Workplace_Hazard_Assessment_Checklist.doc

Workplace Hazard Assessment Checklist This checklist assists you in identifying hazards when walking through the facility. Record the hazards for either the location or the task.

Assessment Conducted By:

Specific Tasks Performed at this Location:

Overhead Hazards

· Suspended loads that could fall

· Overhead beams or loads that could be hit against

· Energized wires or equipment that could be hit against

· Employees work at elevated site who could drop objects on others below

· Sharp objects or corners at head level

· Flying or propelled objects

· Falling objects or materials

If yes, determine the type and class:

· Class G (impact and penetration resistance, plus low-voltage electrical insulation)

· Class E (impact and penetration resistance, plus high-voltage electrical insulation)

· Class C (impact and penetration resistance)

Eye and Face Hazards

· Chemical splashes

· Dust

· Smoke and fumes

· Chemical gases or vapors

· Welding operations

· Lasers/optical radiation

· Bioaerosols

· Projectiles

· Flying particles

· Molten metals

· Acids or caustic chemicals

Types of Eye and Face Protection

Hand Hazards

· Chemicals

· Sharp edges, splinters, etc.

· Harmful temperature extremes

· Biological agents

· Exposed electrical wires

· Sharp tools, machine parts, etc.

· Material handling

· Absorbing harmful substances

· Severe cuts, lacerations or abrasions

· Punctures

· Chemical burns and/or thermal burns

If yes, determine the type and class:

Foot Hazards

· Heavy materials handled by employees

· Sharp edges or points (puncture risk)

· Exposed electrical wires

· Unusually slippery conditions

· Wet conditions

· Construction/demolition

· Falling objects

· Rolling objects

· Piercing/cutting injuries

· Electrical hazards

Types of Foot Protection

Drowning Hazards

· Working on the water

· Working over the water

· Working alongside the water

If yes, determine the type and record.

Summary of Hazard and the Required PPE at Post

I certify that the above inspection was performed to the best of my knowledge.

(Signature)

(Date)