Title Page

  • Conducted on

  • Prepared by

  • Location

General

  • Task description

  • Take photo of work environment

Before Task Commences

  • Do I clearly understand what is required?

  • Am I trained to do the work and familiar with the equipment/task?

  • Are the tools and equipment in a safe condition?

  • Do I have approved documentation for the task?

  • Am I safe from other activities/tasks in the area?

  • Have I informed others who may be affected by my work?

  • Do I have the correct PPE for the Task?

Hazards

  • Have I identified any hazards associated with the task?

  • Description of hazards

  • Take photo of hazards

  • Description of controls

Risk Assessment

  • Have all hazard controls been implemented?

  • Have all potential problems been discussed and understood by all?

  • Can the Task proceed safely?

Completion

  • Other observations comments

  • Sign off

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