Step 1 - Initial Assessment

1. Stop, Step back and Think

  • Am I clear on what the task is?

  • Do I have the required skills, training and licenses?

  • Is there a JSEA or SWMS available for this task ?

  • Is my equipment fit and correct for the task and in good working order?

  • Do I have the correct Personal Protective Equipment for the task?

Consider the following permits

  • Is a WORKING AT HEIGHTS permit required ?

  • Simply define task requiring permit:

  • Is a HOT WORK permit required?

  • Simply define task requiring permit:

  • Is a CONFINED SPACE permit required ?

  • Simply define task requiring permit:

  • Is a FIRE SYSTEM IMPAIRMENT permit required ?

  • Simply define task requiring permit:

  • Is a SURFACE PENETRATION or EXCAVATION permit required ?

  • Simply define task requiring permit:

  • Tick the box if you have arranged the required permits.

Step 2 - Hazard / Issue Check

2. Identify the Hazards and Controls with the following JSEA

  • Are there any manual handling hazards?
    (Lifting, awkward positions, impacts or over exertion)

  • What are the HAZARDS or RISKS ? List them here:

  • What CONTROLS are you putting in place to reduce risks to LOW ? List them here:

  • Are there any Gravity hazards?
    (Slips, trips and falls, or being struck by falling objects)

  • What are the HAZARDS or RISKS ? List them here:

  • What CONTROLS are you putting in place to reduce risks to LOW ? List them here:

  • Are there any Mechanical hazards?
    (Caught in moving parts, struck by plant or flying objects)

  • What are the HAZARDS or RISKS ? List them here:

  • What CONTROLS are you putting in place to reduce risks to LOW ? List them here:

  • Are there any Electrical hazards?
    (Faulty tools or live power)

  • What are the HAZARDS or RISKS ? List them here:

  • What CONTROLS are you putting in place to reduce risks to LOW ? List them here:

  • Are there any Chemical hazards?
    (Inhalation, swallowing, acids, solvents or asbestos)

  • What are the HAZARDS or RISKS ? List them here:

  • What CONTROLS are you putting in place to reduce risks to LOW ? List them here:

  • Are there any High Pressure hazards?
    (Liquid, gas or air)

  • What are the HAZARDS or RISKS ? List them here:

  • What CONTROLS are you putting in place to reduce risks to LOW ? List them here:

  • Are there any Noise hazards?
    (Potential hearing damage, masking of emergency alarms)

  • What are the HAZARDS or RISKS ? List them here:

  • What CONTROLS are you putting in place to reduce risks to LOW ? List them here:

  • Are there any Biological hazards?
    (Potential disease contact, ,zoonoses, animals)

  • What are the HAZARDS or RISKS ? List them here:

  • What CONTROLS are you putting in place to reduce risks to LOW ? List them here:

  • Are there any Radiation hazards?
    (X-rays, sunlight, ultra violet)

  • What are the HAZARDS or RISKS ? List them here:

  • What CONTROLS are you putting in place to reduce risks to LOW ? List them here:

  • Are there any Environmental hazards?
    (Dust, heat, cold, snow, ice)

  • What are the HAZARDS or RISKS ? List them here:

  • What CONTROLS are you putting in place to reduce risks to LOW ? List them here:

Step 3 - Final Assessment

3. Consultation with Supervisor or Manager.

  • Did you consult with you or Supervisor or UTAS Contact person for items in Section 2 where you answered YES and during the JSEA preparation

  • List your reason for not contacting your works Supervisor or UTAS Contact person.

4. Make the Hazards safe.

  • Are all hazards now removed or at LOW level?

  • Add reasons below for not reducing the hazard to a LOW risk rating:

  • Where needed, I have updated the JSEA or SWMS for this task?

  • Add the JSEA or SWMS title and reference number below: then forward a copy to your works Supervisor or UTAS Contact person.

5. Is the site now be SAFE so the task can be started ?

  • Tick the box if you have identified and assessed all hazards and made them safe. It is now SAFE to start the work.

6. Contractor / Worker Sign Off

  • Name of Person signing:

  • Enter name of person signing this audit in the space below then select "Sign"

  • Contractor / Worker Signature

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