Information

  • Document No.

  • Audit Title and/or Job Description and/or Task Description.

  • Site/Location

  • Conducted on

  • Prepared by

  • Location

Job Information

  • Person in charge of work.

  • Persons involved

Break Task Into Steps

  • Task

  • Step 1

  • Hazards Associated with Step 1

  • Safe Work Procedures / PPE for step 1

  • Media.

  • Risk Level Remaining

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Is there another step??

  • Step 2

  • Hazards Associated with Step 2

  • Safe Work Procedure / PPE for Step 2

  • Media

  • Risk Level Remaining

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Is there another step??

  • Step 3

  • Hazards Associated with Step 3

  • Safe Work Procedure / PPE for step 3

  • Media

  • Risk Level Remaining

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

  • Is there another step??

  • Step 4

  • Hazards Associated with Step 4

  • Safe Work Procedure / PPE for step 4

  • Media

  • Risk Level Remaining

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Is there another step??

  • Step 5

  • Hazards Associated with Step 5

  • Safe Work Procedure / PPE for step 5

  • Media

  • Risk Level Remaining

  • With the Hazard & Risk assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Add media

Jobsite and Task Checklist

  • Are permits required? (Permit to work, hot work, confined spaces, working at height etc.)

  • Is the permit complete? DO NOT PROCEED WITHOUT A PERMIT

  • Is special training needed? ( e.g. Forklift, Scaffold, Power Actuated Tool)

  • Do the people involved have the appropriate training/certification/licences?

  • Can weather conditions affect safety?

  • Consider posponing the job until the weather improves.

  • Is lighting a problem?

  • Consider if additional lighting is required. Consider delaying task.

  • Contact with acids, toxic or caustics? (Material Safety Data Sheet)

  • Wear PPE and refer to Material Safety Data Sheets on company 'HSSE' drive.

  • Will there be exposure to dust, fumes or mist? (Material Safety Data Sheet)

  • Wear a dust mask appropriate to the risk. SEEK ADVICE TO ENSURE YOU HAVE THE CORRECT MASK. Ensure you have been Face Fit Tested for the mask you are using.

  • Is the employee working with sharp or rough materials that require PPE?

  • Wear correct hand protection appropriate to the task. SEEK ADVICE TO ENSURE YOUR PPE IS APPROPRIATE.

  • Can the worker slip, trip or fall?

  • Ensure the work area is free from hazards. Wear a safety harness/flotation device if appropriate. Clean slippery surfaces.

  • Do tools, machines or equipment present any hazards?

  • Ensure you are competent to use the equipment. Ensure the equipment is safe to use. Does the equipment need an inspection certificate? Does I have one?

  • Can any body part get caught in, struck by or caught between objects? THIS INCLUDES HANDS, THINK BEFORE YOU REACH

  • You MAY be at risk of mechanical entrapment. Do not wear loose clothing

  • Can pushing, pulling, lifting, bending or twisting cause strain?

  • Use correct manual handling.
    Source equipment to reduce risk. Ask for assistance.

  • Is there danger from falling objects?

  • Check area overhead and remain clear of overhead loads.

  • Is excessive noise or vibration a problem?

  • Wear ear defender, hearing protection.
    Do you need to carry out a Hand Arm Vibration Risk Assessment?
    Use Anti Vibration Gloves. SEEK ADVICE.

  • Are there flammable, explosive or electrical hazards?

  • Does the area need to be purged of fumes?
    Engage electrician to remove electrical hazard if appropriate.
    Do not smoke.
    Remove sources of ignition. Are Fire Extinguishers available?

  • Fall hazard from one level to another or same level?

  • Use fall protection/flotation device .

Comments/Discussion

  • Comments/Discussion

  • With all the Hazards & Risks assessed, is it considered that the safeguards that have been put in place, offer sufficient protection and the job can proceed?

  • Person completing Task Hazard Analysis & SSOW

  • Employee 2

  • Employee 3

  • Employee 4

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.