Title Page
Job And Location details
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Date
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Job number
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Site Supervisor
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Operatives covered in this risk assessment
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Location of nearest welfare facilities
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Nearest A+E Hospital
Stage 1
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Is a copy of the task RAMS available on site and has it been briefed to all those involved? (If ‘no’ you cannot continue)
Stage 2
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Is the person completing this form competent in the completion of risk assessments? (If ‘no’ you cannot continue).
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Competency Evidences
- CSCS Scheme
- NRSWA Unit O1
- SA002 - UG Safety
- K008 Hand Rodding
- SA001 - OH Safety
- S008 - OH Cabling
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Competency Evidences
- CSCS Scheme
- NRSWA Unit O1
- SA002 - UG Safety
- K008 Hand Rodding
- SA001 - OH Safety
- S008 - OH Cabling
-
Competency Evidences
- CSCS Scheme
- NRSWA Unit O1
- SA002 - UG Safety
- K008 Hand Rodding
- SA001 - OH Safety
- S008 - OH Cabling
-
Competency Evidences
- CSCS Scheme
- NRSWA Unit O1
- SA002 - UG Safety
- K008 Hand Rodding
- SA001 - OH Safety
- S008 - OH Cabling
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Competency Evidences
- CSCS Scheme
- NRSWA Unit O1
- SA002 - UG Safety
- K008 Hand Rodding
- SA001 - OH Safety
- S008 - OH Cabling
Stage 3 – Does the work involve interaction with any of the following (if ‘yes’, this you must stop work and consult your Supervisor before progressing)?
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HV Cables / Substation
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High Public Amenity Area
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Pedestrian Crossing
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OH Lines
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Emergency Services Access
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On or near Rails
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HP or IP Gas
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Bridge / Culvert
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Bus Stop
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Fuel/Oil Pipelines
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Lone Working
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School/Play Area
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Trunk Mains
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Busy Traffic Junction
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Telephone exchange
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Hi-Speed Road (40+ Mph)
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Work at Night
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3rd Party Sites
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Poor / Uneven Ground
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Restricted Access
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Excavations requiring shoring
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Adverse Weather
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Height Work/Ladders/MEWPS
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Contaminated Ground
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Adjacent to Water
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Deliveries – Moving Vehicles
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Lifting Operations
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Protected Species/Site/Tree
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Monuments / Structures
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Invasive Species i.e Knotweed
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Asbestos
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Confined Spaces
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Other:
Required PPE
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Tick relevant PPE
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High-Visibility VEST
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Protective OVERALL
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Dust / Breathing MASK
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Head Protection HELMET
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Foot Protection BOOTS
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Hand Protection GLOVES
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Eye Protection GLASSES
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Hearing Protection EAR DEFENDERS
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Respiratory Protection RESPIRATOR
Stage 5 – Identify key task hazards and the control measures to be used that are not suitably covered by the RAMS that has been produced for the task, particularly those not identified in section 3:
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Hazard
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Control Measure
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Hazard
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Control Measure
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Hazard
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Control Measure
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Hazard
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Control Measure
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Hazard
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Control Measure
Stage 6 - Communication
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I/we confirm that the contents of this Risk Assessment have been explained to me/us and I/we agree to abide by the control measures and inform the site supervisor immediately of any changes that may affect the health and safety of me/us or others likely to be affected by the works. We have the correct competencies, permits, equipment, and PPE to carry out the work safely.
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Sign
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Print
Stage 7 – Pre-start checks
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Signs being used?
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Do adequate advance warning signs exist and are they secured?
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Are pedestrian arrows required and attached correctly?
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Are all S&G uprights supported by bases / feet?
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Is the work zone and safety zone barriered off correctly?
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If a safe pedestrian walkway is required is it established and the correct width?
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Are kerb ramps / walk boards in place where necessary and are they secured?
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Are road plates required, and if so are they in place and secured?
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Are courtesy boards in place, readable and attached correctly?
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If footway is to be closed is an agreement in place and logged and are the correct
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Is all the equipment fit for purpose?
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Signed by the person completing this form who is responsible for the safe set up of the site (must be signed before work starts and check made that all are signed to the RAMS and a copy is present with the team)
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IF CIRCUMSTANCES ON SITE CHANGE, WORKS MUST STOP AND THE RISKS MUST BE RE-ASSESSED