SF-054- Point of work risk assessment

• Conducted on

  Date

• Work / Plant location

• Weather Conditions

  Select

• Ground Conditions

  Compliant

  Non-Compliant

  N/A

• Please take your time AS A TEAM, you must complete this form at the workface following sign on to the daily briefing. Review the list below and ask yourself how can we reduce the likelihood of an accident or injury before we start?

• Can you identify any OTHER issues not already detailed in your risk assessment from the hazards listed below?

Potential Hazards

• Falls from height

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Falling / flying objects

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Chemicals / harmful substances

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Heat / fire / explosion

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Asphyxiation / drowning

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Risk to plant

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Contact with stationary objects

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Object overturning /collapsing

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Manual handling

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Stored energy or insecure load

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Vehicles

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Risk to you from the work of others

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Vermin (rats,pigeons)

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Access / egress

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Dust / fumes

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Asbestos / MMMF

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Noise

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Vibration

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Electricity

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Radiation (ionizing and non-ionizing)

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Contamination (loose, airborne)

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Poor lighting

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Temperature (hot/cold)

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Adverse weather

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Pinch / trapping points

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Entry into confined space

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Risk to others from your work

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Lifting operations

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

• Emergency procedures

  Safe

  At Risk

  Already Covered

  N/A

• What control measures will be put in place ?

• Remaining risk

  High

  Medium

  Low

Environmental Considerations

• Housekeeping issues

  Safe

  At Risk

  Already Covered

  N/A

• Waste disposal issues

  Safe

  At Risk

  Already Covered

  N/A

• Spill kits available

  Safe

  At Risk

  Already Covered

  N/A

• Drains not affected by work

  Safe

  At Risk

  Already Covered

  N/A

• Air pollution possible

  Safe

  At Risk

  Already Covered

  N/A

• Water pollution possible

  Safe

  At Risk

  Already Covered

  N/A

• Drip trays required

  Safe

  At Risk

  Already Covered

  N/A
Workforce members signoff

• I confirm that i have had input into this work face risk assessment

  Yes

  No

  N/A

• Name

• Signature

  Sign

• I confirm as site Supervisor/Manager that this form has been completed

• Add signature

  Sign

• If you have answered YES to either of these following questions, tell your Contract Manager / Supervisor / HSE Manager.

• Are there any lessons to be learned for next time?

  Yes

  No

  N/A

• Please give details of lessons to be learned from today's tasks

• Has the work created any new hazards?

  Yes

  No

  N/A

• Please give details of any hazards that have been created.