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m= El
& iAuditor commerce SE,
by soferyculeure digital forms
Take or Attach Photo of Site
Job Title
Description of Work (overview list of planned activities)
‘Supervision of Task
Click +’ and add personnel in charge of task supervision (e.g site supervisor, safety officer, foreman, ete.) Employee
Name
Role
Contact No.
Employees Involved Employee
Name of personnel
Role
Methodology
In this section, provide step-by-step instruction as to how the work activity should be safely carried out and
completed
Sequence of Operations Plant & Equipment to be used
Specific Staff Training
Select the type of hazard associated with the planned activities below
Associated Hazard
Hazard
Working at heights/excavation
‘Material and manual handling
Airborne fibers and materials
Moving objects
Collapsing trenches
Other
Slips, trips, and falls
Abestos
Electricity
Control Measures PPE (select the required ppe)
Safety gloves Hesring Protection _Eye Protection
Other
Respiratory Protection
Coveralls
Emergency Procedures
Name of Person with Health & Safety Responsibility
Emergency Contact Details (include mobile no.)
