Take2 Generic

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Are you fit to work? <br>This includes: Fatigue, Physical Ability, Drug/Alcohol Free

  Yes

  No

• Is your mental health in a good place today? RU Ok? if No, seek Assistance from Supervisor- We can Help

  Yes

  No

• Do you have a copy of the WaterNSW Consent Conditions with you (mandatory if working in Catchment)?

  Yes

  No
Rig Number

• Task being carried out

• Who is included in this Take2

  I'm Alone

  My Team
Members Involved

• Name

• Position

• Take 2 For Safety
  Use to identify AND control hazards before you start work
  
  Take2 - prove it safe before you start work

  

• Do I have clear instructions for the task? Am I competent & authorised?

  Yes

  No

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Do I have all the required ATW/Permits in place?

  Yes

  No

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Do I have the right tool or equipment (fit for purpose)?

  Yes

  No

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Have I identified all energy sources and isolated them?

  Yes

  No

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Can I be caught in, on or between anything?

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Can I strain or over exert myself?

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Can I fall onto or from anything, can something fall on me or someone else?

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Can I slip or trip on anything?

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Can I be struck by a vehicle or other moving object?

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Can I be injured by nearby activities or can my activities injure others?

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Can I spill or pollute something?

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Can weather conditions or poor lighting affect job safety?

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Can I be bitten or stung?

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Do I require any special PPE? (P2 mask, hearing protection, face-shield, gaiters etc.)?<br>Note: Mandatory PPE includes gloves at all times

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk

• Emergency escape route/assembly point identified & known

  Yes

  No

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Are there any other hazards present?

  No

  Yes

Comments

• Risk Details

• Control Details

• Risk Rating Descriptions:
  0: (Low Risk: Tolerable and continual improvement required)
  1: Rare (Medium Risk: Tolerable provided risk is ALARP (As Low As Reasonably Practicable))
  2: Unlikely (High Risk: Tolerability but must be endorsed by management. Additional Long term risk reduction required)
  3: Possible (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  4: Likely (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)
  5: Almost Certain (Extreme Risk: Intolerable, STOP and seek specialist advice. Immediate interim risk reduction required)

• Risk Rating

  Low Risk

  Medium Risk

  High Risk

  Extreme Risk