Information

  • Document No.

  • Crew

  • Job Descrition

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

STOP AND LOOK

  • 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

  • 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?

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LOOK FOR HAZARDS

  • 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

  • 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?

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DO THE JOB SAFELY

  • 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
  • Sign Off

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.