SLAM - 1/3/13

• Document No.

• Job Task:

• Crew or Area:

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel (if more than 1 person involved):

1. STOP - Engage your mind before you Hands.

• Am I trained, competent and authorised?

  Yes

  No

  N/A

• Am I fit to perform the task?(aware, rested, alert)

  Yes

  No

  N/A

• Do I understand the task? (Is the task planned?)

  Yes

  No

  N/A

• Is there a current Procedure or SWP for this task?

  Yes

  No

  N/A

• Can the task be done without a permit?

  Yes

  No

  N/A

• Am I using appropriate tools / PPE for the task?

  Yes

  No

  N/A

• Do I know what to do in an emergency?

  Yes

  No

  N/A

• IF YOU ANSWERED NO TO ANY OF THE ABOVE QUESTIONS, THEN STOP AND CHECK WITH SUPERVISOR OR DEPUTY.

2. LOOK - At the workplace and find the Hazards

3. ASSESS: The effects of the hazards on people, property and environment.

• 1. Does the task involve any hazardous forms of Energy?

  NO

  YES

• 2. Is isolation required?

  NO

  YES

• 3. Can I slip, trip or fall?

  NO

  YES

• 4. Have I completed basic housekeeping in my work area?

  YES

  NO

• 5. Can I get caught in or between anything?

  NO

  YES

• 6. Is this a manual handling task?

  NO

  YES

• 7. Have I planned the communication for the task?

  YES

  NO

• 8. Will I come in contact with mobile plant / moving equipment?

  NO

  YES

• 9. Do I need to barricade or block my work area?

  NO

  YES

• 10. Can I get hurt and/or introduce hazards to others?

  NO

  YES

• IF ANY OF THE ABOVE QUESTIONS ARE FLAGGED AS RED THEN COMPLETE AN ASSESSMENT BELOW EACH ONE. PROCEED: IF THE CONTROLS IMPLEMENTED MAKE THE TASK FEEL SAFE TO DO.

MANAGE: With effective controls and by advising others.

• If you are unable to perform the task safely, contact your supervisor.

• Please Sign:

  Sign