Site Specific Dynamic Risk Assessment

• Document No.

• Name

• Job No

• Location

• Date

  Date
• Address
  Address

Site

• Site induction completed

  Yes

  No

  N/A

• Permit To Work in Place

  Yes

  No

  N/A

• Lone Working Controls in Place

  Yes

  No

  N/A

• First Aider

  Yes

  No

Fire Provisions

• Fire Provisions

• Fire Alarm / Call point

• Means of Escape

• Assembly Point

Hazards

• Asbestos ( Identified & Controlled )

  Yes

  No

  N/A

• Chemicals Controlled

  Yes

  No

  N/A

• Biological Hazards controlled

  Yes

  No

  N/A

• Noise Controls in Place

  Yes

  No

  N/A

• Dust & Fumes Controlled

  Yes

  No

  N/A

• Waste Management Controlled

  Yes

  No

  N/A

Work Area

• Visibility & Light Adequate

  Yes

  No

  N/A

• Access & Egress Adequate

  Yes

  No

  N/A

• Slip Trip & Fall Preventative measures

  Yes

  No

  N/A

• People who may be Affected Controlled

  Yes

  No

  N/A

• Work Area Controlled (Barriers)

  Yes

  No

  N/A

• Space Adequate to Work

  Yes

  No

  N/A

• Confined Spaces Controlled

  Yes

  No

  N/A

Tools and Equipment

• Personal Protective Equipment Used

  Yes

  No

  N/A

• Portable Equipment Checked and Usable

  Yes

  No

  N/A

• Manual Handling AIDS / Assistance

  Yes

  No

  N/A

Electrical

• Electrical Risks Controlled

  Yes

  No

  N/A

• Electrical Secondary Supplies Controlled

  Yes

  No

  N/A

External

• Weather Conditions Adequate

  Yes

  No

  N/A

• Traffic / Pedestrian separation in place

  Yes

  No

  N/A

Working at Heights

• Working at Heights Required

  Yes

  No

• Working at Heights Correctly Selected

  Yes

  No

  N/A

• Working at Heights Equipment Checked

  Yes

  No

  N/A

• Preventing Falling Objects Controlled

  Yes

  No

  N/A

• Overhead Services / Obstructions

  Yes

  No

  N/A

Hot Works

• Hot Works carried out

  Yes

  No

• Where required is a hot works permit in place

  Yes

  No

  N/A

• Is the correct type of fire extinguisher available

  Yes

  No

  N/A

• Signed

  Sign