SAFE-F-103 Hazard Identification Assessment checklist

• What is being assessed?

• Work area

• Location
  Address

• Conducted on

  Date

• Prepared by

Assessed by:

• Add signature

  Sign

1. General

• What is the process giving rise to the risk assessment?

• Has the hazard arisen because of a capital project undertaking?

  Yes

  No

  N/A

• Has the hazard arisen because of plant, equipment or facility commissioning?

  Yes

  No

  N/A

• Has the hazard arisen because of purchasing?

  Yes

  No

  N/A

• Has the hazard arisen because of systematic risk assessment process?

  Yes

  No

  N/A

• Has the hazard arisen because of other reasons? please detail.

  Yes

  No

  N/A

• If you answered ticked one or more of the above questions, refer to applicable procedure relating to the area identified

• Is repetitive or sustained application of force needed?

  Yes

  No

  N/A

• Is repetitive or sustained awkward posture needed?

  Yes

  No

  N/A

• Is repetitive or sustained movement needed?

  Yes

  No

  N/A

• Is application of high force needed?

  Yes

  No

  N/A

• Is the handling of live animals or people involved?

  Yes

  No

  N/A

• Is the handling of loads that are unstable/unbalanced or difficult to move involved?

  Yes

  No

  N/A

• If you ticked one or more of the above questions, you will need to undertake: Manual handling assessment form and a risk assessment for each task identified.

• Use, storage or handling of hazardous substance (substances which have the potential to cause harm to human health) or dangerous goods (substances which are classified as dangerous goods and designated with DG diamond)?

  Yes

  No

  N/A

• Does the task involve the use, or production of chemicals (solid, liquid or gas)? please list the chemical used or produced.

  Yes

  No

  N/A

• If you ticked one or more of the above questions, you will need to undertake: chemical assessment form for each substance identified and a risk assessment for each task identified.

• Please address each of the following questions

• Is the use of machinery required?

  Yes

  No

  N/A

• Is the use of equipment required?

  Yes

  No

  N/A

• Is the use of plant required?

  Yes

  No

  N/A

• Is the use of an appliance required?

  Yes

  No

  N/A

• Is the use of an implement required?

  Yes

  No

  N/A

• Is the use of a tool required?

  Yes

  No

  N/A

• If you ticked one or more of the above questions, you will need to undertake: plant and equipment assessment form , for each item identified and a risk assessment for each task identified.

• Please address each of the following questions

• Is the use of loud plant and equipment or process involved?

  Yes

  No

  N/A

• does the plant, equipment or process involve vibration ?

  Yes

  No

  N/A

• If you said yes to one or more of the above questions, you will need to undertaken a noise and vibration assessment.

• Does the task involve employees working on an elevated work area?

  Yes

  No

  N/A

• Can employees fall from the elevated work area?

  Yes

  No

  N/A

• Can employees fall from the elevated work area?

  Yes

  No

  N/A

• Is there a work task involved being above of a structure, plant or rooftop?

  Yes

  No

  N/A

• if you answered Yes to one or more of the above questions you will need to undertake, working at height checklist for each of the items identified and complete a risk assessment form for each task in which working at heights work is completed

• 1. Is not designed or intended primarily to be occupied by a person; and

  Yes

  No

  N/A

• 2. Is or is designed or intended primarily to be at, normal atmospheric pressure while any person is in that space.

  Yes

  No

  N/A

• 3. Is, or is likely to be, a risk to health and safety form:

• A. An atmosphere that does not have a safe oxygen level; or

• B. Contaminants, including airborne gases, vapours and dust that may cause injury from fire or explosion; or

• C. Harmful concentrations of any airborne contaminants ; or

• D. Engulfment

• If you answered YES to questions 1, 2 and ticked any of 3 a, 3b 3c or 3d you will need to undertake:
  A confined spece identification checklist
  A confined space register template
  Have placed on the confined space register and
  complete a risk assessment for each task completed in the confined space.