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1. General Information: Date, time, location, supervisor name, and weather conditions (if applicable)
2. Work Activity Description: Brief description of planned work activities for the day
3. Team Members: List of workers present and their roles
4. Site Conditions: Current workplace conditions including housekeeping, lighting, and access/egress
5. Hazard Identification Checklist: Structured checklist of common hazards categorized by type (physical, chemical, biological, etc.)
6. Risk Assessment Matrix: Tool for evaluating likelihood and severity of identified hazards
7. Control Measures: Required safety measures and PPE for identified hazards
8. Emergency Response Information: Emergency contact numbers and evacuation procedures
9. Sign-off Section: Signatures of supervisor and team members acknowledging the assessment
1. Environmental Conditions Assessment: Detailed assessment of environmental factors - use when work is conducted outdoors or environmental conditions significantly impact safety
2. Special Equipment Checklist: Detailed equipment safety checklist - include when specialized machinery or tools are being used
3. Permit Requirements: Section for recording necessary permits - include when working in confined spaces, hot work, or other permitted activities
4. Sub-contractor Information: Details of sub-contractor activities and their safety requirements - include when sub-contractors are present
5. Previous Day Issues Follow-up: Review of previous day's safety issues and reĂÜĚŇÖ±˛Ąs - include when there's a need for continuous monitoring of specific hazards
6. Chemical Hazard Specific Assessment: Detailed chemical hazard evaluation - include when working with hazardous chemicals
1. Schedule A - Risk Matrix Guide: Detailed guide for using the risk assessment matrix
2. Schedule B - PPE Selection Guide: Reference guide for selecting appropriate personal protective equipment
3. Schedule C - Emergency Response Procedures: Detailed emergency procedures and contact information
4. Schedule D - Common Hazard Reference Guide: Illustrated guide of common workplace hazards and their controls
5. Appendix 1 - Site-Specific Hazard Library: Reference list of site-specific hazards and control measures
6. Appendix 2 - Incident Reporting Forms: Forms for reporting any incidents or near-misses identified during assessment
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