Work Equipment Assessment Form

• Document No.

• Category

  A

  B

  C

• Audit Title

• Site/Department

• Conducted on

  Date

• Review Date

  Date

• Prepared by

• Assessor(s)

Section One - Suitability

• 1.1 Is the equipment designed & suitable for the purpose for which it is used?

  Yes

  No

  N/A

• 1.2 Has the equipment been selected with regard for the H&S of the users?

  Yes

  No

  N/A

• 1.3 Is the use of the equipment restricted to purposes for which it is suitable?

  Yes

  No

  N/A

• 1.4 Are written operating instructions available for the equipment being assessed?

  Yes

  No

  N/A

Section Two - Maintenance

• 2.1 Is the equipment subject to periodic inspection?

  Yes

  No

  N/A

• 2.2 Is all maintenance work arising from an inspection or planned maintenance work recorded?

  Yes

  No

  N/A

• 2.3 Where the answer to question 2.2 is Yes. Is the record kept up to date?

  Yes

  No

  N/A

• 2.4 Is all maintenance, repair, servicing etc of the equipment, restricted to listed, designated competent staff?

  Yes

  No

  N/A

Section Three - Restrictions on Use

• 3.1 Is the use of the equipment restricted to authorised staff?

  Yes

  No

  N/A

• 3.2 When specific operator training and work instructions are required for the equipment, has it been given?

  Yes

  No

  N/A

• 3.3 Is all staff that uses the equipment, and their supervisors, trained in SSoW, risk assessments, specific precautions and other safety requirements?

  Yes

  No

  N/A

• 3.4 Are the training records signed?

  Yes

  No

  N/A

Section Four - Equipment

• 4.1 Does the equipment comply with statutory requirements and / or British European standards? (CE marking should be on the equipment.) If unsure, treat as No and complete section 5.

  Yes

  No

  N/A

Section Five - Guarding of Machinery

• 5.1 Are all dangerous parts of equipment guarded or interlocked so far as practical to protect against danger?

  Yes

  No

  N/A

• 5.2 Where steps & work platforms are provided is access to moving /rotating parts of equipment still prevented?

  Yes

  No

  N/A

• 5.3 Where equipment cannot practicably be guarded in accordance with 5.1, are jigs, push-sticks, holders or other protective devices used to prevent risks to Health and Safety?

  Yes

  No

  N/A

• 5.4 Where protection in accordance with elements 5.1 or 5.2 is not practicable, are the risks adequately controlled by the provision of permits, information, instruction, training and supervision?

  Yes

  No

  N/A

Section Six - Specified Hazards

• 6. Are the following specified hazards reduced to as low a level as practical?

• 6.1 Ejected/Falling objects

  Yes

  No

  N/A

• 6.2 Noise

  Yes

  No

  N/A

• 6.3 Rupture or disintegration of the equipment

  Yes

  No

  N/A

• 6.4 Fire or overheating

  Yes

  No

  N/A

• 6.5 Unintended discharge of any article or gas, dust, liquid, vapour or other substance

  Yes

  No

  N/A

Section Seven - Burn Protection

• 7.1 Are all hot/cold parts of the equipment, which are likely to cause burns, protected?

  Yes

  No

  N/A

• 7.2 Are all hot/cold substances or articles associated with the equipment, protected to prevent burns?

  Yes

  No

  N/A

Section Eight - Control Systems

• 8.1 Is the equipment provided with start, stop and where applicable, level controls that are clearly visible and easily identifiable and which require deliberate action to operate?

  Yes

  No

  N/A

• 8.2 If the equipment causes a hazard in operation, is it fitted with a readily accessible and clearly identified emergency stop control which overrides other controls on the equipment?

  Yes

  No

  N/A

• Elements 8.3 to 8.6 apply wherever mechanised plant creates a danger zone.

  Yes

  No

  N/A

• 8.3 Are all controls safely situated out of any danger zone associated with the equipment?

  Yes

  No

  N/A

• 8.4 Can the operator at the controls of the equipment ensure that nobody is in the danger zone while he/she is operating the equipment?

  Yes

  No

  N/A

• 8.5 If 8.4 is not reasonably practicable, is there a safe system of work in operation to prevent anybody from entering a danger zone while the equipment is operating?

  Yes

  No

  N/A

• 8.6 If neither 8.4 nor 8.5 is reasonably practicable, is an audible or visual warning given before the equipment is started?

  Yes

  No

  N/A

Section Nine - Isolation from Sources of Energy

• 9.1 Is the equipment capable of being isolated from its energy supply by safe, clearly identifiable means?

  Yes

  No

  N/A

• 9.2 Can the equipment be re-energised without exposing any persons to risks to Health and Safety?

  Yes

  No

  N/A

Section Ten - Securing

• 10.1 Is the equipment stabilised / secured / restrained as far as is necessary to prevent hazard?

  Yes

  No

  N/A

• 10.2 Are steps, access platforms, walkways, guardrails stabilised, secured, free from obstruction & trip points

  Yes

  No

  N/A

Section Eleven – Workplace Environment

• 11.1 Is the equipment installed and used in an appropriate suitable location and environment?

  Yes

  No

  N/A

• 11.2 Is there sufficient lighting to prevent hazards from arising from poor visibility?

  Yes

  No

  N/A

• 11.3 Is the area free from articles, substances & waste that may cause a hazard?

  Yes

  No

  N/A

• 11.4 Is their adequate space around the machine to allow safe & easy access?

  Yes

  No

  N/A

• 11.5 Are the equipment & its access platforms steps etc free from substances, waste, tools & equipment?

  Yes

  No

  N/A

• 11.6 Where seating is required, is it provided & in good condition?

  Yes

  No

  N/A

• 11.7 Is the equipment in an un-exposed area?

  Yes

  No

  N/A

• 11.8 Is the equipment & work area free from extremes of temperature?

  Yes

  No

  N/A

Section Twelve - PPE

• 12.1 If Specific PPE is required for this equipment /area is it available?

  Yes

  No

  N/A

• 12.2 Are operators aware that the PPE is required & know how to use it?

  Yes

  No

  N/A

Section Thirteen – Maintenance Safety

• 13.1 Is all maintenance carried out with the equipment stopped?

  Yes

  No

  N/A

• 13.2 Where 13.1 is not reasonably practicable, is maintenance work carried out without entry to any danger zone or, by staff following specific procedures to protect against danger?

  Yes

  No

  N/A

Section Fourteen - Markings and Warnings

• 14.1 Are all necessary Health & Safety labels & signs etc fitted, visible & legible? E.g. Prohibited Actions. PPE. Hazardous Parts/ Surfaces/Materials.Emergency Action

  Yes

  No

  N/A

• 14.2 Do all signs & warnings, conform to the current legislation.

  Yes

  No

  N/A

15.If Corrective Action is required (Please make reference to question No’s)