Project Information: Project Name: Location: Supervisor : Company name : Date: Task Description: Before work starts, the following must be in place Induction Supervision Test Certificates Communication in same language Method Statement Risk Assessment Permit To Work Area Lighting SELECT HAZARDS SELECT CONTROLS ( Tick to identify the controls in place) Fall from height Training Access Ladder Access Handrail Edge Protection Secure Ladder Adequate Work Platform Guards for Openings Safety Harness Life Lines Others( Specify) Manual Handling Training Check Weight Mechanical Aids Access Route Team Lifting Wrong method Right Method Power tools Training Color code inspection tag Check Cable Wheel guards Safe plug & sockets Cable Protection Proper Scaffold Cable Overhead Rotatory part guards Scaffold Scaffold Tag Edge Protection Check Overhead works Access Ladder Adequate Work Platform Weather condition Out riggers Ladder 3 feet above platform Safety Harness SELECT HAZARDS SELECT CONTROLS ( Tick to identify the controls in place) Risk Assessment Lifting Plan Tag Lines Lifting points / hooks Banks man Load stability Check Lifting gear Examination /Inspection Sharp edges protected Lifting operations Weather/ Wind Speed Ground conditions Exclusion zone Communication Loading/ unloading vehicles Spreader Beams Check Ground conditions Check outriggers Others Fire Fire Extinguisher Fire Hose Fire Exit Assembly point others Slip/Trip Clean before you go Barricade the waste Waste Management Clean Access Housekeeping Clean liquid spillage Access signs Maintain access/ Egress PPE Safety Harness Safety Helmet Coveralls Hi vis Jacket Safety Shoe Face Shield Ear Protection Dust mask Respiratory Equipment Life line/ harness anchorage Hand Gloves Goggles/ Glass Pre start Briefing done by: Signature: Reviewed By HSE Manager/ In charge: Signature: