Title Page
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Conducted on
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Prepared by
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Location
Scope of Work
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Enter description of procedure, task or worksite being assessed
Hazards, Risks and Controls
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Click Add Hazard (+) after you have observed and identified a hazard
Hazard
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Identify the task
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What are the risks associated with each activity?
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Photo of hazard (optional)
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Risk rating
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Select control measures (include notes)
- Elimination
- Substitution
- Engineering Controls
- Administrative Controls
- PPE
- Other
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Enter other control measures
Completion
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Recommendations
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Signature