General Details

  • WHS Ticket Number

  • Date of Ticket

  • Person Reporting the Hazard

Assessment Details

  • Delivery Address of Hazard
  • Specific concerns to be assessed

Hazard Items for Carriers

Parking at or outside of delivery location

  • Images Relevant to this Hazard

  • Assessment Findings

  • Assessed Risk

Forward entry into delivery location

  • Images Relevant to this Hazard

  • Assessment Findings

  • Assessed Risk

Reverse entry into delivery location

  • Images Relevant to this Hazard

  • Assessment Findings

  • Assessed Risk

Ability to unload stock at delivery location

  • Images Relevant to this Hazard

  • Assessment Findings

  • Assessed Risk

Ability to exit delivery location

  • Images Relevant to this Hazard

  • Assessment Findings

  • Assessed Risk

Overall Assessment and Recommendations

  • Overall Risk Rating

  • Recommendations

  • Date completed

  • Signature of Assessor

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