Field Level Hazard Assessment Form

Use this Field Level Hazard Assessment Form to identify and assess potential hazards of a specific job, ensuring compliance with safety protocols.

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Facility & Services
Field Level Hazard Assessment Form

Ergonomic Hazards

Access/Egress Hazards

Overhead Hazards

Rigging & Hoisting Hazards

Electrical Hazards

Personal Limitations

Environmental Hazards

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Checklist by GoAudits.com – Please note that this checklist is intended as an example. We do not guarantee compliance with the laws applicable to your territory or industry. You should seek professional advice to determine how this checklist should be adapted to your workplace or jurisdiction.

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Field Level Hazard Assessment Form

Use this Field Level Hazard Assessment Form to identify and assess potential hazards of a specific job, ensuring compliance with safety protocols.

1. Is the body position awkward?

2. Is the hazard of overextension addressed?

3. Are there ergonomic hazards present, such as prolonged twisting/repetitive/bending motion?

4. Is working in a tight area a potential issue?

5. Is the lift too heavy/awkward to handle?

6. Are hands not in the line of sight?

7. Is there a risk associated with working above your head?

1. Has the aerial lift/man basket been inspected and tagged?

2. Is the scaffold inspected and tagged?

3. Are ladders tied off?

4. Are there potential slips/trips in the area?

5. Is the hosting of tools and equipment done?

6. Are evacuation alarms, and routes set in place?

7. Is a confined/restricted space entry permit required?

1. Are barricades and signs in place?

2. Have hole coverings been identified?

3. Have harnesses/lanyards been inspected?

4. Is there a 100% tie-off with the harness and identified anchor points?

5. Is there a risk of falling objects?

6. Are power lines a hazard?

7. Is hoisting or moving loads overhead a concern?

1. Is a lift study required?

2. Are proper tools used?

3. Are tools/slings inspected?

4. Is equipment inspected?

5. Are others working overhead/below?

6. Is the critical lift permit available?

1. Is a GFI Test done?

2. Are lighting levels too low?

3. Are working on/near energized equipment done?

4. Are electrical cords/tool conditions monitored?

5. Is a fire extinguisher available?

6. Is there a need for a hot work or electrical permit?

1. Are procedures not available for tasks?

2. Are instructions confusing?

3. Is training for tasks or tools to be used provided?

4. Is it your first time performing the task?

1. Is the work area clean?

2. Is material storage identified?

3. Are there dust/mist/fumes present?

4. Is there excessive noise in the area?

5. Are extreme temperatures a concern?

6. Is there a potential for spills?

7. Is waste properly managed?

8. Is an excavation permit required?

9. Are there other workers in the area?

10. Have weather conditions been considered?

11. Has the MSDS been reviewed?