Title Page
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Site conducted
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Conducted on
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Activity being undertaken
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Prepared by
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Location
Untitled Page
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Do you have a risk assessment for this activity
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Do not proceed until verification of approval
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take photo of register
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Have you reviewed the asbestos register?
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Do not proceed until it is reviewed
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is there any asbestos located where you will be working
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is there a risk of disturbing it
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do not proceed until you have spoken to your SHAPE + Rep
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Are there any electrical hazards present?
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Are they suitable controlled?
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Are there any working at height hazards involved with this activity?
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what will you do to control this hazard
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Will you be working in the ceiling space?
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are there live cables near by?
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what will you be doing to control the hazard?
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Are there any manual handling hazards involved in this activity?
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What will you do to control this hazard
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Will the activity create dust
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What will you do to control this hazard?
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Are you using any 240 volt power tools?
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Have they been tested and tagged and are the tags in date?
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Do not use tools until they are tested and tagged
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Are there any sharp edges present?
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are they suitable controlled? (i.e protected sign posted)
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Do not proceed until these are controlled
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exhaust equipment in place for any task that could produce silica dust (drilling grinding)
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Do not proceed with this task until exhaust equipment is available
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14. Are you going to be using substances containing a hazardous chemical?
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Do you have the SDS and chemical risk assessment for the product
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do you have the SDS for the product
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All workers are wearing 6 points of PPE?
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Do not proceed until all PPE is available and worn (take photo once received and worn)
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Is the work area suitability isolated from others
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What are you doing to isolate the area?
