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General Information
Location of work at height
Date of assessment
Assessors name
Hazard Identification
Fall from height
Falling objects
Collapse of working platform
Unstable/inadequate access
Other hazards identified
Risk Assessment
Likelihood of incident
Severity of potential injury
Overall risk rating
Control Measures
Edge protection in place
Secure fixed access
Fall arrest equipment
Exclusion zones
Competent persons
Permit to work
Other control measures