Site Hazard Assessment Form Template for New Zealand

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Key Requirements PROMPT example:

Site Hazard Assessment Form

"I need a Site Hazard Assessment Form for a large construction project starting in March 2025 in Auckland, with particular focus on working at heights and heavy machinery operation, ensuring compliance with New Zealand construction industry standards."

Document background

The Site Hazard Assessment Form is a fundamental workplace safety document required under New Zealand's Health and Safety at Work Act 2015. This document should be completed before commencing work at any new site, when significant changes occur in the workplace, or as part of regular safety reviews. The form captures critical information about potential hazards, risk levels, control measures, and emergency procedures. It serves multiple purposes: ensuring regulatory compliance, protecting worker safety, documenting due diligence, and establishing clear safety protocols. The assessment must be conducted by competent persons and reviewed regularly to maintain its effectiveness. This document is particularly crucial in high-risk industries but is relevant across all sectors where workplace safety is a concern.

Suggested Sections

1. Site Information: Basic details including site address, date of assessment, assessor name and contact details

2. Purpose of Assessment: Specify whether this is an initial assessment, periodic review, or response to an incident/change

3. Site Access and Security: Details of site entry points, security requirements, and emergency exit locations

4. General Hazard Identification: Checklist of common workplace hazards including physical, chemical, biological, and psychological hazards

5. Risk Assessment Matrix: Standard risk assessment matrix to evaluate likelihood and consequence of identified hazards

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

7. Emergency Procedures: Overview of emergency response procedures and contact information

8. Sign-off and Review: Signatures of assessor, site supervisor, and review date requirements

Optional Sections

1. Specific Work Activity Assessment: Detailed assessment of hazards associated with specific work activities, used when special tasks are being performed

2. Environmental Hazards: Assessment of environmental impacts and hazards, required when activities may affect the environment

3. Hazardous Substances Register: Detailed list of hazardous substances present on site, required when chemicals or dangerous goods are stored/used

4. Contractor Management: Special considerations for contractor work, used when contractors are present on site

5. Public Safety Assessment: Assessment of risks to public safety, required when work affects public areas

6. Noise Assessment: Specific assessment of noise hazards, required for sites with high noise levels

7. Working at Heights Assessment: Specific assessment for work at heights, required when elevated work is performed

Suggested Schedules

1. Hazard Identification Checklist: Comprehensive checklist of potential hazards by category

2. Site Map: Detailed map showing hazard locations, emergency equipment, and evacuation routes

3. Risk Matrix Guidelines: Detailed guidelines for using the risk assessment matrix

4. Control Measures Library: Reference guide of standard control measures for common hazards

5. Emergency Contact List: Complete list of emergency contacts and procedures

6. PPE Requirements: Detailed list of required Personal Protective Equipment for different areas/activities

7. Incident Report Form: Standard form for reporting incidents or near-misses

Authors

Alex Denne

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

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Site Information
Risk Assessment
Hazard Identification
Control Measures
Emergency Procedures
Personal Protective Equipment
Access and Security
Environmental Hazards
Training Requirements
Safety Equipment
Reporting and Documentation
Review and Monitoring
Consultation
Incident Response
Authority and Responsibility
Compliance Requirements

Relevant Industries

Construction

Manufacturing

Mining and Resources

Agriculture

Warehousing and Logistics

Healthcare

Education

Retail

Hospitality

Industrial Services

Utilities

Transportation

Facilities Management

Chemical Processing

Waste Management

Relevant Teams

Health and Safety

Operations

Facilities Management

Risk Management

Compliance

Production

Maintenance

Quality Assurance

Emergency Response

Environmental Health

Site Management

Project Management

Relevant Roles

Health and Safety Manager

Site Manager

Operations Manager

Project Manager

Safety Officer

Risk Assessment Specialist

Compliance Officer

Facilities Manager

Construction Supervisor

Industrial Hygienist

Environmental Health Officer

Production Manager

Maintenance Supervisor

Quality Control Manager

Emergency Response Coordinator

Occupational Health Nurse

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Authors

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