Information
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Please complete the following FLRA, to identify any hazards and/or risks around you, if you do, please support the risk reduction process by addressing this immediately.
If this can not be achieved, please escelate this to your manager after consulting with the customer and advising of your actions.
Think Safe, Work Safe, Home Safe
Customer Information
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Customer:
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Machine Location:
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Add location
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Service Technicians Name:
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Machine Model:
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Serial No:
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Machine Hours:
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Completed On:
Risk Assessment
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Have you reported in to on-site customer contact?
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Are you aware of the customers site safety rules, emergency procedures and rescue plans if working at height?
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Are you and the machine in a safe and suitable environment?
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Are you equiped with the suitable PPE?
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Do you have all the necessary tools/equipment to work safely and are they in good and safe condition?
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Does the activity require the need for Lock Out/Tag Out of the machine or associated parts?<br>If YES is answered here, please follow next set of questions.
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Have you taken the necessary steps to identify the hazards and stored energy to protect yourself and others from high risk of Serious Injury or Fatality (SIF)?
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Once you have completed the service/maintenance of the machine, have you taken the necessary steps to remove all the Lock Out/Tag Out devices?
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Are you aware of local environmental procedures for oil spillages, pollution, noise etc?
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Are you protected from falling objects?
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Have all precautions been taken to prevent fire, electrocution, burn, drowning, falls, crushing, trapping any other health risks?
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Is there sufficient lighting to work safely?
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If accompanied by visitors, have they been made aware of any relevant risk assessments?
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Are you or other personnel suitably qualified to operate any of the equipment in use?
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Is all lifting equipment certified and in test period, is it also suitable for the job?
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If using hazardous substances, do you have all the relevant safety data sheets and hazardous information?
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If working at height, is suitable equipment and protection available?
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If the task involves hot work have specific precautions been taken and fire fighting equipment is located near by?
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During your risk assessment have you identified any Serious Injury, Life altering or Fatal hazardous conditions?
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WARNING - If you are not able to answer YES to any of the above questions, PAUSE, ASSESS and RESOLVE the issue with the customer. If this is not possible then escalate this to your relevant supervisor/manager.
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If you identify any risks/hazards that needs attention please take a photo and include them here
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Terex Team Member Print Name:
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Add signature
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Please either select "Today" or manually input the date and time
