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WHS UNIT
SAFE WORK PROCEDUREInitial Details
Faculty/Division: Unit:
Work Activity:
Tye (select one only): Field Work General Maintenance Office
Other Research Teachin
Develoer/s: Arover/s: Si!nature: Date:
!" !"
#" #"
$" $"
%" %"
&" &"'" '"
Risk Assess"ent
Conse#uence (select one only):
Seere (eath or e*tensie in+,ries)
Ma+or (Medical treat-ent)
Moderate (First aid treat-ent)
Minor (In+,ry re.ort/ no treat-ent)
$ikeli%oo& (select one only):
0l-ost 1ertain (2*.ected to occ,r in -ost
circ,-stances)
3ikely (Will .ro4a4ly occ,r in -ost circ,-stances)
5ossi4le (May occ,r at so-e ti-e)
Unlikely (May occ,r/ 4,t .ro4a4ly neer 6ill)
Risk Score:
Re'erence& Docu"entation
Tye (select one only): Descrition
0,st Std 1o5 3eis" Other UOW oc"
0,st Std 1o5 3eis" Other UOW oc"
0,st Std 1o5 3eis" Other UOW oc"
0,st Std 1o5 3eis" Other UOW oc"
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Personal Protective E#ui"ent
Tye (Check the box for required PPE ) Descrition
Gloes
Safety lasses
Goles
Face shield
Safety foot6are
2nclosed foot6are
G,-4oots
Hard hat
Hat
Hairnet
2ar .l,s -,ffs
3a4 coat o6n
0.ron
Oeralls
Hih isi4ility est clothin
Wet 6eather clothin
;o4 s.ecific clothin
Fire resistant clothin
5artic,late res.irator
Gas res.irator
S,..lied air res.irator
S,nscreen
3ifeline 4ody harness
5ersonal -onitor
5ersonal floatation deice
Radio co--,nication deice
Sinae
Safety cones 4arricades
Intrinsically safe e
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Action Plan
Ste(u")er
*o) Ste(Ste.s in the .rocesstask)
Potential +a,ar&s(What co,ld ca,se an in+,ry)
Controls(What can 4e done to -ini-ise the risk of in+,ry)
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Action Plan
Ste(u")er
*o) Ste(Ste.s in the .rocesstask)
Potential +a,ar&s(What co,ld ca,se an in+,ry)
Controls(What can 4e done to -ini-ise the risk of in+,ry)
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