FS-Daily-Work-Record Please enable JavaScript in your browser to complete this form.Name *Name of person filling this in Do you have other Staff working with you today? *YesNoWho else is in your work party? (list them below)Part 1 - STOPContract Name *Please include Project No.Work Type *Date / Time *DateTimeLocation Detail (Site Name, Pipeline, Asset Number, Location ID etc) *Pre-Start Checks(Tick appropriate box)Do you have the right documents for the job? *Click dropdown to select answerYesNoN/ADo you have the right PPE for the job? *Click dropdown to select answerYesNoN/AAre all tools and equipment tested and serviceable? *Click dropdown to select answerYesNoN/AIs there safe access to the works location? *Click dropdown to select answerYesNoN/AHave you read, signed and do you understood the contents of the RAMS? *Click dropdown to select answerYesNoN/APart 2 - Think (If the hazard / aspect is present tick the box below on any hazards / aspects that you feel are inadequately controlled and proceed to part 3)Harzard Checklist - Tick all that applySlips, trips or Falls on the same levelFalling / Flying ObjectsNoiseAsphyxiation / DrowningContact with Stationary ObjectManual HandlingVehiclesEnvironmental Pollutions (Land, Water, Air)Dust / FumesVibrationFalls from HeightChemical / Hazardous SubstancesHeat / Fire / ExplosionRisk to Plant / Equipment / VehiclesObject Overturning / CollapsingStored Energy / Insecure LoadRisks from the activities of othersEntry into a confined spaceAsbestosElectricityRadiation ( ionising and non-ionising)Contamination (loose and airborne)Poor lightingTemperatureAdverse WeatherPinch / trapping pointsRisk to others from your activitiesProduction of WasteLivestock or WildlifeOther site hazard(s) (specify)Other Site Hazards (Not listed): Please specifyPart 3 - ActControl Measures Required (If you ticked any of the hazards you now need to ensure that appropriate control measures are put in place to reduce the identified risk to an acceptable level)Control Measures Required: Slips, trips or falls on the same levelControl Measures Required: Falls from HeightControl Measures Required: Falling / flying objectsControl Measures Contact with stationary objectControl Measures Required: Object overturning / collapsingControl Measures Required: Manual handlingControl Measures Required: Risks from the activities of othersControl Measures Required: Environmental Pollution (Land, Water, Air)Control Measures Required: Entry into a confined spaceControl Measures Required: Dust / fumesControl Measures Required: Stored energy / insecure loadControl Measures Required: VehiclesControl Measures: Risk to plant / equipment / vehiclesControl Measures Required: Chemicals / hazardous substancesControl Measures Required: Asphyxiation / drowningControl Measures Required: NoiseControl Measures Required: Heat/ Fire / ExplosionControl Measures Required: AsbestosControl Measures Required: VibrationControl Measures Required: ElectricityControl Measures Required: Radiation ( ionising and non-ionising)Control Measures Required: Contamination (loose and airborne)Control Measures Required: Poor lightingControl Measures Required: TemperatureControl Measures Required: Adverse WeatherControl Measures Required: Pinch / trapping pointsControl Measures Required: Risk to others from your activitiesControl Measures Required: Production of WasteControl Measures Required: Livestock or WildlifeControl Measures Required: Other Site HazardsSubmit
