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    4 5.site Specific Assessment Example

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    TrustEmma
    This document provides a site-specific job hazard assessment for delivering widget crates by boom truck. It identifies congested workspace as a hazard due to multiple workers in the unloading area. To control this risk, a spotter will be designated to control access and ensure all workers are behind traffic cones 25 feet from the truck during unloading. All workers on site have been notified of the activity and safety requirements. Sign off is required by attending staff to acknowledge review and approval of the controls before work begins.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    4 5.site Specific Assessment Example

    Uploaded by

    TrustEmma
    189 views2 pages
    This document provides a site-specific job hazard assessment for delivering widget crates by boom truck. It identifies congested workspace as a hazard due to multiple workers in the unloading area. To control this risk, a spotter will be designated to control access and ensure all workers are behind traffic cones 25 feet from the truck during unloading. All workers on site have been notified of the activity and safety requirements. Sign off is required by attending staff to acknowledge review and approval of the controls before work begins.

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    Site Specific Assessment Example for use in drafting templates

    Original Title

    4 5.Site Specific Assessment Example

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    This document provides a site-specific job hazard assessment for delivering widget crates by boom truck. It identifies congested workspace as a hazard due to multiple workers in the unloading area. To control this risk, a spotter will be designated to control access and ensure all workers are behind traffic cones 25 feet from the truck during unloading. All workers on site have been notified of the activity and safety requirements. Sign off is required by attending staff to acknowledge review and approval of the controls before work begins.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    189 views2 pages

    4 5.site Specific Assessment Example

    Uploaded by

    TrustEmma
    This document provides a site-specific job hazard assessment for delivering widget crates by boom truck. It identifies congested workspace as a hazard due to multiple workers in the unloading area. To control this risk, a spotter will be designated to control access and ensure all workers are behind traffic cones 25 feet from the truck during unloading. All workers on site have been notified of the activity and safety requirements. Sign off is required by attending staff to acknowledge review and approval of the controls before work begins.

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    You are on page 1of 2

    <Insert Your Logo Here>

    ABC Widget Oilfield Services Ltd.


    SITE – SPECIFIC JOB HAZARD ASSESSMENT

    Site – Specific Job Hazard Analysis & Pre-job Meeting Record

    Task: Delivery of Widget Crates Date:


    Relevant SOP(s): Aug 30-13
    Refer to ‘Safe Work Practice 015-Loading and Unloading with use of Boom Trucks’

    Pre-Job Meeting Conducted? Meeting Topics/Concerns:


    ___ No
     Yes Truck Driver had concerns about the number of labourers/field workers
    working in close proximity to where the Widget Crates have to be
    If yes,
    unloaded by the field crane.
    Date: Aug 30-13

    Time: (7:15 am) ----am/pm

    Risk Approved
    Common Hazards Describe Current Conditions Describe Applied Controls
    Posed By:

    Area designated for the Widget Crate 12 A spotter will be designated by the Prime John Doe
    storage has multiple workers engaged in to control the unloading area and ensure (Prime’s
    Congested Workspace
    other work directly in line with unloading all workers are behind traffic cones when Supervisor) and
    Yes ☐ No area. unloading commences. ABC Truck
    Cones to be placed 25 ft from truck. Driver

    Concurrent Work
    ☐Yes ☐ No

    Severe Weather
    ☐Yes ☐ No

    Other

    Other

    Notes:
    Everyone on the job site has been made aware of the unloading activity and the need to follow the direction of the Prime’s
    designated spotter. Unloading will only commence when all staff are in a safe zone.

    Attending Staff Sign-Off:

    Site Specific Job Hazard Assessment


    Page 1
    <Insert Your Logo Here>

    Site – Specific Job Hazard Analysis Instructions

    Severity: Determining the impact that the transfer of energy will have on the target person or object
    Probability (Likelihood): Determining the likelihood that the hazard will result in a transfer of unintended energy
    Frequency: Determining how often the target can reasonably be expected to be exposed to the hazard

    A physical hazard is a physical factor or material thing (including the environment) that has the potential to transfer
    energy by direct or indirect contact. There is a mechanical application of force to the target (such as contact with
    moving parts, electricity and awkward body posture).

    A chemical hazard is a substance that through its intrinsic properties or due to being handled has the potential to
    cause harm or loss by direct contact or from a distance. The WHMIS classifications identify the regulated hazards of a
    chemical (such as H2S and asbestos).

    A biological hazard is an organism or substance derived from an organism that has the potential to cause harm or
    loss by direct contact or from a distance (such as the hanta virus).

    A psycho-social hazard is a specific situation that may cause mental or physical health problems. These problems, in
    turn, can give rise to behavioral problems (such as absenteeism) or physical manifestations (such as ulcers or fatigue).
    Psycho-social hazards are also called workplace stressors (such as excessive workload and bullying).

    Severity Probability

    1. Negligible/OK: Causing minor injury that requires 1. Extremely Remote: Unlikely to occur
    first aid or less 2. Remote: Could occur at some point
    2. Minor: Causing non-serious injury, illness, or 3. Reasonably Probable: Likely to occur eventually
    damage that requires medical aid 4. Probable: Likely to occur immediately or soon
    3. Serious: Causing severe injury, serious illness, that is
    disabling or lifelong, or property and equipment Multiply Severity by Probability according to the chart
    damage below to determine the risk.
    4. Imminent danger: Causing death, widespread
    occupational illness, or loss of facilities

    4 4 Medium 8 Medium 12 High 16 High


    Severity

    3 3 Low 6 Medium 9 Medium 12 High


    2 2 Low 4 Medium 6 Medium 8 Medium
    1 1 Low 2 Low 3 Low 4 Medium
    1 2 3 4
    Probability (Likelihood)

    Low: CONTINUE WITH TASK. Ensure existing control measures are being used as intended. Watch for new hazards
    to develop.
    Medium: PAUSE. What new control measures can be introduced to reduce the risk?
    Re-assess after new control measures are in place.
    High: STOP. Can the hazard be eliminated? Can the task be completed in a different manner? Does the task have to
    be completed at all?
    Very High: STOP. Do not proceed. Contact the Supervisor to determine a course of action.

    All affected workers and supervisors must sign off before work begins.

    Site Specific Job Hazard Assessment


    Page 2

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