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Pre-Job Hazard/Task Assessment

Check all applicable hazards that may be present before or during the task(s)

PERMITS EMERGENCY EQUIPMENT BIO-HAZARDS EQUIPMENT


Hot Work Fire extinguisher Sharps/Bio-Hazard Operating power equipment
Confined Space Eyewash Animal Droppings Operating lifts
Lockout Other Equipment as required Mould/Asbestos Power tools
WHMIS IS WORKER WORKING ALONE
First aid kit Hand Tools (Knives/saws, etc.)
MSDS reviewed No
Spill Potential Spill kit Equipment/Tool inspection
Yes
Someone informed
Work Alone Procedures apply
ERGONOMIC ENVIRONMENT PERSONAL PROTECTIVE EQUIPMENT OVERHEAD/WORKING AT HEIGHTS
Manual Lifting Weather conditions Work gloves Harness required
Too heavy/awkward Hazardous waste Chemical gloves Appropriate tie-off IDd
Over-reaching Limited access/egress Rain gear Others working above/below
Prolonged/extreme bending Exposure to energized electrical Rubber boots Falls from height
Repetition Lighting level too high/low Monogoggles/Faceshield Hoisting/moving loads
overheard
Unstable position Exposure to share Safety goggles Use of scaffolds
objects/edges
ingers/hands pinch points Noise Suitable respiratory mask Working above your head
Hands not in line of sight Fumes/vapours Hearing protection Objects/debris falling
Working in tight clearances Extreme heat/cold Safety harness/lanyard
Physical limitation/need help Reactive chemicals Head protection
Steam Hi-vis vest
Adequate ventilation Fire retardant wear
Housekeeping Other:
Dust Click here to enter text if
other is selected.
Once you have written all tasks and hazards, complete the third column identifying all plans to eliminate/control hazards.
IT IS IMPORTANT THAT ALL HAZARDS HAVE PLANS TO ELIMINATE/CONTROL THEM AND THAT THE PLANS ARE PUT INTO PLACE.
TASK(S) HAZARDS PLANS TO ELIMINATE/CONTROL RISK
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ALL MEMBERS OF THE CREW MUST SIGN PRIOR TO COMMENCING WORK AT THE TASK LOCATION.

WORKER: (PRINT) _______________________________

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