Field Level Hazard Assessment

Complete at the worksite prior to starting the task
Complete individually or as a small group working nearby.
Share with those arriving late or moving in/out of the area.
Review and update throughout the day or as conditions change.
Start fresh with a new assessment each day.

Date

Time

If a site or location is not listed in the dropdown menus below, select "Other".

Location

Location (Other)

Task Description

Completed by

ATCO Reviewers - Search the name "Reviewed With (ATCO)"

Contractor/Other - Type the name "Reviewed With (Other)"

Reviewed With (ATCO Personnel)

Reviewed With (Other)

Pre-work Validation

Are all workers fit for duty?

YesNo

Comments

Has work been authorized?

YesNo

Comments

Any energy isolation requirements?

YesNo

Comments

Hazard Categories

Select all that apply.

Electrical

Pressure

Sound

Radiation

Biological

Chemical

Temperature

Gravity

Motion

Mechanical

Psychosocial

Electrical

The presence and flow of an electrical charge or current.

! = HIGH ENERGY

! Contact with energized equipment

Cause by/Source

Common Controls

Review Control of Hazardous Energy ProcedureConfirm and review Electrical Safety Training Systems (ESTS) / High Voltage TrainingConfirm and review Hazardous Energy Control Log (Test and Try)Don Arc-flash PPE (coveralls, boots etc.)Don Face shields and insulated gloves

Are additional controls required?

Yes

Additional Controls

! Underground cables

Caused by/Source

Common Controls

Locate and mark underground cablesConfirm and review safe digging practices and Ground Disturbance and Excavation ProcedureConfirm and review Ground Disturbance training

Are additional controls required?

Yes

Additional Controls

! Overhead powerlines

Caused by/Source

Common Controls

Confirm and review Electrical Safety Training Systems (ESTS) / High Voltage TrainingConfirm and review Overhead Powerline Limits of ApproachInstall signage, flags, or barriersDevelop a plan for working in close proximity to electrical equipment

Are additional controls required?

Yes

Additional Controls

! Lightning

Caused by/Source

Common Controls

Confirm and review lightning protocols in the Severe Weather ProcedureUse Flash-to-Bang Guidance Chart and the 30/30 Rule to determine if/when work should be paused.Seek shelter from the storm (Severe Weather Procedure)Review Emergency Response Plan

Are additional controls required?

Yes

Additional Controls

! Arc flash

Caused by/Source

Common Controls

Confirm and review Review Control of Hazardous Energy Procedure and the Hazardous Energy Control LogConduct electrical equipment inspection and maintenanceDon Arc-rated clothingDon Face shields and insulated glovesConfirm Personal Protective Equipment ProcedureReview Arc Flash emergency response proceduresConduct an arc flash risk assessment

Are additional controls required?

Yes

Additional Controls

Static charges

Caused by/Source

Common Controls

Verify the implementation of grounding and bonding techniquesUse anti-static materials and toolsConduct equipment inspections and maintenance

Are additional controls required?

Yes

Additional Controls

Have additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Pressure

Force exerted by a gas, liquid, or solid.

! = HIGH ENERGY

! Explosion

Caused by/Source

Common Controls

Confirm and review Chemical Handling and Hazardous Substances ProcedureConfirm and review Emergency Response Plan (Fires and Explosions)Maintain proper building entry proceduresDon proper PPE (fire retardant clothing)

Are additional controls required?

Yes

Additional Controls

! Pressure piping, vessels, or tanks

Caused by/Source

Common Controls

Conduct inspections and non-destructive testingVerify installation of pressure release systemsConfirm and review working with pressurized equipment procedureIsolate and blowdown meter runFollow Control of Hazardous Energy Procedure and verify zero energyAssess site and maintain awareness of surroundingsDon proper PPE (Hard hat, protective footwear, protective eyewear, and coveralls)Depressurize equipment

Are additional controls required?

Yes

Additional Controls

! Working in or around trenches and/or excavations (>4 feet/1.2 metres)

Caused by/Source

Common Controls

Establish proper Access / EgressConduct trench / excavation inspectionsConfirm and review Ground Disturbance and Excavation ProcedureVerify installation of signage and barriers

Are additional controls required?

Yes

Additional Controls

Pneumatic equipment

Caused by/Source

Common Controls

Conduct equipment inspections and maintenanceDon proper PPE (Protective eyewear, gloves, and hearing protection)

Are additional controls required?

Yes

Additional Controls

Hydraulic equipment

Caused by/Source

Common Controls

Verify installation of proper hydraulic systemConduct hydraulic equipment inspections and maintenance

Are additional controls required?

Yes

Additional Controls

Compressed cylinders

Caused by/Source

Common Controls

Ensure proper securement and storage of compressed cylinders, esperate by storage classKeep cylinders away from heat, flames, and direct sunlightConduct compressed cylinder inspection

Are additional controls required?

Yes

Additional Controls

Have additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Sound

Sound that interferes with or could damage hearing.

Noise (>85db) (85db is equal to heavy traffic)

Caused by/Source

Common Controls

Conduct noise surveyVerify installation of noise barriers / enclosuresDon hearing protectionAudiometric TestingConfirm and review noise exposure procedure

Are additional controls required?

Yes

Additional Controls

Impact noise

Caused by/Source

Common Controls

Conduct noise surveyVerify installation of noise barriers / enclosuresDon hearing protectionAudiometric TestingConfirm and review noise exposure procedure

Are additional controls required?

Yes

Additional Controls

Tools or Equipment

Caused by/Source

Common Controls

Conduct equipment / tool inspections and maintenanceDetermine if quieter alternatives are availableDon hearing protectionConduct noise surveyConfirm and review noise exposure procedure

Are additional controls required?

Yes

Additional Controls

Have additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Radiation

Releases of ionizing or non-ionizing radiation.

! = HIGH ENERGY

! Radiography/X-ray

Caused by/Source

Common Controls

Implement Time, Distance, Shielding ControlsEquipment inspected and properly maintainedReview Radiographic Testing Procedure

Are additional controls required?

Yes

Additional Controls

Welding arc

Caused by/Source

Common Controls

Confirm, review, and enforce welding safe work proceduresVerify effective ventilation is establishedDon welding helmet with filtersVerify welding certificationDon proper PPE (protective eyewear, fire retardant clothing, and welding apron)Don respiratory protective equipmentConfirm Fit Testing completionRespirator Fit Test Training (Don respiratory protection equipment)

Are additional controls required?

Yes

Additional Controls

Sun exposure (UV radiation)

Caused by/Source

Common Controls

Verify installation of shaded areas/sheltersReview Severe Weather ProcedureDon proper PPE (protective eyewear, long sleeves, and pants, brimmed hat)Apply Broad Spectrum sun screen

Are additional controls required?

Yes

Additional Controls

NORMs

Caused by/Source

Common Controls

Conduct NORMs survey / testingConduct NORMs hazard assessmentDon PPE and respirator

Are additional controls required?

Yes

Additional Controls

Have additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Biological

Living organisms that pose health, safety, or security hazards.

Wildlife / Poisonous Insects / Snakes

Caused by/Source

Common Controls

Review Animal Awareness Procedure and Wildlife Management ProcedureConduct Site InspectionContact BiologistComplete Snake Safety Awareness TrainingDon proper PPE (gloves, long sleeves, pants, snake gaiters)

Are additional controls required?

Yes

Additional Controls

Human Waste or Blood

Caused by/Source

Common Controls

Don proper PPE (disposable gloves, mask, goggles)Proper cleanup (use puncture and leak-proof containers, clean with a 1 part bleach to 10 parts water solution)Proper handwashing (Wash hands with soap and water for 40 to 60 seconds before and after)

Are additional controls required?

Yes

Additional Controls

Viruses

Caused by/Source

Common Controls

Review Animal Awareness Procedure and Wildlife Management ProcedureConfirm availability of hand washing stations / sanitizerUtilize Flu Clinics or 2TwoNurses Program and ServicesReview Communicable Disease Response Procedure

Are additional controls required?

Yes

Additional Controls

Contaminated food or water

Caused by/Source

Common Controls

Proper handwashing (Wash hands with soap and water for 40 to 60 seconds before and after)Prevent cross-contaminating foodPerform inspection of food/water storage and handling

Are additional controls required?

Yes

Additional Controls

Have additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Chemical

Hazardous chemicals in the environment or workplace.

! = HIGH ENERGY

Toxic Compounds

Caused by/Source

Common Controls

Reviewed the Safety Data Sheets, verify WHMIS TrainingDon proper PPE (Gloves, Respirator, eye protection)Verify barrier tape / exclusion zone is establishedReplace hazardous materials with less toxic alternativesWork rotation - Limit exposure

Are additional controls required?

Yes

Additional Controls

Flammable or combustible material

Caused by/Source

Common Controls

Conduct fire protection system inspection and maintenanceReviewed the Safety Data Sheets, verify WHMIS TrainingVerify flammable and combustible materials containmentConduct atmospheric testing of building prior to entryVerify presence of fire extinguishersReview Emergency Response Plan

Are additional controls required?

Yes

Additional Controls

Corrosive / Reactive Substances

Caused by/Source

Common Controls

Don proper PPE (chemical resitant clothing and gloves, eye/face protection)Reviewed the Safety Data Sheets, verify WHMIS TrainingVerify barrier tape / exclusion zone is established

Are additional controls required?

Yes

Additional Controls

Dust / Fumes / Gases / Vapors

Caused by/Source

Common Controls

Verify installation of ventilation systemsWet methods (Applying water or other liquids to suppress dust generation)Replace hazardous materials with less toxic alternativesDon proper PPE (coveralls, gloves, respirator, safety googles/glasses)Reviewed the Safety Data Sheets, verify WHMIS TrainingWork rotation - Limit exposure

Are additional controls required?

Yes

Additional Controls

Oxygen deficient atmospheres

Caused by/Source

Common Controls

Don air supplied respiratory protective equipmentVerify signage and access restrictionsVerify installation of ventilation systemsConduct initial and continous atmospheric monitoring

Are additional controls required?

Yes

Additional Controls

Carcinogens

Caused by/Source

Common Controls

Verify installation of ventilation systemsDon proper PPE (disposable coveralls, gloves, mask, safety glasses)Reviewed the Safety Data Sheets, verify WHMIS TrainingProper wipe down of the area and hand washing after work is completedVerify barrier tape / exclusion zone is established

Are additional controls required?

Yes

Additional Controls

Have additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Temperature

Heat or cold sources that could pose a hazard.

! = HIGH ENERGY

! Extreme (hot or cold) temperatures

Caused by/Source

Common Controls

Verify and check temperature and humidityConfirm and review working in temperature extremes procedure (Severe Weather Procedure)Don weather-appropriate clothingEstablish and enforce regular break intervalsVerify provision of drinking waterReview fluids consumption recommendations

Are additional controls required?

Yes

Additional Controls

! Releases of steam

Caused by/Source

Common Controls

Conduct steam system inspection and maintenanceVerify installation of pressure release valves

Are additional controls required?

Yes

Additional Controls

Body contact with hot or cold surfaces

Caused by/Source

Common Controls

Conduct Equipment inspections and maintenanceDon appropriate PPE (Heat resistant clothing and gloves)Verify installation of signage and barriersEnsure equipment has cooled down

Are additional controls required?

Yes

Additional Controls

High winds

Caused by/Source

Common Controls

Secure equipment and materialsConfirm and review working in temperature extremes procedure (Severe Weather Procedure)Verify installation of a wind sockMonitor weather alert systems

Are additional controls required?

Yes

Additional Controls

Performing hot work

Caused by/Source

Common Controls

Review Hot Work Procedure and complete Hot Work PermitEnsure area is free of flammables and combustiblesInitial and Continuous Gas MonitoringMin. 20lb ABC fire extinguisher in areaFire Watch selected and established

Are additional controls required?

Yes

Additional Controls

Equipment friction

Caused by/Source

Common Controls

Verify installation of machine guardsVerify installation of emergency shut down systemConfirm and review the applicable equipment operating procedureDon proper PPE (protective gloves)

Are additional controls required?

Yes

Additional Controls

Have additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Gravity

Force that attracts the mass of objects towards the earth.

! = HIGH ENERGY

! Dropped objects from overhead

Caused by/Source

Common Controls

Install toe boards / protective mesh / safety nettingUse tool/equipment securement bags/lanyardsVerify the installation of barricades / exclusion zonesDon proper PPE (hard hat)

Are additional controls required?

Yes

Additional Controls

Fall from same level

Caused by/Source

Common Controls

Verify installation of adequate lightingUse anti-slip flooring or matsFollow proper housekeeping requirementsDon proper PPE (footwear)

Are additional controls required?

Yes

Additional Controls

! Steep slopes

Caused by/Source

Common Controls

Verify installation of barriers and fencingConduct site-specific slope hazard assessmentInstall barricades and signageConfirm and review Ground Disturbance and Excavation Procedure

Are additional controls required?

Yes

Additional Controls

! Fall from elevation (> 4 ft [1.2 m])

Caused by/Source

Common Controls

Verify installation of fall protection systemsConduct fall protection equipment inspections and maintenanceConfirm and review fall protection plan and trainingDon personal fall arrest

Are additional controls required?

Yes

Additional Controls

! Safe mechanical lifting

Caused by/Source

Common Controls

Review Lifting Devices ProcedureConfirm and review Critical Lift Plan and Rigging/Crane TrainingUse of a Spotter/Crane SignalerEquipment Pre-Use Inspections/Crane Logbook

Are additional controls required?

Yes

Additional Control

Unstable/rolling material

Cause by/Source

Common Controls

Store rolling materials appropriatelyConfirm and review material handling requirementsUse mechanical Lift Device (forklift, crane)Forklift and Crane Training

Are additional controls required?

Yes

Additional Controls

Have any additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Motion

Change in position of objects or substances.

! = HIGH ENERGY

! Driving at high speeds (>30mph/50kph)

Caused by/Source

Common Controls

Confirm and review AMA Driver trainingConduct vehicle inspections and maintenanceAdhere to all local traffic laws (Legislation)Review travel route and potential obstructionsEnact Journey Management Plan (Field Safe)Ensure use of hands free and Bluetooth systemsComplete trip risk assessmentReview Safe Driving Policy

Are additional controls required?

Yes

Additional Controls

! Vehicles near workers

Caused by/Source

Common Controls

Verify installation of signage and barriersVerify two-way communication system, cameras, proximity sensorsUse a spotterDon high-visibility safety apparelConfirm and review the applicable Operator trainingConfirm and review Traffic Control planVerify the installation of traffic control barriersVerify back up alarms / lights are workingConduct vehicle awareness at pre-job safety meeting

Are additional controls required?

Yes

Additional Controls

Line of fire situation

Caused by/Source

Common Controls

Keep hands and body out of the line of fireUse barriers and/or exclusion zonesVerify toe boards and guardrailsVerify guards are in place

Are additional controls required?

Yes

Additional Controls

Repetitive or awkward body motions

Caused by/Source

Common Controls

Review Manual Materials Handling ProcedureConduct proper lifting techniques and body mechanicsConduct job rotation and breaks

Are additional controls required?

Yes

Additional Controls

Working in confined/restricted spaces

Caused by/Source

Common Controls

Reviewed Confined and Restricted Space InventoryVerify installation of ventilation systemsReviewed and completed Confined Space Entry Permit - Code of Practice and Hazardous Energy Control LogUse of Confined Space Entry - Exit and Supplemental Gas Detection Log and perform initial and continous air monitoringConfirm and reviewed confined space entry and rescue training certificatesEstablish confined space attendants and rescue personnel and methodsDetermined and completed ventialtion / flushing / purging / inerting requirementsEstablished communication requirementsDon proper PPE (respiratory protective equipment) (Respirator Fit Test Training)Respiratory Protective Equipment TrainingConfirm Fit Testing completion

Are additional controls required?

Yes

Additional Controls

Lifting/carrying heavy objects (>40lbs/18kg)

Caused by/Source

Common Controls

Perform a pre-lift hazard assessmentUse mechanical lift aid (crane, forklift, dolly)Review Manual Materials Handling Procedure

Are additional controls required?

Yes

Additional Controls

Simultaneous Operations (SIMOPS)

Caused by/Source

Common Controls

Developed documented SIMOPS Plan - Plan work, assess hazards and controlsConfirmed affected parties hold a joint pre-job site safety meetingUse barriers and/or exclusion zones seperating partiesPermits - Have one authority to control SIMOPSReinfored Stop Work Accountability

Are additional controls required?

Yes

Additional Controls

Have any additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Mechanical

Rotation, vibration, or motion of equipment, machinery, or materials.

! = HIGH ENERGY

! Rotating equipment

Caused by/Source

Common Controls

Verify presence of emergency shut down device/systemConduct equipment inspections and maintenanceVerify installation of machine guardsLock out / de-energize equipment prior to starting work

Are additional controls required?

Yes

Additional Controls

Vibrating tools or equipment

Caused by/Source

Common Controls

Conduct job rotation and breaksConduct tool inspections and maintenanceDon proper PPE (anti-vibration gloves)

Are additional controls required?

Yes

Additional Controls

Motors

Caused by/Source

Common Controls

Lock out / de-energize equipment prior to starting workConduct equipment/machine inspections

Are additional controls required?

Yes

Additional Controls

Pinch or crush points

Caused by/Source

Common Controls

Verify installation of machine guardsConduct equipment/machine inspectionsDon proper PPE (impact resistance gloves)Verify installation of signage and barriers

Are additional controls required?

Yes

Additional Controls

Compressed springs

Caused by/Source

Common Controls

Confirm and review proper storage and labelling of compressed springsConduct compressed spring inspection

Are additional controls required?

Yes

Additional Controls

Belts and or pulleys

Caused by/Source

Common Controls

Conduct belt and pulley inspection and maintenanceVerify installation of machine guards

Are additional controls required?

Yes

Additional Controls

Have additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Psychosocial

Could affect the physical and psychological health of workers or impact work performance.

New workers

Caused by/Source

Common Controls

New worker is working under the direct supervision of a competent workerOutline safety procedures and hazards and controls for the jobDemonstrate tasks, verify directions are understood, set expectations to ask for help when needed

Are additional controls required?

Yes

Additional Controls

Fatigue

Caused by/Source

Common Controls

Immediately report to leader if I or another worker are unfit for workAdhere to Alberta Employment Standards for hours of work and rest

Are additional controls required?

Yes

Additional Controls

Working alone

Caused by/Source

Common Controls

Utilize Field Safe Lone Worker AppReviewed Working Alone Procedure and following requirements

Are additional controls required?

Yes

Additional Controls

Stress

Caused by/Source

Common Controls

Self-care: Sleep, exercise, healthy eating, deep controlled breathsWorkload Management: Manage time, set priorities and realistic expectations, delegatePromote a supportive working environmentReview resources such as EFAP and other services provided with Health Benefits

Are additional controls required?

Yes

Additional Controls

Violence and Harassment

Caused by/Source

Common Controls

Harassment and Violence Prevention TrainingHarassment and Violence Prevention ProceduresRespectful Workplace ProcedureSpeaking Up Policy and Integrity Line

Are additional controls required?

Yes

Additional Controls

Have additional hazards been identified?

Yes

Hazard

Caused by/Source

Controls

Top High Energy Hazards (What STCKY Was Identified Today?)

MORE ENERGY = MORE POTENTIAL HARM

Based on the hazards identified in your assessment, select what you believe to be the top High Energy Hazards for added awareness. If no High Energy Hazards were selected than proceed with your submission.

Electrical High Energy Hazard

Pressure High Energy Hazard

Radiation High Energy Hazard

Temperature High Energy Hazard

Gravity High Energy Hazard

Motion High Energy Hazard

Mechanical High Energy Hazard

Environment Considerations

Could your work affect sensitive/protected habitat, vegetation or land/soil, air, water, wildlife/aquatics? If yes. or you're unsure, contact your Environment Resource.