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Workplace Hazard Assessment Form: Task Hazard(s) PPE Required Notes Department

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Mashur Al Junaibi

The document is a workplace hazard assessment form that contains an example hazard assessment by task. It lists various tasks conducted at the workplace, the potential hazards associated with each task, the required personal protective equipment, and notes about the task. The form is used to identify workplace hazards and ensure appropriate safety precautions are taken for different jobs and departments.

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Workplace Hazard Assessment Form: Task Hazard(s) PPE Required Notes Department

Uploaded by

Mashur Al Junaibi
43 views2 pages
The document is a workplace hazard assessment form that contains an example hazard assessment by task. It lists various tasks conducted at the workplace, the potential hazards associated with each task, the required personal protective equipment, and notes about the task. The form is used to identify workplace hazards and ensure appropriate safety precautions are taken for different jobs and departments.

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Workplace Hazard Assessment Form

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The document is a workplace hazard assessment form that contains an example hazard assessment by task. It lists various tasks conducted at the workplace, the potential hazards associated with each task, the required personal protective equipment, and notes about the task. The form is used to identify workplace hazards and ensure appropriate safety precautions are taken for different jobs and departments.

Copyright:

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

Workplace Hazard Assessment Form: Task Hazard(s) PPE Required Notes Department

Uploaded by

Mashur Al Junaibi
The document is a workplace hazard assessment form that contains an example hazard assessment by task. It lists various tasks conducted at the workplace, the potential hazards associated with each task, the required personal protective equipment, and notes about the task. The form is used to identify workplace hazards and ensure appropriate safety precautions are taken for different jobs and departments.

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© All Rights Reserved
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Workplace Hazard Assessment Form

Work Area Assessment Conducted By Date

Personal Protective Equipment (Hazard Assessment by Task)

Task Hazard(s) PPE Required Notes Department


Workplace Hazard Assessment (Example)

Work Area Assessment Conducted By Date

Personal Protective Equipment (Hazard Assessment by Task)

Task Hazard(s) PPE Required Notes Department

Entering high noise area Noise in excess of 85dB Foam, cap, or earmuff type Both ears, all production All persons
hearing protection areas, prior to exposure area

Chemical mixing Caustic burns Chemical gloves, apron, Only authorized employees Authorized
goggles and face shield, are to mix chemicals. Read Employees
rubber boots, sleeves MSDS prior to using any
chemicals.
Immediate notification if
First aid/CPR Bloodborne pathogens/ Air Latex / non-latex examination exposed to body fluids. See Any staff required
borne diseases gloves, safety eyewear, CPR Bloodborne Pathogen Control to render first aid.
device protective mask Program

Grinding, sanding, chipping, Debris in eyes, burns, Safety glasses / goggles, face Use point of operation area Maintenance
abrading lacerations to face and shield, gloves, arm protection, guarding when available.
other non- protected body Safety toed leather boots
parts.

Grinding, sanding, chipping, Hand lacerations, Leather or thick cloth work When using powered tools Maintenance
abrading impingement gloves

Welding, brazing Eye hazard, burns Welding helmet, apron, See selection chart for proper Maintenance
gloves, chaps lens shade
Must be licensed
Work on live electrical Electrical shock Reference NFPA 70-E Maintenance and trained.
circuits
Exposure to traffic Body injuries ANSI Class II Safety Vest Wear near road ways or high Drivers, helpers
traffic areas Supervisors all
other.

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