Information
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Document No.
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Site
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Conducted on
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Conducted by
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Location / Equipment ID
TWO MINUTE RULE - EACH TIME - EVERY TIME
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Evaluate the risks & mitigate the hazards
If you identify a hazard, ensure a control measure is in place to reduce or prevent the risk BEFORE starting the task. STOP when unsure or if the risk cannot be eliminated. -
1. SURROUNDINGS - is there anything around the worksite that could hurt me?
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Hazard & Action Taken:
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2. WORKING SURFACES - is there anything on the floor that could cause me to slip, trip or fall?
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Hazard & Action Taken:
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3. JOB TASKS - does this job require me to get in the line of fire of any hazard?
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Hazard & Action Taken:
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4. TOOLS - do I have the right tools? Are they in good condition?
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Defective or Wrong Tool & Action Taken:
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5. OTHER PEOPLE - can I hurt others or could their work hurt me?
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Hazard & Action Taken:
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6. LIFTING - do I have the help needed to safely lift or move heavy items?
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What help or mechanical aid did you get?
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7. BODY STRAINS - do I have to reach, strain, or get into awkward positions to perform work?
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What can you do to minimize he risk?
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8. PPE - do I have the right PPE (personal protective equipment)? Am I wearing it properly?
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If "NO" why not? and/or If worn incorrectly why?
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9. LOTO - do I understand the lockout boundaries and have all the proper permits?
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If "NOT" Action Taken:
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What is LOTO#
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10. BROTHER's KEEPER - will I watch out for others and inform them if they are exposed to a hazard?
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If "No" explain:
