SLAM

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. STOP - Engage your Mind before your 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 planed?)

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Can the task be done without a permit?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Do I know what to do in an emergency?

  Yes

  No

  N/A

IF NOT STOP AND CHECK WITH SUPERVISOR

2. LOOK - At the workplace and find the hazards

• 1. Does the task involve hazardous forms of energy? If "Yes" complete assessment!

  Yes

  No

  N/A

• 2. Is Isolation required? If yes complete assessment!

  Yes

  No

  N/A

• 3. Can I slip, trip or fall? If "At Risk" complete assessment!

  Safe

  At Risk

  N/A

• 4. Have I completed basic housekeeping in my work area? If "At Risk" complete assessment!

  Safe

  At Risk

  N/A

• 5. Can I get caught in or between anything? If "At Risk" complete assessment!

  Safe

  At Risk

  N/A

• 7. Have I planned the communication for the task? If "At Risk" complete assessment!

  Safe

  At Risk

  N/A

• 8. Will I come in contact with mobile plant/moving equipment? If "At Risk" complete assessment!

  Safe

  At Risk

  N/A

• 9. Do I need to barricade or block my work area? If "At Risk" complete assessment!

  Safe

  At Risk

  N/A

• 10. Can I get hurt and/or introduce hazards to others? If "At Risk" complete assessment!

  Safe

  At Risk

  N/A

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

• PROCEED WITH TASK IF "Safe" TO DO SO!

  Safe

  At Risk

  N/A

MANAGE: With effective controls and by advising others

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