Skip to main content

FIELD LEVEL HAZARD ASSESSMENT

Header Information

Chemical Hazards: Exposure to compounds or substances that produce a reaction involving atoms or molecules in the workplace, creating an at risk environment.

Task Specific / Site Specific

Ergonomic Hazards: Is the exposure to a physical condition that puts the human body at risk of injury to the musculoskeletal systems, human engineering.

Task Specific / Site Specific

Biological Hazards: Exposure to living organisms where there is risk of a dangerous medical reaction or infection, threat to the health of living organisms, primarily humans.

Task Specific / Site Specific

Psychosocial Hazards: Existence of a condition or demand within the work environment, where exposure may result in risk of severe emotional, behavioural and physical health problems.

Task Specific / Site Specific

Mechanical Hazards: Exposure to an agent, factor, circumstance or condition that poses a threat to physical safety with or without contact.

Task Specific / Site Specific Hazard

Environmental Hazards: The presence of a substance, state or the potential for an event that threatens the surrounding natural environment and could result in adverse effects.

Task Specific / Site Specific

Barrier Used Pre-Use Checklist

Environmental Controls

FLHA Participant Signatures

Sign here

Include, Site Specific Hazards and Controls, Identification of Extreme Weather Conditions, Conflicting Work Activities, and/or Uncontrolled Site Hazards. (EAA/ICSP locations must be documented if available. Comment must demonstrate the above list has been considered. Date/Time & initial required when returning to location, changes that impact activities are to be added to comments. If required additional lines to be used for the same location. Hazard codes may be referenced.)

* indicates required field