Title Page
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Conducted on
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Prepared by
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Conducted by:
- Brian Rainey
- Chris Baird
- Anthony Sharkey
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Persons Present
- Brian Rainey
- Chris Baird
- Anthony Sharkey
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Location
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Personnel
HAZARD - COULD YOU BE INJURED BY?
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MACHINERY - Can machines start unexpectedly or can you be trapped/ entangled
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FALLING OBJECTS - Is there a risk of being struck by falling objects?
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MOVING VEHICLES - Do vehicles operate in this area?
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MANUAL HANDLING - Observe manual handling techniques
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ENTRAPMENT - Is there a risk of being trapped by machinery?
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LIFTING/SLINGING - Planned lift, correct slings, competent personnel
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SLIPS, TRIPS & FALLS - Housekeeping, good access & egress
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WORKING AT HEIGHT - Rope access works, hand rails, MEWP'S, fall prevention
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DROWNING/ ASPHYXIATION - Fall into water, engulfed by powder
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HARMFUL SUBSTANCES - Contact with hot materials, chemicals, gases, noise
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FIRE OR EXPLOSION - Is there risk of fire/explosion. Ensure good housekeeping
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ELECTRICITY - Live cables in area, underground/overhead
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PERMIT TO WORK REQD -- Confined space, hot work etc.
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ADDITIONAL PPE - Is additional PPE required
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OTHER PERSONNEL - Does your task affect other personnel
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OTHER -
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REMEMBER TO ISOLATE - YOUR TAG YOUR LIFELINE
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IF SIGNIFICANT HAZARD EXISTS CONSULT YOUR SUPERVISOR
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Sign off
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Supervisor
Untitled page
