TAKE 5
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Task
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Customer Site
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Name
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Document No.
STOP
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Is this a routine task?
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STOP, see your supervisor before proceeding.
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Am I trained, competent and authorised to perform this task?
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STOP, contact your supervisor before proceeding.
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Am I fit to perform this task (Aware, Rested and Alert)?
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STOP, contact your supervisor before proceeding.
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Do I understand this task?
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STOP, contact your supervisor before proceeding.
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Do I have the correct PPE for the task?
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STOP, obtain correct PPE before proceeding.
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Do I have any required WIN's, Procedures and JHA's?
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STOP, make contact with supervisor before proceeding.
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Proceed to next section.
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STOP, contact your supervisor to see if the task is routine before proceeding.
LOOK
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Does the task involve hazardous energy sources?
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Hazard
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Can I isolate the hazard?
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De-energise equipment and isolate.
Place personal Lock and Tag.
Test for dead. -
STOP, contact your supervisor before proceeding.
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Are there Slip, Trip or Fall hazards in the work area?
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Can I reduce the hazard to a safe level?
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Controls
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STOP, contact your supervisor before proceeding.
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Are there moving Plant/Equipment hazards in the work area?
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Can I reduce the hazard to a safe level?
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Controls
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STOP, contact your supervisor before proceeding.
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Does the task involve manual handling?
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Do I need mechanical aid?
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Do I have the correct mechanical aid available?<br>Am I trained to use it?<br>Is it safe to use?<br>
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STOP, contact your supervisor before proceeding.
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Use proper manual handling techniques.
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Does the task require the use of tools?
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Are the tools required in an appropriate condition to carry out the task safely?<br>Is there a current test tag in the case of any electric tools required for the task?
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STOP, obtain tools which are in the appropriate condition before proceeding.
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Am I introducing any new hazards to the work area or surrounding areas?
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Hazard
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Can I reduce the hazard to a safe level?
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Controls
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STOP, contact your supervisor before proceeding.
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Do I feel safe to proceed with the task?
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Sign
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Proceed with the task.
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STOP, contact your supervisor before proceeding.
