Task Risk Assessment

Site: Company: Work Scope/Activity:

Pre-Job Briefing (Details):

TRA Issue and Acceptance (Details):

I accept this TRA and confirm that I will complete and update the form to continuously identify and control hazards that will arise during the full course of the above stated wo
scope changes then I will ensure that these changes are assessed and documented on the TRA form.

I will ensure all required PPE is used by members of the working party and any hazards and mitigation actions are effectively communicated to all persons who may be affecte
Supervisor Name (Print): Signature: Date:

Are you at the correct unit / plant and working on the appropriate Equipment? ☐ Yes ☐ No

SECTION 1: LIFE SAVING PRINCIPLES

Hazards Exist?
High Risk Hazards: Mitigation Actions:
YES NO

CONFINED SPACE ☐ Permit

Enter confined space only if authorized to do so and check atmosphere before
☐ Gas checks
entering
☐ ☐ ☐ Attendant

☐ Rescue Plan

EXCAVATION WORKS ☐ Excavation wall supports

Protect any excavations or trench openings ☐ Barriers

☐ ☐ ☐ Rescue plan

☐ Services awareness

HAZARDOUS SUBSTANCES ☐ Safety Data Sheet (SDS)

Identify, understand and control all exposures to hazardous substances ☐ Respirator

☐ ☐ ☐ Goggles/Visor

☐ Chemical Gloves

LOCKOUT-TAGOUT (LOTO) ☐ Walkdown complete

Prepare, Shutdown, Isolate, Apply, Control, Verify ☐ Locks applied

☐ ☐ ☐ Zero-energy confirmed

MOTOR VEHICLES ☐ Vehicle spotter

Don’t be a distracted driver ☐ 360 walk-round

☐ ☐ ☐ Cell phone off

☐ Route planning

WORK AT HEIGHT ☐ Secure anchor point

Hook on where there is a risk of falling. Ensure all scaffolds are tagged, that
ladders are secured and inspected ☐ ☐ ☐ Harness checked

☐ Rescue plan

ELECTRICAL SAFETY ☐ LOTO/Zero-energy Verified

Work on de-energized equipment ☐ Permit if energized

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 ☐ ☐ ☐ Approach boundaries

☐ Shock/Arc assessment

FORKLIFT AND MATERIAL ☐ Pre-inspection

HANDLING ☐ Authorised driver

Maintain a safe distance from pedestrians and operating vehicles ☐ ☐ ☐ Seatbelt

☐ Spotter

LIFTING OPERATIONS ☐ Certified equipment

Follow the Lift Plan & stay clear of ☐ Lift plan

suspended loads ☐ ☐ ☐ Clear Lifting Path

☐ Tagline/Push-Pull poles

MACHINE SAFETY AND ☐ Pre-use inspection

POWERED HAND TOOLS ☐ Guards

Prevent exposure to dangerous parts

☐ ☐ ☐ Trained Technician

☐ No trailing cables/hoses

RADIATION SAFETY ☐ Permit

Control exposure to ionizing radiation ☐ Gas checks

☐ ☐ ☐ Attendant

☐ Rescue Plan

WORKING WITH CONTRACTORS

Employees & Contractors must apply approved requirements ☐ ☐ ☐ TRA/ briefing

STOP WORK! YOU ARE THE LAST LINE OF DEFENCE

SECTION 2: WORKPLACE AREA HAZARDS
Hazards Exist?
Hazards: Mitigation Actions:
YES NO

WEATHER ☐ Weather shelter

Can the workplace safety be impacted by adverse weather conditions or extreme temperatures? ☐ Thermal PPE
☐ ☐ ☐ Anemometer

☐ Water/Rest station

LIGHTING ☐ Temporary lighting

Are lighting levels adequate for the activities being undertaken? (Too bright/glare or too
☐ Handheld lamps
dark?)
☐ ☐ ☐ Headlamps

DROPPED OBJECTS ☐ Exclusion Zone

Are there any activities above or below the point of work where there may be risk from
☐ Guard Rails/Toe-boards
dropped objects?
☐ ☐ ☐ Housekeeping
☐ Tools/Equip. tied
off/Lanyards
HOT WORK ☐ Permit

Are there any welding, cutting, brazing or grinding activities in the work area? ☐ Fire arrangements
☐ ☐ ☐ Spark control

☐ Arc flash protection

RESTRICTED WORKSPACE ☐ Work duration limit

Is there restricted space that can impact the ability to work safely at point of work? ☐ Rescue plan
☐ ☐
 ☐ ☐ ☐ Communication

☐ Bump cap/hard edge padding

PINCH POINTS / SHARP OBJECTS ☐ Tool Holders/Finger Savers

Will any work activities give exposure to pinch point, laceration, impact or line of fire
☐ Armour/Cut resistant PPE
injuries?
☐ ☐ ☐ Guards/Barriers

DUST, FUME, GRIT & NOISE ☐ Respirator

Are there any adjacent operations or activities that introduce health hazards into the work area? ☐ Ear defenders
☐ ☐ ☐ Sealed safety eyewear

☐ Ventilation

SLIPS, TRIPS & FALLS ☐ Good Housekeeping

Are there any materials, obstructions, uneven levels or slippery surfaces that can cause ST&F
☐ Materials/Tools stored
in the work area?
☐ ☐ ☐ No open floorspaces

☐ No slippery/uneven surfaces

MANUAL HANDLING/ ERGONOMICS ☐ Lifting aids / equipment

Can the work scope result in poor posture or unplanned manual handling issues? ☐ ☐ ☐ Laydown planning

☐ 50lbs(23Kg) Body lift limit

WILDLIFE ☐ Medical arrangements

Is there any wildlife in the work area that could cause harm e.g. snakes, wasps, fire-ants? ☐ ☐ ☐ PPE

EMERGENCY ARRANGEMENTS ☐ Routes clear

Are emergency exits and routes clear and marked? Is emergency equipment in place as
☐ Fire extinguisher
required?
☐ ☐ ☐ Emergency plan

☐ First Aid provision

SPILL MANAGEMENT ☐ Spill Kit/Materials

Are bunds, spill kits and chemical storage facilities sufficient to support work activities? ☐ ☐ ☐ Drains guarded

WORKSCOPE CHANGE ☐ TRA updated

Is work-scope understood by all affected persons and do procedures and risk assessments
☐ Permit(s) updated
cover the agreed work?
☐ ☐ ☐ TRA complete

☐ Work-scope approved

SECTION 3: AKNOWLEDGEMENT OF TEAM PARTICIPATION IN TRA

TRA Clearance:

I certify that all persons working under this TRA have been withdrawn from the work area. All gear, tools, equipment, and loose material have been removed and guards and
exceptions, or HSE events, have been detailed below.

Exceptions/Events (note any Exceptions, Near Misses, Stop Works or other HSE Events associated with the TRA below):

Supervisor Name (Print): Signature: Date:

t REGION: ISSUE: DATE PAGE:

Middle East

ctivity: Task Risk Assessment Ref:

ing the full course of the above stated work activity. If work area conditions or the work-

nicated to all persons who may be affected.

Time:

Risk Acceptable?
ctions:
YES STOP

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Risk Acceptable?
ctions:
YES STOP

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erial have been removed and guards and access doors have been replaced or any

Time: