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1801 Falls Ave. Waterloo, IA 50701
319-233-6101
Home
About
Safety
Services
Boiler Systems
Gas Fired Equipment
Certified Welding Services
Process Piping
Pump Services
Certified Backflow Testing
Inspections
Parts
Careers
Contact
Risk Assessment
Risk Assessment
Step
1
of
9
11%
List of WBC Employees Working at this Location
(Required)
Customer
(Required)
Location
(Required)
Job #
(Required)
Date
(Required)
WHAT WORK am I going to do?
WHERE am I going to work?
(Required)
What are the MAIN JOB TASKS I am going to do?
(Required)
What HAZARDS could I face?
Select all that apply:
Slip or trip
Splashes, flying debris
Hot surfaces or materials
Manual handling
Chemicals, dusts or gases
Collapse or overturn
Release of pressure or stored energy
Work at height or overhead
Heavy lifting
Cutting or grinding
Sharp edges or low clearances
Sudden release of hand tools
Electricity or buried services
Vehicle or PIT movements
Machinery movement
High noise levels
Fire or explosion
Confined space or excavation
Other (describe below)
Other:
DON'T FORGET OTHER WORK GOING ON IN THE AREA!
Is my WORK EQUIPMENT safe?
Do I have the correct equipment?
Yes
No
Is the equipment inspected and free from defect?
Yes
No
Is the workspace accessible and does it allow for proper use?
Yes
No
What ACTION should I take?
Are there OTHER RISK FACTORS?
Is the lighting sufficient?
Yes
No
Do I have the proper training to complete the task?
Yes
No
Do I have safe and easy access to workspace/equipment?
Yes
No
Do I need to inform anyone else?
Yes
No
What ACTION should I take?
Do I need a PERMIT-TO-WORK?
Select all that apply:
Work at Height
Hot Work
High-hazard Electrical Work
Confined Space Entry
Hazardous Line Breaking
Critical Lifting Operation
Demolition
Ladders
Lifts
No Permits Required
What do I need to LOCK-OUT or TAG-OUT?
(Electricity, Compressed Air, Hydraulics, Gravity, Springs, Other store energy)
List here:
What else do I need to do BEFORE JOB STARTS?
Pre-job measures to be taken:
(Required)
What do I need to do DURING THE JOB?
Precautions required:
(Required)
What PPE do I need?
Select all that apply:
(Required)
Helmet
Safety footwear
Reflective vest
Eye protection
Face protection (full shield)
Ear protection
Protective gloves
Personal fall arrest system
Protective clothing
Other (describe below)
Other
What if things GO WRONG?
Can I deal with an emergency?
(Required)
Yes
No
Can I summon help if I get hurt?
(Required)
Yes
No
How should I PREPARE?
(Required)
ONLY PROCEED IF YOU ARE SURE YOU CAN DO THE JOB SAFELY! IF IN DOUBT, STOP AND SEEK ADVICE!
Δ
