Title Page
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Site conducted
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Document number
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Conducted on
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Prepared by
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Location
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Date work commences
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Date work finishes
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Task being assessed
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Names of people carrying out the work
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Total number of workers
Who might be affected
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Types of People
Risk Assessment
- Hazard, Risks and Controls
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What is the hazard?
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What are the control measures?
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Specify
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What is the likelihood?
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What are the consequences?
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What is the risk level?
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Is the risk level acceptable?
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Specify the extra control measures required to ensure the risk level becomes acceptable.
References
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Risk Matrix Reference
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Hierarchy of Controls Reference
Method Statement
Training
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Specify the training
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Specify
Tools and Equipment
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PPE
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Requirements
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Specify
First Aid
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Requirements
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Specify
Emergency Procedures
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Requirements
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Specify
Welfare Requirements
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Requirements
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Specify
Environmental and Waste Management
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Requirements
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Specify
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Do you need a Permit to Work?
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Specify the PTW required
Procedure Before Work Commences
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What do you need to do ?
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Specify
Procedures During the Work
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How are you going to do the work?
Procedure at the End of Works
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What do you need to do?
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Specify
Completion
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Are there any other issues that might need to addressed in future
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Specify
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Signature