Take 5

Take 5 Risk Assessment

This procedure applies to all ADG staff and contractors that may conduct work activities with the potential to cause harm or damage on ADG sites.

Please click here to see the ADG Take 5 Risk Assessment Procedure Guideline.

Before starting work, a Safe Work Method Statement (SWMS) must be completed if your work involves any High-Risk Construction Work or Common Hazards where someone's health and safety are at risk.

Click Here to view High Risk Construction Works

High-risk construction hazards:

Working at heights of more than 2 metres
Demolition
Removal or disturbance of asbestos
Diving
Trenches or shafts deeper than 1.5 metres
Temporary supports for structural alterations
Powered mobile plant
Explosives
Confined spaces
Tunnels
Tilt-up or precast concrete

or work that is in or near the following:

Electrical installations or services
Roads or railways in use by traffic
Water/liquids that pose a drowning risk
Telecommunications towers
Pressurised gas distribution mains or piping
Artificial temperature extremes
Contaminated or flammable atmospheres
Chemical, fuel or refrigerants lines

Reported By

Full Name *

Phone Number *

Email *

Department *

Team *

Your Manager's Name *

Your Manager's Email *

Operations Team *

Other team (Please specify) *

Task *

Other task (Please specify) *

Task *

Location

Select Your Location *

Area *

Description of location

Date *

1 - Stop, step back and think

Do I understand what I need to do? *

YesNo

Please Specify *

Do I need a SWMS for any "High Risk Construction Work"? *

YesNo

Please Specify Identified Hazards *

Do I need any ADG permits? *

YesNo

Please Specify required permits *

Do I have the correct PPE? *

YesNo

Please Specify *

Please Comment *

Do I have the correct tools and equipment for the task? *

YesNo

Please Comment *

Do I have my vehicle and machinery parked correctly? *

YesNo

Please Comment *

Am I competent to perform this work? *

YesNo

Please Comment *