Audit

Time Take 5 Checklist completed
STOPS

Is this task part of a Job?

THINK

Is there a work instruction for this task?

Has this task been identified in my JHA?

Does this task present any immediate hazards to others nearby?

Am I trained to do this task?

IDENTIFY

Have I communicated with other work groups any hazards that may affect them or me?

Are the controls from my JHA in place?

What hazards are around me "here and now"?

HAZARD

CONTROL

PLAN

Do I have all the permits required for this task?

Do I have the correct tools & equipment?

Is the equipment isolated and I applied my red locks (if required)

PROCEED
Operator Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.