LINE OF FIREFIELD LEVEL HAZARD ASSESSMENT (FLHA)
For each question below, ask yourself “Are the existing safeguards satisfactory to reduce the risk to manageable level?”
Fall Protection Does your task require fall protection? ☐Yes ☐No
If Yes - Review and follow fall protection plan
Confined Space
Does your task require confined space? ☐Yes ☐No
If Yes - Are the correct control measures in place?
Specialized PPE
Do you require any special PPE gloves or respirators etc? ☐Yes ☐No
If Yes - Do you have the right PPE for the task?
Right Tools Do you have the proper tools for the task? ☐Yes ☐No
If Yes - Have you reviewed applicable Safe Work Practice (SWP)?
Lifting Are you doing any lifting of hoisting? ☐Yes ☐No
If Yes - Plan and follow proper rigging practices (SWP)
Overhead Work
Are you doing any overhead work? ☐Yes ☐No
If Yes - Are controls in place with workers below or above?
EnvironmentalDoes your work have potential to impact environment? ☐Yes ☐No
If Yes - Are you prepared for spill potential
Isolation Verification (Initial Required)
Mechanical Supervisor Tradesperson N/A
All mechanical energy sources have been isolated
Drain points assessed as adequate zero energy confirmedSingle isolation procedure/Risk Assessment performed, reviewed and documented
Verified by the Company and operations
First break required / single isolation
Isolation points completed and verified by the Company
Electrical Supervisor Tradesperson N/A
All electrical energy sources have been isolated
Bump test witnessed to confirm zero energy
Maintenance locks & tags installed
Bump test written on permit
All three questions need to be checked prior to work commencing Supervisor Tradesperson N/A
Confirmed correct equipment & location as per permit?
Identified correct equipment & location with crew?
Zero Energy Checks Completed?
LINE OF FIREFIELD LEVEL HAZARD ASSESSMENT (FLHA)
STOP Step back and observe
Do all crew members understand the scope of work? ☐Yes
THINK It Through
Are all crew members physically and mentally ready? ☐ Yes
ASSESS Hazards, Pathways, Impact
Make it safe, use the right tools and use the right procedure. ☐ Yes
REVIEW And document findings
We listed & implemented all the hazards/controls? ☐ Yes
TALK It through and complete the Task
We discussed the impacts with all persons involved in this task? ☐ Yes
Motion
☐ Yes
Line of Fire
☐ Yes
Temperature
☐ Yes
Housekeeping
☐ Yes
Chemical
☐ Yes
Gravity
☐ Yes
Electrical
☐ Yes
Radiation
☐ Yes
Pressure
☐ Yes
Kinetic Energy
☐ Yes
We are satisfied that ALL HAZARDS are controlled.If NOT, STOP & contact your foreman or supervisor. ☐ Yes ☐ No
We have reviewed the task and are ready to start
Name: Signature:
Name: Signature:
Name: Signature:
Name: Signature:
Simple isolations should be field verified each day/shift by next level of authority. Complex systems involving multiple isolations carrying over to multiple days/shifts
may be verified via handovers with previous Supervisor & Operations.