Point of Work Risk Assessment

Please fill out each row.*

Rows	Yes	No	N/A
Are PtW, RAMS in place and signed by ALL operatives?
Are you working at height?
Is there a rescue plan in place?
Are you trained/qualified for the task to be completed?
Are all power tools PAT tested?
Are any scaffolds tagged?
Is all rope access and lifting equipment inspected certifications available?
Do you have the correct PPE for the work?

Note: If any of the above answers is NO, take the required action or report to your Supervisor/Manager.
Step Two: THINK

(Put Precautions in Place)

Safety Assesment: Please document the risk level of the following items by indicating None, Low(L), Medium(M), or High(H):*

Rows	None	L	M	H
1. Slips, trips, or falls on the same level
2. Confined space
3. Falls from height
4. Dust
5. Falling/dropped objects
6. Fumes
7. Chemicals/harmful substances
8. Noise
9. Heat/fire/explosion
10. Vibration
11. Asphyxiation
12. Electrocution
13. Contact with stationary object
14. Contamination (loose, airborne)
15. Vehicles
16. Poor lighting
17. Risk to you from the work of others
18. Temperature (high/low)
19. Stored energy unsecured load
20. Adverse weather
21. Manual handling
22. Uncertified equipment
23. Object overturning collapsing
24. Risk to others from your work
25. Sharp edges
26. Lone working
27. Access/egress clear
28. Others (specify below)

If any hazards listed in Step 2 were 'Medium' or 'High', please list them here using the number listed above and the control measures

Rows	List Hazard Number From Above	Control Measures/Precautions	Remaining Risk
#
#
#
#
#
#
#
#
#
#
#
#
#

Work Party Acceptance

As the Competent Person, I have made sure that the entire work party has participated in the Point of Work Risk Assessment and they understand the necessary control measures.*

First NameLast Name
Competent Person Signature*
YesNo
Operative 1 Signature
Operative 2 Signature
Operative 3 Signature
Operative 4 Signature
Operative 5 Signature
Operative 6 Signature
Operative 7 Signature
Operative 8 Signature
Step Five: REVIEW

End of Job Review:

Rows	Yes	No
Are there lesson to be learnt?
Has the work created additional hazards?

If you answered 'Yes' to either of the above questions, tell your supervisor.
Working Together for Safety. Remember--manage the hazard before it manages you!
Please put in your email address to receive a copy:*
example@example.com
Date*

MonthDayYear
Date
Hour MinutesAM/PM Option
Name of Your Supervisor
All members of the working team MUST take part in carrying out the POWRA. Anyone found to be falsifying names, and or part of the form maybe subject to disciplinary action by the Company.
Should be Empty:

Step One: STOP