Information

  • Assessment Title

  • Document No.

  • Client

  • Site

  • Conducted on

  • Audited by

  • Location

Details of Equipment being assessed:

  • Picture

  • Equipment Description

  • Make

  • Model

  • Serial Number
  • S/N

  • Location

  • Sub-location

  • Responsible person
  • Name

  • Other equipment which may utilise same risk assessment

Regulation 4 - Suitability of Work Equipment

  • Is the work equipment suitable for:<br>All the task(s) it is intended to be used for,<br>The environment, location, space, ventilation and conditions in which it is (or may) be used,<br>All the people that will (or may) use it, taking into account ergonomics aspects?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 5 - Maintenance

  • Is the equipment maintained in an efficient state, in efficient working order and in good repair? <br>(Pay particular attention to the maintenance of any safety features, guards, interlocks etc)

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 6 - Inspection

  • Are arrangements in place for ensuring that the equipment is inspected to ensure it continues to operate as intended ?<br>(Pay particular attention to the need for regular inspection where the operating conditions or environment may result in deterioration of the equipment.)

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 7 - Specific Risks

  • Have all (non-trivial) risks associated with setting, operating, adjusting, cleaning, and maintaining the equipment been identified?<br><br>N.B. the risks must include consideration of foreseeable abnormal situations, equipment malfunction and misuse.

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 8 - Information & Instructions

  • Do those involved in setting, operating, adjusting, cleaning, and maintaining the equipment have access to WRITTEN information and instruction in how to perform those tasks safely?<br><br>N.B. the information provided must include consideration of foreseeable abnormal situations, equipment malfunction and misuse.

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 9 - Training

  • Are suitable arrangements in place to ensure that anyone involved in setting, operating, adjusting, cleaning, or maintaining the equipment has had any necessary training?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 10 - Conformity with Community Requirements

  • CE marking

  • Does the equipment meet EC requirements?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 11 - Dangerous parts of Machinery

  • Is the equipment adequately guarded (all moving parts)?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 12 – Protection against specified hazards.

  • Is the equipment safe from any article or substance falling or being ejected ?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Is the equipment safe from rupture or disintegration of parts?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Is the equipment safe from overheating or catching fire?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Is the equipment safe from any unintended discharge of any gas, dust, liquid, vapour or other substance which is produced, used or stored in the equipment?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Is the equipment safe from unintended explosion of the equipment or any substance produced, used or stored in it?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 13 - High or very low temperature

  • Is there adequate protection to prevent any injury caused by contact with any parts of the equipment or any materials that are at high or very low temperatures?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 14 - Controls for starting or making a significant change in operating conditions.

  • Is the equipment designed so that it can only be started (or re-started after being stopped*) by a deliberate action by an operator using clearly defined controls?<br><br>N.B. “being stopped” includes being stopped for ANY reason including due to any interlock or other safety device having been triggered.

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Are the controls for changing operating conditions such as speed and pressure adequate?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 15 – Stop Controls

  • Does the “Stop Control” bring the equipment to a complete stop and switch off all sources of energy after stopping the functioning of the work equipment?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Does the stop control work in priority of any start control?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 16 – Emergency Stop Controls

  • Has the equipment got one or more readily accessible emergency stop controls, and are they available at every location where a person may need to activate them in order to prevent danger or injury to themselves or others ?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Do the emergency controls “latch closed” so that they require a deliberate action to release and reset them before the equipment can be re-started ?<br>(N.B. the equipment must NOT re-start when the emergency stop is re-set unless deliberately re-started using one of the correct “Start Controls”.)

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 17 – Controls

  • Are all controls for the equipment clearly visible and identifiable?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Are all controls for the equipment in a position where any person operating the equipment is not exposed to a risk to their health and safety?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Are all controls for the equipment in a position so that the operator of any control is able to ensure that no-one is in a place where they would be exposed to any risk to their health or safety as a result of the equipment being started ?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 18 – Control Systems

  • Are the control systems designed such that any fault in, or damage to any part of, the control system or the loss of supply of any source of energy used by the work equipment cannot result in additional or increased risk to health or safety? ie. Does the equipment fail to a safe condition

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 19 - Isolation from sources of energy

  • Are there clearly identifiable and readily accessible means of securely isolating the equipment from ALL sources of energy ?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Is the equipment designed such that re-connection of any energy source does not expose anyone to any risk to their health or safety?<br>(e.g. the equipment should not start operating as a result of re-connection of a power supply or other energy source.)

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 20 - Stability

  • Is the equipment stable in all modes of operation and under all foreseeable loading conditions.<br>i.e. prevented from toppling over, moving in an unpredictable or dangerous manner

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 21 - Lighting

  • Is there adequate lighting, taking account of the operations to be carried out during all modes of operation of the equipment? (e.g. This includes adequate lighting for maintenance of inaccessible parts of the equipment etc...)

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 22 - Maintenance operations

  • Can all maintenance operations on the equipment which involve a risk to health or safety be carried out while the work equipment is shut down and isolated fully from all sources of energy? (PTW, Isolation, Hotwork)

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulations 23 - Markings

  • Has the equipment got appropriate markings and are they all unambiguous, easily perceived and easily understood?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Regulation 24 - Warnings

  • Are safety and or warning signs (if applicable) adequate and clearly visible?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

  • Has the equipment got readily accessible controls which will bring the work equipment to a safe condition in a safe manner?

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

  • Positive comment

  • Add a typed comment

  • Additional comment

  • Add a preset comment

  • Additional comment

Risk Assessment

  • Description of hazard and likely harm that may occur

  • Persons at risk

  • Severity

  • Likelihood

  • Risk

  • Priority

Noise Assessment

  • Were noise measurements carried out?

  • Noise parameter 1

  • Noise parameter 2

  • Comment

  • Comment

  • No noise assessments carried out on this equipment

Vibration Assessment

  • Were vibration measurements carried out?

  • Vibration parameter 1

  • Vibration parameter 2

  • Comment

  • Comment

  • No vibration assessments carried out on this equipment

Further action required

  • Further action required

  • Add a typed recommendation

  • Recommendation

  • Add a preset recommendation

  • Recommendation

Assessment Sign Off

  • This assessment was performed by the undersigned and is a true and accurate reflection of the equipment on the date of the assessment.

  • Completed

  • Add an auditors comment

  • Auditors comment

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.