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HAZARD CHECKLIST for (Workplace) ………………………… Date ……. /……/………….

Electrical hazards Yes/ Report What action is


No to needed?

Any exposed leads

Electrical equipment checked regularly and


tagged

Any double adaptors

Manual handling

Limits to weight to be lifted are signed

Equipment available for heavy lifting

Heavy objects labelled with a warning

First aid

First Aid kit available at all times

First Aid kit stocked adequately

First Aid Kit checked regularly

First Aid contact person clearly identified

Passageways

Passageways are clear, nothing to trip over

Passageways are wide enough for everyone

Safe surface for walking on

Steps not too steep

Handrails if needed

Access ramps available where needed

Work Environment

Good air quality

Air is free of fumes

Comfortable working temperature

Noise levels are comfortable for working

Enough lighting

Air conditioning working and regularly checked

Furniture allows for normal body positions when


seated or standing

Work Environment

Computers at correct height

No sharp edges

No low overhead projections

No items stored in non–storage areas


Electrical hazards Yes/ Report What action is
No to needed?
e.g., on top of cupboards

Washing and eating areas clean and free of


rubbish

Security and Emergency

Emergency exits clearly marked

Exits accessible and unlocked

Exit doors opening outward

Emergency procedures clearly displayed

Emergency contact numbers clearly displayed

Emergency procedures known by all workers

After hours’ security procedures adequate

Fire doors closed at all times

Fire extinguishers available

Fire extinguishers checked regularly


Risk Control Action Sheet
Contribute to the development, implementation and evaluation of risk control

Complete the Action Plan Below. You may make any assumptions about the date and the period of time
required to close out the tasks assigned.

No Item ACTIONS PERSON TARGET COMPLETED


RESPONSIBLE DATE
1

10

11

12

13

14

Assessor Feedback

Assessor decision (circle) Satisfactory Not satisfactory


Signed Assessor
Date
Toolbox safety meetings/pre-start talks
All Toolbox safety meetings/pre-start talks undertaken on behalf of are recorded
on this form and signed by participants.

All corrective actions noted on this form are implemented and signed by the nominate
person. It is the responsibilities of the Work Supervisor to ensure that all corrective actions
are completed and reviewed for effectiveness.

Toolbox safety meetings/pre-start talks

Business name:

Subject of talk:

Presented by:

Duration: Date:

Person present

Print Name: Signature: Print Name: Signature


Points Raised/ Comments:

Corrective Action Action by Action complete

Sign off Date

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