eHazard Assessment

eHazard Assessment

Site Specific or Field Level Hazard Assessments
The MeadowsRidgeview
Your Company Name
Your Name
Your Email
example@example.com
Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Muster Point
Just MyselfOur Work Crew
How Many in your Work Crew?
Enter Names of Work Crew
Foreman
Clear/SunnyCloudyWindRainLightening / ThunderstormFreezing RainSnowFogSmoke/Haze
Expected Temperature for Today
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
1. Phone/check in with supervisor every 30 mins2. Communicate/check in with other work crews on site3. Explain Other Method
1. Tasks
1. List all Tasks to complete the job today*
(steps to complete the job)
2. Hazards
Consider the four contributing factors to hazards – P. E. M. E.
- People – are they competent/well trained? Are they tired? What motivates them?
- Equipment – Is it appropriate for the task? Is it properly installed and maintained? Are manufacturers specs being followed?
- Materials – What materials are being used? Are they being handled, stored and disposed of properly?
- Environment – Where is the task being performed? Does the work site environment introduce hazards?
YesNo
YesNo
Complete a Fall Protection Plan before continuing
Explain why fall protection plan is not required
YesNo
YesNo
YesNo
A Powered Mobile Equipment Checklist is required before starting work. Follow the link after submitting this Hazard Assessment to complete.
N/AAwkward LoadsConfined SpaceDustFalling ObjectsFlying debrisHeavy LiftingPoor ErgonomicsPoor LightingPowered Mobile EquipmentPowered ToolsRepetitive MotionsSharp blades / drill bitsSlips, Trips and FallsTrades/other workersViolenceWeatherWildlifeWorking at HeightsOther
N/AHazardous Fumes/GasesHazardous LiquidsSpillsVehicle ExhaustOther
N/AAnimal/Pet WasteInsectsMoulds/FungiPandemic/SicknessSewageOther
N/AFatigueHarassment / BullyingProcess ChangeShift WorkStressTime PressureOther
N/AChemical Hazards (explosives/flammables)Energized Electrical SystemHydraulic (Compressed Fluids)Mechanical (moving machinery parts)Mechanical (parts under tension/raised)Pneumatic (Compressed Air)Temperature (Heat/Cold)Vibration (Equipment or Noise >85dB)Other
3. Controls
N/ABarricades to limit accessEquipment guards in placeInsulate to reduce excessive noiseIsolate from Energy SourceLightingScaffoldingSubstitute chemicals for less toxic substanceUse hoists or equip to lift heavy loadsVentilationOther
N/AInspect EquipmentLimit Exposure timesLockout / Tagout ProcedureReview SDSSafe Job Procedure/Work PracticeTidy the Work AreaTrain workersOther
N/AApproved footwearCoverallsFall protection EquipmentGlovesHard HatsHearing ProtectionMasks / RespiratorsReflective Hi-Vis ClothingSafety GlassesOther
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Work Crew

You are confirming that the work crew entered above have been involved in completing this Site Specific eHazard Assessment, and all are fully aware of the hazards and understand the controls implemented.
Signature*
Work Crew Signature #1
Work Crew Signature #2
Work Crew Signature #3
Work Crew Signature #4

eHazard Assessment

1. Tasks

2. Hazards

Consider the four contributing factors to hazards – P. E. M. E.

3. Controls

Work Crew

Reassessment