Title Page

  • Site/WO#:

  • Date:

  • Person Undertaking TLRA:

  • 002 - Contractor Management

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 003 - Intercoms

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 004 - Secure Entrance

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 005 - External Cameras Using EWP

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 006 - Perimeter Fence

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 007 - Internal Cameras

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 008 - Security Management Systems

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 009 - X-Ray & Trace Detection

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 010 - BMS

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 012 - Soldering Station

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 013 - Locks

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 014 - UPS

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 015 - Gates

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 016 - GDS Testing Using Torso and Extension Pole

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 020 - General Fault Finding

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 021 - COVID-19

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • 024 - Management of Crystalline Silica Dust Exposure

  • Additional Hazards Identified
  • Task Step

  • Hazard

  • Controls

  • Risk Matrix.JPG
  • Residual Risk

  • Supervisor Notified?

  • Lock Out Tag Out Required

  • Person 1

  • Person 2

  • Person 3

  • Person 4

  • Person 5

  • Time works commenced?

  • Time works Completed?

  • Nominated PIC: (Person In Charge)

  • Plant Re-Energised Correctly?

  • High Risk Works Permit Required?

  • Permit Number:

  • Completed By:

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.