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Exhibit I CITY OF MUSKOGEE PPE HAZARD ASSESSMENT CERTIFICATION FORM Name of Workplace Workplace Address Work area s use a separate sheet for each job/task or work area EYES Work activities abrasive blasting chopping cutting drilling welding soldering torch brazing working outdoors computer work punch press operator other FACE cleaning cooking siphoning painting dip tank operations pouring sanding sawing grinding hammering foundry work mixing pouring molten metal Assessment Conducted by...

How to fill out hazard assessment form

1. Start by obtaining a hazard assessment form. These forms are usually available from your employer or the relevant regulatory agency. It is important to ensure that you are using the correct form for your specific industry or occupation.
2. Read and understand the instructions provided with the form. This will help you gather all the required information and complete the form accurately. If you have any questions or are unsure about certain aspects, consult with your supervisor or safety officer for clarification.
3. Begin filling out the form by providing the necessary identification information. This typically includes your name, job title, department, and any other relevant personal details.
4. Assess the hazards present in your workplace or job site. Carefully evaluate the various tasks, equipment, and substances that could potentially cause harm or injury. This may involve conducting detailed inspections or reviewing safety data sheets and operating procedures.
5. Document the identified hazards on the form. Be as specific as possible and include any relevant details such as the location of the hazard, the potential consequences, and any existing control measures in place.
6. Evaluate the likelihood and severity of each hazard. Consider the frequency or probability of an incident occurring and the potential impact it could have on workers or the surrounding environment. This step will help prioritize the hazards and determine appropriate control measures.
7. Determine control measures to mitigate or eliminate the identified hazards. This could include engineering controls, administrative controls, or personal protective equipment. Clearly document these control measures on the form, including any additional procedures or training that may be required.
8. Review the completed form for accuracy and completeness. Ensure that all sections have been filled out and that the information provided is clear and concise. Obtain any necessary approvals or signatures as required by your organization or regulatory requirements.
9. Keep a copy of the hazard assessment form for your records and submit the original to the designated individual or department responsible for safety at your workplace.

Who needs the hazard assessment form?

1. Employers are required by law to assess and evaluate hazards in the workplace. Therefore, employers need the hazard assessment form to comply with health and safety regulations and ensure the protection of their employees.
2. Workers or employees who are directly involved in their job's day-to-day tasks need the hazard assessment form to be aware of the potential dangers and take necessary precautions. This form allows them to understand the hazards present in their workplace and stay informed about the appropriate control measures.
3. Safety officers, supervisors, or managers also need the hazard assessment form to oversee and monitor the implementation of necessary safety measures. This form helps them identify any gaps in safety procedures and provides a tool for ongoing risk management and improvement.

For pdfFiller’s FAQs

What is hazard assessment form?

Hazard assessment form is a document used to evaluate and assess potential hazards and risks in a workplace.

Who is required to file hazard assessment form?

Employers or business owners are required to file hazard assessment form.

How to fill out hazard assessment form?

The hazard assessment form can be filled out by identifying potential hazards, evaluating their risks, and implementing control measures.

What is the purpose of hazard assessment form?

The purpose of hazard assessment form is to ensure workplace safety by identifying and mitigating potential hazards and risks.

What information must be reported on hazard assessment form?

The hazard assessment form should include information about identified hazards, evaluation of risks, control measures, and responsible parties.

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