Title Page
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Document No.
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Name of Supervisor/ Leading hand.
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Name of worker completing assessment.
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What station are works being carried out?
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Conducted on
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Task being carried out?
- S.A.V Install
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Have all workers read and understand the SWMS for the works?
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Read SWMS immediately
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Before starting work you are required to sign in at the security desk.
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Are you working during trade hours?
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What control measures are taken to ensure the public's safety?
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What type of surface are you installing over?
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Are you using water with Soap for the install?
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Make sure all wet areas are dry before leaving the area.
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Is there any chemicals being used for this install?
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What chemicals are being used?
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Is there a ladder being used?
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What type and size is the ladder being used?
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Can the ladder be placed on even ground?
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Stop work and look for a more stable and safe location for the ladder.
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Is there a EWP being used?
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What type of EWP is being used? (eg. Scissor, Boom lift, Other).
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Who is the ticketed operator and do they have their EWP card on them?
Hazards and general comments
Identify and list control measures.
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Hazard 1?
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Control measures 1?
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Hazard 2?
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Control measures 2?
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Hazard 3?
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Control measures 3?
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Hazard 4?
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Control measures 4?
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Hazard 5?
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Control measures 5?
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Further General comments?
Location and sign off.
Address of works being carried out.
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Street address and cross road for station?
Sign off section.
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Supervisor sign off: this risk assessment have been checked by me and verified as true and correct.
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Leading hand sign off.
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Once both the risk assessment and SWMS have been consulted and completed, please sign below to state that you have read and understood all the safety conditions.
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Installer 1
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Installer 2
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Installer 3
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Installer 4
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installer 5
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Installer 6
