Terex Field Service Risk Assessment Cranes NA

• Site name and type (customer's yard, refinery, construction, ext)

• Conducted on

  Date

• Prepared by

• Case Number

• Location
  Address

• Is anyone else from Terex with you on site?

  Yes

  No

• List team members

• Starting from the inside out; evaluate the environment, tasks, and systems involved with the job. Next, identify the hazardous energies that need to be controlled within the environment, task and systems. Keep in mind that some systems or task can fall in multiple sections of the energy wheel. The outside of the wheel describes the controls to be used. If the hazards cannot be controlled, Pause The Job!

  

• Environment / Site condition

• Briefly describe task or tasks

• Select systems involved with all tasks

  Select Electrical Hydraulic Pneumatic Mechanical

  • Electrical
  • Hydraulic
  • Pneumatic
  • Mechanical

Identified hazardous energies

• Select the energies that create a hazard for the task or tasks

  Select Pressure Electrical Radiation Chemical & Biological Physical & Mental Gravity Motion Temperature

  • Pressure
  • Electrical
  • Radiation
  • Chemical & Biological
  • Physical & Mental
  • Gravity
  • Motion
  • Temperature

• Briefly describe the hazard from each energy source

Controls and verification of for hazardous energies

• Select the type of control that will be used for each of the identified hazardous energies

  Select Remove Reduce Redirect Absorb Distance Shield Change Rate

  • Remove
  • Reduce
  • Redirect
  • Absorb
  • Distance
  • Shield
  • Change Rate

• How did you verify that the control is suitable?

• Take pictures of the controls if possible

  Media

Removal of controls

• Once the task / tasks have been completed you will need to remove the controls and test the system to ensure proper functionality.

Job pause

• Given the information listed above and the environment, briefly list what would cause a job pause while on site.

• Report all job pauses to management via phone, text, or email. If you are unable to correct a job pause with the resources on site, contact management immediately.

Completion

• I have performed this risk assessment of the task or tasks to the best of my ability. I will follow the procedures that are outlined within this assessment and pause the job if something should occur that isn't planned.

• Print Name

• Signature

  Sign