Job Safety Assessment Form

Job Safety Assessment Form Template for New Zealand

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Key Requirements PROMPT example:

"I need a Job Safety Assessment Form for a construction project in Auckland involving working at heights and crane operations, compliant with New Zealand regulations and scheduled to commence in March 2025."

Document background

The Job Safety Assessment Form is a fundamental tool in New Zealand's workplace health and safety framework, designed to meet obligations under the Health and Safety at Work Act 2015 and associated regulations. This document should be completed before commencing any new task, when procedures change, or when reviewing existing work processes. It provides a systematic method for identifying potential hazards, assessing their risks, and implementing appropriate control measures. The form serves as both a risk management tool and a legal record, demonstrating due diligence in maintaining workplace safety. It is particularly crucial for high-risk activities and industries where worker safety is paramount, and it helps organizations maintain compliance with New Zealand's strict workplace safety requirements.

Suggested Sections

1. Job/Task Details: Basic information about the job/task being assessed, including location, date, and description of work

2. Assessment Team: Details of personnel conducting the assessment, including names, roles, and contact information

3. Hazard Identification: Systematic listing of all potential hazards associated with the task

4. Risk Assessment: Evaluation of identified risks using likelihood and consequence matrix

5. Control Measures: Detailed description of required controls following the hierarchy of controls

6. Personal Protective Equipment: Specific PPE requirements for the task

7. Emergency Procedures: Emergency response procedures specific to the identified hazards

8. Authorisation and Sign-off: Approval section for relevant supervisors and workers

Optional Sections

1. Environmental Impact Assessment: Required when work may affect the environment or when working with hazardous substances

2. Permit Requirements: Include when specific work permits are needed (e.g., confined space, hot work, working at heights)

3. Special Equipment Requirements: Required when task involves specialized equipment or machinery

4. Contractor Management: Include when contractors are involved in the task

5. Site-Specific Requirements: Add when there are particular site conditions or rules that need to be considered

6. Change Management: Include when assessment needs to account for potential changes in conditions or scope

Suggested Schedules

1. Risk Assessment Matrix: Standard risk assessment matrix used for evaluating hazard risks

2. Hazard Checklist: Comprehensive checklist of common workplace hazards

3. PPE Selection Guide: Guide for selecting appropriate personal protective equipment

4. Emergency Contact List: List of emergency contacts and procedures

5. Safe Work Method Statement Template: Detailed step-by-step procedure template for high-risk activities

6. Incident Report Form: Template for reporting any incidents or near-misses during task execution

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok��˰� | 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

Relevant Industries

Construction

Manufacturing

Mining

Agriculture

Transportation

Warehousing

Energy and Utilities

Healthcare

Forestry

Marine Operations

Chemical Processing

Waste Management

Infrastructure

Telecommunications

Relevant Teams

Health and Safety

Operations

Production

Maintenance

Quality Assurance

Engineering

Field Operations

Risk Management

Compliance

Project Management

Facilities Management

Technical Services

Environmental Management

Relevant Roles

Health and Safety Manager

Safety Coordinator

Site Supervisor

Project Manager

Operations Manager

Risk Assessment Specialist

Compliance Officer

Construction Manager

Factory Supervisor

Maintenance Manager

Production Manager

Quality Control Manager

Field Operations Supervisor

Engineering Manager

Environmental Health and Safety Specialist

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