Information
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Document No.
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Crew
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Job Descrition
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Client / Site
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Conducted on
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Prepared by
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Location
STOP AND LOOK
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Observe the work area and surrounds for hazards. Look Close, Look Above, Look Below, Look Wide and Look for Hidden Hazards
STOP! THINK THROUGH THE TASK
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Are we fit to perform the job? Are we free from fatigue, alert, free from impairment, adequately hydrated?
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Are we clear on what the task is?
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Have we checked the SWMS/SOPs for the task?
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Do we have the required skills, training, licences and permits for the task?
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Is all my equipment and tools suitable to the task and in good order? Are all electrical tools tagged and tested?
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Do we have all the appropriate PPE?
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Is the plant suitable for this task?
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Do we have an agreed form of communication for the task?
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Does the TMP suit the site?
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Do we have a clear plan & job steps in mind?
LOOK FOR HAZARDS
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Is there a risk of plant rollover? Uneven/sloping ground conditions?
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Are there overhead services?
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Are there underground services?
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Do you need Dial Before you Dig?
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Could I fall?
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Can I be caught in, on or between anything?
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Could something fall on me or strike me?
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Will the task take longer than 20 minutes and/or is the sight distance less than 250m?
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Do I need to Work Alone?
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Weather conditions? E.g. fog, rain, ice, sun glare, high temperatures or high winds
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Could I slip or trip?
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Could I strain or over exert myself?
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Could I come in contact with something that may harm me or others like chemicals, heat, gas, fumes, or pressurised pipes?
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Are there vehicles or plant reversing?
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Are there any other hazards not identified – Environmental, Biological, Chemical, Electrical, Atmospheric, Fire/Explosions, Gravitational, Manual Handling, Mechanical, Pressure
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Details
CONTROLS AND COMMUNICATIONS
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Have I communicated to my workmates the risks associated with this task and the controls implemented?
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Does this feel right?
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Have I controlled all the hazards so I will be safe?
DO THE JOB SAFELY
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Note: If the job changes whilst you are doing it, STOP and re-do the Take 5 steps to make sure you are safe
- Hazards Identified / Controls Implemented / Notes
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Sign Off