Professional Documents
Culture Documents
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Technicians skills
Confined
Electricians
Welder
Duct
Fabricator
Plumber
Lifting
Specify
Rigger
Electrical (LOTO)
Others
Insulator
Pipe fitter
Responsible In charge:
02
Date:
NO WORK!!
Resources Required
Rev. No.
Others
Formwork
(casting/striking)
Hazardous materials /
chemicals :
Emergency Contact
Numbers:
33284344
Contact Names &
Numbers:
Male Nurse :
Description of Works :
Supervisio
n
Test
Certificates
SELEC
T
HAZAR
DS
Communicati
on
Drinking
Water
Risk
Assessment
Permit To
Work
Area
Lighting
SELECT CONTROLS
( Tick to identify the controls in place)
Fall from
height
Risk
Assessme
nt
Access
Ladder
Access
Handrail
Edge
Protection
Secure
Ladder
Adequate
Work
Platform
Guards
for
Openings
Fall
Arrestor
Life
Lines
Manual
Handling
Risk
Assessme
nt
Check
Weight
Mechanic
al Aids
Access
Route
Training
Team
Lifting
Wrong
method
Right
Method
Others
Power tools
Risk
Assessme
nt
Colour
code
inspectio
n tag
Check
Cable
Guards in
place
Proper
Positionin
g
Proper
Scaffold
Cable
Protection
Ventilatio
n
Dust
extractio
n
NO WORK!!
FORMAT NO:
Rev. No.
02
Page:
2 of 5
Date:
Electricity
Risk
Assessme
nt
Training
Permit to
work
Tag out
Lock out
Warning
Signs
Check
plug tops
Check
Cable
Others
Confined
Space
Risk
Assessme
nt
Survey
Permit to
work
Gas
Detection
Communic
ation
Access/egr
ess
Monitorin
g
Air supply
Rescue
System
SELEC
T
HAZAR
DS
SELECT CONTROLS
( Tick to identify the controls in place)
Risk
Assessme
nt
Clean
Access
route
House
keeping
Check oil
spills
Use
Pedestrian
way
Access/eg
ress
Risk
Assessm
ent
SWL
Tag Lines
Lifting
points /
hooks
Banks
man
Load
stability
Lifting
operations
Weather
condition
Ground
condition
s
Exclusion
zone
Communic
ation
Loading/u
nloading
vehicles
Spreader
Beams
Check
Ground
conditions
Check
outriggers
Others
Compresse
d Gas
Risk
Assessme
nt
Cylinder
storage
Cylinder
Trolley
Permit to
Work
Flash Back
Arrestors
Warning
Signs
Hose/pipe
check
Pressure
Gauges
No
smoking
Fall from
ladder
Risk
Assessme
nt
Dont use
in edges
Check
stability
Secure
Ladder
Over
Reaching
Ladder
anti skid
shoe
Others
Others
Others
Scaffold
Risk
Assessme
nt
Scaffold
Tag
Check
Over head
works
Access
Ladder
Edge
Protection
Weather
condition
Out
riggers
Ground
condition
Adequate
Work
Platform
Industrial
Vehicles
Risk
Assessme
nt
SWL
Load
stability
Route
survey
Speed
Limits
Warning
devices
Banks
man
Secure
Load
Examinati
on /
Inspectio
n
Training
Controlled
access
Chemical
resistant
Hand
Respirator
y
equipmen
Ventilatio
n
Fume
extraction
Chemical
Risk
Assessme
nt
Check
Label
Adequate
Work
Platform
Check
Lifting
gear
Jumping
manholes
/ trenches
Examinati
on /
Inspection
Others
Packing
Pieces
Others
Fire
Excavation
Emergency
Plan
Emergency
Response
Training
Risk
Assessme
nt
Check
slope /
repose
angle
SELECT
HAZAR
DS
ABC Fire
Extinguishe
r
Shoring
CO2 Fire
Extinguishe
r
Access /
egress
NO WORK!!
Rev. No.
02
Page:
3 of 5
Date:
Fire Blanket
Barricade
FORMAT NO:
Fire Hose
Others
Others
Fire Exit
Assembly
point
Others
Others
Ventilatio
n
Barricade
hot work
zone
Leather
apron /
gloves
Proper
Scaffold
Access /
egress
Adequate
Work
Platform
SELECT CONTROLS
( Tick to identify the controls in place)
Risk
Assessme
nt
Permit to
Work
Training
Welding
screens
Welding
face
shield
Risk
Assessm
ent
Permit to
Work
Warning
boards
Fall
Arrestor
Life Lines
Shafts /
Floor
Openings
Training
Overhead
Protection
Opening
guards
Ventilatio
n
Task light
Others
Others
Others
Others
Biological
Hazard
Environm
ent
Assessm
ent
Survey
Wash
rooms /
Toilets
Pest
control
Waste
managem
ent /
Recycling
Waste
removal
Waste
Skip
Others
Others
Others
(Hazard)
Others
Others
Others
Others
Others
Others
Others
Others
Others
Safety
Helmet
Hand
Gloves
Eye
protectio
n
Coveralls
Face
Shield
Hi vest
Jacket
Safety
Shoe
Ear
Protectio
n
Safety
Harness
Dust
mask
Respirator
y
Equipmen
t
Breathin
g
Apparatu
s
Fall
Arrestor
Others
Others
Others
Others
Others
Welding /
Hotworks
PPE
Fume
extraction
Guard
shaft
openings
NO WORK!!
FORMAT NO:
Rev. No.
02
Page:
4 of 5
Date:
Any Others
Observations and
actions taken:
Task Hazard
Analysis
Prepared BY
Name:
Signature:
Attendee Form
I.D.
No.
Talks
NO TBT / PRE TASK START!!
Attendee Name
NO WORK!!
Designation
FORMAT NO:
Rev. No.
02
Page:
5 of 5
Date:
Signature