RESCo Worksite Hazard Assessment

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General

• Date / Time

  Date

• Project Name

• Foreman

• Crew Size

• Superintendent

Identified Hazards

• Hazard Priority
  1.Very hazardous
  2.Hazardous with moderate risks
  3.Low Risk
  4.Ok
  5.Not Applicable

• 1. Flammables (fire/ explosion)

• Hazard & Location:

• Add media

  Media

• 2. Hot Work (torch, Cutting, Welding)

• Hazard & Location

• Add media

  Media

• 3. Work at Height (fall protection)

• Hazard & Location

• Add media

  Media

• 4. Electrical Hazards (Powerlines)

• Hazard & Location

• Add media

  Media

• 5. Material Storage

• Hazard & Location

• Add media

  Media

• 6. Overhead Hazards

• Hazard & Location

• Add media

  Media

• 7. Hoisting / Lifting

• Hazard & Location

• Add media

  Media

• 8. Housekeeping

• Hazard & Location

• Add media

  Media

• 9. Scaffolds

• Hazard & Location

• Add media

  Media

• 10. Ladders

• Hazard & Location

• Add media

  Media

• 11. Hazardous Materials (WHMIS)

• Hazard & Location

• Add media

  Media

• 12. Power Tools

• Hazard & Location

• Add media

  Media

• 13. Mobile Equipment

• Hazard & Location

• Add media

  Media

• 14. Traffic Control (barricades / restrictions)

• Hazard & Location

• Add media

  Media

• 15. Extreme Temperatures (hot / cold)

• Hazard & Location

• Add media

  Media

• 16. Compressed Gas Cylinders

• Hazard & Location

• Add media

  Media

• 17. Sewer / Drain Openings

• Hazard & Location

• Add media

  Media

• 18. Sky Lights

• Hazard & Location

• Add media

  Media

• Other Hazards

  Yes

  No

  N/A

• Explain

• Hazard rating

• Add media

  Media

• General media:

  Media

Site Details

• Work Area Isolated:

• Roof Access Location:

• Chute Set-up / Garbage Removal:

• Fire Protection:

• Propane Tank & Hoses:

• Building Protection:

• Special Customer Requirements:

• Load Requirements of Deck:

• General media:

  Media

Fall Protection To Be Used

• Guardrails (ladder, hoist, chute & as required at perimeter)

• Warning Lines

• Travel Restraint (anchor 800lbs per person)

• Fall Arrest (anchor 5000lbs per person)

• General media:

  Media

Worksite Hazard Assessment Correction Form

• Crew Members:

• Item # / Priority / Recommended Action / Action Taken -Date / By Whom

• General media:

  Media

• Above Items Discussed With Crew

  Yes

  No

  N/A

• Date:

  Date

• Manager's Signature:

  Sign