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Lumiform

Mobile audits & inspections
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Visionstream HSC

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Digitalize this paper form now

Register for free on lumiformapp.com and conduct inspections via our mobile app

  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 4000 expert-proofed templates
Rated 4.8/5 stars on Capterra
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Visionstream HSC

Focus on critical risks

1. Am I working with electricity?

Note the applicable SHEWMS you are working to and ensure you have been inducted into that SHEWMS, understand it's contents and signed on.

SHEWMS Ref.:

2. Is there a risk I could fall more than 2m?

Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's contents and signed in.

SHEWMS Ref.:

3. Is there a risk I could become fatigued whilst driving?

Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's contents and signed in.

SHEWMS Ref.:

4. Am I working in the vicinity of utility services?

Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's contents and signed in.

SHEWMS Ref.:

5. Am I completing excavation works or working in excavations or trenches deeper than 1.5m?

Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's contents and signed in.

SHEWMS Ref.:

6. Am I working in the vicinity of live traffic?

Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's contents and signed in.

SHEWMS Ref.:

7. Am I working in or around mobile plant?

Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's contents and signed in.

SHEWMS Ref.:

8. Am I working in a remote or isolated location?

Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's contents and signed in.

SHEWMS Ref.:

9. Am I performing heavy lifting using a crane or plant?

Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's contents and signed in.

SHEWMS Ref.:

10. Might I be exposed to asbestos?

Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's contents and signed in.

SHEWMS Ref.:

11. Am I working in a confined space?

Note the applicable SHEWMS you are working off and ensure you have been inducted into that SHEWMS, understand it's contents and signed in.

SHEWMS Ref.:

Selecting and applying controls to New Hazards

Identify any uncontrolled hazards (including critical risks above), assess your risk and note your controls

Have you identified any hazards?

Examples

Try to apply 'above the line' controls where possible

Consequence and Likelihood

Risk Matrix

Hazard

Control

Residual Risk Rating after my Control has been applied

Attach a picture if appropriate.

Have I achieved an acceptable risk rating and do I feel safe to carry out the task?

Stop work and contact your supervisor

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