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Jobsite Hazard Assessment Form for New Zealand

Jobsite Hazard Assessment Form Template for New Zealand

A comprehensive workplace safety document designed to comply with New Zealand's Health and Safety at Work Act 2015 and associated regulations. This form facilitates systematic identification, assessment, and control of workplace hazards at specific job sites. It includes detailed sections for documenting site-specific risks, control measures, emergency procedures, and required personal protective equipment. The document serves as both a risk assessment tool and a legal record of safety compliance, incorporating requirements from WorkSafe NZ guidelines and relevant industry codes of practice.

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What is a Jobsite Hazard Assessment Form?

The Jobsite Hazard Assessment Form is a critical workplace safety document required under New Zealand's health and safety regulatory framework. It should be completed before commencing work at any new site or when significant changes occur in existing work environments. The form addresses the requirements of the Health and Safety at Work Act 2015 and associated regulations, providing a structured approach to identifying, assessing, and controlling workplace hazards. It includes comprehensive sections covering general and task-specific hazards, control measures, emergency procedures, and PPE requirements. This document is essential for demonstrating due diligence in hazard management and maintaining compliance with WorkSafe NZ requirements. Regular reviews and updates of the assessment are necessary to ensure ongoing effectiveness of safety measures.

What sections should be included in a Jobsite Hazard Assessment Form?

1. Site Information: Basic details including site location, date of assessment, project details, and responsible persons

2. Assessment Team: Names and roles of personnel conducting the hazard assessment

3. Work Activities Description: Detailed description of work tasks to be performed on site

4. General Site Hazards: Assessment of common workplace hazards including access/egress, lighting, weather conditions, etc.

5. Task-Specific Hazards: Identification and assessment of hazards specific to planned work activities

6. Control Measures: Existing and proposed control measures for identified hazards following the hierarchy of controls

7. Emergency Procedures: Site-specific emergency response procedures and contact information

8. PPE Requirements: Required personal protective equipment for identified hazards

9. Review and Authorization: Sign-off section for relevant parties and review timeline

What sections are optional to include in a Jobsite Hazard Assessment Form?

1. Hazardous Substances Assessment: Detailed assessment of hazardous materials present or being used on site - include when hazardous substances are present

2. Working at Heights Assessment: Specific assessment for work at heights - include when working above 2 meters

3. Confined Space Assessment: Detailed assessment for confined space work - include when confined space entry is required

4. Environmental Impact Assessment: Assessment of environmental hazards and controls - include when work may impact environmental elements

5. Noise Assessment: Specific assessment of noise hazards and controls - include when high noise levels are anticipated

6. Mobile Plant and Equipment: Assessment specific to mobile plant operations - include when heavy machinery is being used

What schedules should be included in a Jobsite Hazard Assessment Form?

1. Hazard Identification Checklist: Comprehensive checklist of common workplace hazards to assist in identification

2. Risk Matrix: Standard risk assessment matrix for evaluating likelihood and consequences

3. Site Map: Diagram showing site layout, access points, and locations of major hazards

4. Emergency Contact List: List of emergency contacts and first responders

5. PPE Selection Guide: Reference guide for selecting appropriate PPE based on hazard type

6. Control Measures Reference: Reference guide for typical control measures for common hazards

Authors

Alex Denne

Head of Growth (Open Source Law) @ Ƶ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

New Zealand

Publisher

Ƶ

Cost

Free to use
Relevant legal definitions






























Clauses




















Relevant Industries

Construction

Manufacturing

Mining

Agriculture

Forestry

Transportation

Warehousing

Energy

Infrastructure

Telecommunications

Industrial Services

Utilities

Oil and Gas

Chemical Processing

Waste Management

Relevant Teams

Health and Safety

Operations

Project Management

Field Operations

Risk Management

Compliance

Quality Assurance

Site Operations

Facilities Management

Environmental Health and Safety

Relevant Roles

Health and Safety Manager

Site Supervisor

Project Manager

Construction Manager

Operations Manager

Risk Assessment Officer

Safety Coordinator

Site Safety Officer

Compliance Manager

Field Supervisor

Work Crew Leader

Quality Assurance Manager

Environmental Health and Safety Specialist

Operations Supervisor

Facilities Manager

Industries






Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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