BRIEF DESCRIPTION OF TASK

SIGNIFICANT HAZARDS

  • Work at height

  • working from ladder

  • Working from scaffold

  • Working from EWP

  • Electricity

  • Confined space

  • Overhead hazard

  • Underfoot hazard

  • Heavy/awkward lifting

  • Noise

  • Excavations

  • Floor openings

  • Chemicals

  • Poor houskeeping

  • Other trades/members of the public

  • Additional hazard

  • Additional hazard

PERSONAL PROTECTIVE EQUIPMENT

  • Eye protection

  • Hearing protection

  • Hi-visibility vest/clothing

  • Hard hat

  • Respiratory protection

  • Safety harness

  • Isolation lock/tag

  • Other

CONTROLS IN PLACE

  • Fall protection in place

  • Ladders safe and secured

  • Scaffold tagged and secured

  • EWP maintained/fit for purpose

  • Electrical supply isolated/locked/tagged

  • Electrical safety device (RCD)

  • Portable electrical equipment tested/tagged

  • Clear safe underfoot

  • Floor openings covered

  • Excavations identified/fall protection

  • Protection from overhead hazards

  • First aid kit availiable

  • Fire extinguisher availiable

  • Other

  • Other

LIST ANY WORK PERMITS/MBIE NOTIFICATIONS

Please sign and email the report to the OSH Coordinator.

  • Select date

  • Add signature

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