

  Yes

  No

  N/A

• Oranisation

• Arrival Time

• Departure Time

• More visitors on site?

  Yes

  No

  N/A

• Oranisation

• Arrival Time

• Departure Time

• Signed off by Client Representative:

  Sign

Post Task Inspection Checklist

• Post job clean-up

  Yes

  No

  N/A

• Installed materials secured?

  Yes

  No

  N/A

• Are safety signed required?

  Yes

  No

  N/A

• Barricades installed where needed?

  Yes

  No

  N/A

• Equipment shut down and/secured?

  Yes

  No

  N/A

• Post task inspection completed by:

  Sign