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
Hazardous Energies and Controls
Identified hazardous energies
Select the energies that create a hazard for the task or tasks
- Chemical & Biological
- Physical & Mental
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
- Change Rate
How did you verify that the control is suitable?
Take pictures of the controls if possible
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.
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.
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.