Raynow eHazard Assessment

eHazard Assessment

Site Specific OR Field Level Hazard Assessments
Your Name*
Your Email*
We will use your email to send a copy of the completed eHazard Assessment as a PDF
Date

MonthDayYear
Date
Hour MinutesAM/PM Option
224 Muskrat Street208 Otter StreetOther
Your Company*
Just MyselfOur Work Crew
How Many in your Work Crew?
Including yourself
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
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
N/AAwkward LoadsDustExtreme TemperaturesFalling ObjectsFlying debrisHeavy LiftingNoisePoor ErgonomicsPoor LightingPowered ToolsRepetitive MotionsSharp blades / drill bitsSlips, Trips and FallsVibrationViolenceWeatherWildlifeWorking around other trades on siteWorking around PMEWorking at HeightsOther
N/AHazardous Fumes/GasesHazardous LiquidsSpillsVehicle ExhaustOther
N/AAnimal/Pet WasteInsectsMoulds/FungiCOVID 19SewageOther
N/AFatigueHarassment / BullyingProcess ChangeShift WorkStressTime PressureOther
N/AElectricalHydraulic (Compressed Fluids)Mechanical (moving machinery parts)Mechanical (parts under tension/raised)Pneumatic (Compressed Air)Temperature (Heat/Cold)Vibration (Equipment or Noise)Other
3. Controls
N/AInsulate to reduce excessive noiseSet up lightingSet up ventilationSubstitute hazardous chemicals for something less toxicUse barricades to limit accessUse equipment guardsUse hoists or equip to lift heavy loadsUse scaffoldingOther
YesNo
WARNING : Scaffold must be inspected every 21 days and inspection submitted to the site superintendant. Please submit your inspection.
N/AInspect EquipmentKeep work area tidyLimit Exposure timesProvide training for workersReview SDSUse Safe Job Procedure/Work PracticeOther
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 #2
Work Crew Signature #3
Work Crew Signature #4
Work Crew Signature #5
Click SUBMIT below and you will recieve a PDF copy of the eHazard Assessment you just completed to your inbox.

eHazard Assessment

1. Tasks

2. Hazards

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

3. Controls

Work Crew

Reassessment