Site Risk Assessment Checklist Site Risk Assessment Checklist

8- Are all Hot Works controls applied (e.g. planned, trained on use and techniques ones, using proper PPEs, rescue
and emergency plan developed and n place …etc.?
Important Note: This form must be assessed carefully according to job type, any marked questions with "Unsafe", you should go to form ‫ﻣدرب ﻋﻠﻰ اﻻﻧﻘﺎذ واﻟطوارئ( ؟‬, ‫ اﺳﺗﺧدام وﺳﺎﺋل اﻷﻣﺎن‬,‫ ﻣدرب ﻋﻠﯾﮭﺎ‬,‫ھل ﺗم اﻟﺗﺣﻛم ﻓﻲ اﻋﻣﺎل اﻟﻘطﻊ واﻟﻠﺣﺎم ) ﻣﺧطط ﻟﮭﺎ‬
9- Are electrical work controls applied (e.g. no live electrical activity, proper PPEs, Lockout/ Tagout, portable hand
3/3 named "Residual risk register" to re-assess the uncontrolled identified hazards, where additional control measures must be in place tools grounded and double insulated, earth means, permanent wiring used instead of extension cords …etc.?
prior to start the job ‫ﻧظﺎم اﻷرﺿﻲ ( ؟‬, ‫ ﻧظﺎم اﻟﻐﻠﻖ‬,‫ھل ﺗم ﺗطﺑﯾﻖ اﻟﺗﺣﻛم ﻓﻲ اﻋﻣﺎل اﻟﻛﮭرﺑﺎء ) ﻋدم اﻟﻌﻣل ﻓﻲ اﻟﻛﮭرﺑﺎء اﻟﺣﯾﮫ‬
Assessment Date: 10- Is street work controls applied (e.g. Planned, supervised, use appropriate signage, wear high visibility, clothing
Adapt to changing weather and traffic conditions …etc.)?

Activity
Site ID: ‫ ﻋﻼﻣﺎت ارﺷﺎدﯾﮫ‬, ‫ اﺳﺗﺧدام اﻟﺳدﯾري اﻟﻌﺎﻛس‬,‫ اﺳﺗﺧدام اﻟﻠوﺣﺎت اﻹرﺷﺎدﯾﺔ‬, ‫ ﺗﺣت اﻻﺷراف‬,‫ﺗطﺑﯾﻖ اﻟﺗﺣﻛم ﻓﻲ اﻻﻋﻣﺎل ﻓﻲ اﻟﺷوارع )ﻣﺛل اﻟﺗﺧطﯾط‬
‫( ؟‬... ‫ﻟﻠﻣرور‬
Site Name: Site Area: 11- Is drilling work controls applied (e.g. Planned, supervised, avoid the location of underground hazards such as
electric cables, area isolation, proper PPEs …etc.)?
Site type: Roof top / Monopole / Palm Tree / Shelter / G.F Tower / Other: ‫ اﺳﺗﺧدام‬,‫ اﻟﻌﻣل ﻓﻲ ﻣﻧطﻘﮫ اﻣﻧﮫ‬,‫ اﻻﺑﺗﻌﺎد ﻋن اﻣﺎﻛن اﻟﻛﺎﺑﻼت اﻟﻛﮭرﺑﺎﺋﯾﺔ اﻟﻣدﻓوﻧﺔ‬,‫ ﺗﺣت اﻻﺷراف‬,‫ھل ﺗم ﺗطﺑﯾﻖ اﻟﺗﺣﻛم ﻓﻲ اﻋﻣﺎل اﻟﺣﻔر )ﻣﺛل اﻟﺗﺧطﯾط‬
‫ﻣﮭﻣﺎت اﻟوﻗﺎﯾﺔ اﻟﻣﻧﺎﺳﺑﺔ(؟‬
Contractor: Assessor Name: Title: Signature: 1- Are appropriate PPEs used and pre-inspected as hazards are indicated?
‫ھل ﺗم اﺳﺗﺧدام وﺳﺎﺋل اﻟﺣﻣﺎﯾﺔ اﻟﺷﺧﺻﯾﺔ وﻓﺣﺻﮭﺎ ﻋﻧد ﺗﺣدﯾد اﻟﺧطر؟‬
Status 2- Are fall protection PPEs and tools used in a good safe working condition (e.g. harness, lifelines and lanyards)?
‫ھل وﺳﺎﺋل اﻟﺣﻣﺎﯾﺔ ﻣن اﻟﺳﻘوط ﻓﻲ ﺣﺎﻟﺔ ﺟﯾده ﻗﺑل اﻻﺳﺗﺧدام؟‬
Category Potential Hazards Yes No NA 3- Foot & head protection in a good safe working condition?
Safe Unsafe ‫ھل ﺣﺎﻣﻰ اﻟوﺟﮫ واﻟﻘدم ﻓﻲ ﺣﺎﻟﮫ آﻣن ؟‬

PPE & Tools

4- Are tools and equipment subject to appropriate system of pre-use/after use checks, visual examination and are
Person(s) who carry the job: ‫اﻟﺷﺧص اﻟذي ﯾﻘوم ﺑﺎﻟﻌﻣل‬ they maintained in a safe condition, neatly stored, safely carried?
1- Are all team members competent, certified and authorized to do the job? ‫ھل ﺗم ﻓﺣص اﻻدوات ﺑﺎﻟﻧظر وﺗﺧزﯾﻧﮭﺎ ﺑﻌﻧﺎﯾﮫ وﺣﻣﻠﮭﺎ ﺑﺄﻣﺎن ؟‬
‫ﻛل اﻻﻓراد ﻣؤھﻠﯾن وﻣﺻرح ﻟﮭم ﻟﻠﻘﯾﺎم ﺑﺎﻟﻌﻣل‬ 1- Do Vehicle used to transport employees comply with Nokia requirements (e.g. airbag, ABS, seatbelts, equipped
2- Are all team members medically fit to do the job they are assigned to? with emergency kits …etc.)?
‫اﻓراد اﻟﻌﻣل ﻻﺋﻘﯾن طﺑﯾﺎ ﻟﻠﻘﯾﺎم ﺑﺎﻟﻌﻣل اﻟﻣﻛﻠف ﻟﮭم‬ ‫ﺷﻧطﺔ طوارئ(؟‬, ‫ﺣزام اﻣﺎن‬, ‫ ﻓراﻣل ھﯾدروﻟﯾﻛﯾﺔ‬,‫ھل اﻟﻣرﻛﺑﺎت ﻣطﺎﺑﻘﮫ ﻟﻣواﺻﻔﺎت ﻧوﻛﯾﺎ )ﻣﺛل اﯾرﺑﺎج‬
3- Is a competent supervisor available on site? 2- Is the vehicle driver trained on Safe driving techniques?

People
‫وﺟود ﻣﺷرف ﻣﺧﺗص ﻓﻲ اﻟﻣوﻗﻊ‬ ‫ھل اﻟﺳﺎﺋﻖ ﻣدرب ﻋﻠﻰ اﺳﺎﻟﯾب اﻟﻘﯾﺎدة اﻷﻣﻧﺔ ؟‬
4- Is any high-risk activity performed by minimum of two personnel attending and at least one of them trained on 3- Is there an inspection checklist inside the vehicle, signed by the site engineer?
emergency procedures; (e.g. WAH rescue, emergency shutdown, first aid, firefighting …etc.? ‫ھل ﺗوﺟد ﻗﺎﺋﻣﮫ اﻟﻔﺣص ﻓﻲ اﻟﺳﯾﺎرة ﻣوﻗﻌﮫ ﻣن اﻟﻣﮭﻧدس ؟‬
‫واﺣد ﻣﻧﮭم ﻋﻠﻰ اﻻﻗل ﻣدرب ﻋﻠﻰ اﺟراءات اﻟطوارئ )ﻣﺛل اﻻﻧﻘﺎذ واﻟطوارئ واﻻﺳﻌﺎﻓﺎت اﻷوﻟﯾﺔ‬, ‫وﺟود اﺛﻧﯾن ﻋﻠﻰ اﻻﻗل ﻓﻲ ﺣﺎﻟﺔ اﻻﻧﺷطﺔ اﻟﺧطرة‬

Vehicle Safety
4- Are the vehicle daily inspection, preventive / corrective maintenance, driver evaluation done and proven?
(‫وﻣﻛﺎﻓﺣﺔ اﻟﺣراﺋﻖ‬ ‫ھل ﺗم ﻋﻣل ﻓﺣص وﺻﯾﺎﻧﮫ ﻟﻠﺳﯾﺎرة وﺗﻘﯾﯾم اﻟﺳﺎﺋﻖ ؟‬
1- Is the site housekeeping in good condition? 5- Is the journey plan done according to Nokia rules (e.g. Rest periods, No. of driver, gas station, istance,time...etc)
‫ھل اﻟﻣوﻗﻊ ﻧظﯾف‬ (...‫ اﻟوﻗت‬,‫ اﻟﻣﺳﺎﻓﺔ‬,‫ أﻣﺎﻛن ﺗﻣوﯾن اﻟﺳﯾﺎرة ﺑﺎﻟوﻗود‬,‫ ﻋدد اﻟﺳﺎﺋﻘﯾن‬,‫ھل ﺗم ﻋﻣل ﺗﺧطﯾط ﻟﻠرﺣﻠﺔ طﺑﻘﺎ ﻟﻘواﻋد ﻧوﻛﯾﺎ )ﻣﺛل ﻓﺗرات اﻟراﺣﺔ‬
2- Is the site secured and has limited access? And are all the warning and safety signage in place (e.g. Electrical, 1- Is there an emergency response plan in place?
limited access, climbing, radiation …etc.? ‫ﻣوﻗﻊ ﻣؤﻣن وﻟﮫ طرﯾﻖ دﺧول ﻣﺣدد ووﺟود اﻟﻌﻼﻣﺎت اﻹرﺷﺎدﯾﺔ واﻟﺗﺣذﯾرﯾﺔ‬ ‫ھل ﺗوﺟد ﺧطﺔ طوارئ ﻓﻲ ﻣﻛﺎن اﻟﻌﻣل ؟‬
( ‫اﻻﺷﻌﺎﻋﺎت‬, ‫اﻟﺗﺳﻠﻖ‬, ‫ ﻣﻧطﻘﮫ اﻟدﺧول واﻟﺧروج‬,‫)ﻣﺛل اﻟﻛﮭرﺑﺎء‬
2- Are people well trained on the emergency plan?
3- Are the site & surrounding area free from flammables, combustible liquids, or gases, explosive agents, vapors, ‫ھل اﻓراد اﻟﻌﻣل ﻣدرﺑﯾن ﻋﻠﻰ ﺧطﺔ اﻟطوارئ؟‬
fumes, dusts and mists? ‫اﻟﻣوﻗﻊ واﻟﻣﻧطﻘﺔ اﻟﻣﺣﯾطﺔ ﺧﺎﻟﯾﮫ ﻣن اﻟﻣواد اﻟﻣﺷﺗﻌﻠﺔ واﻟﺑﺗروﻟﯾﺔ واﻟﻐﺎزات واﻻﺑﺧرة واﻷﺗرﺑﺔ واﻟﺿﺑﺎب واﻷدﺧﻧﺔ‬
3- Is the first aid kit fully loaded with all the required materials?
4- Are all exits(e.g. doors, road, stairs ...etc.) allow safe access and egress? ‫ھل ﺷﻧطﺔ اﻻﺳﻌﺎﻓﺎت اﻷوﻟﯾﺔ ﺗﺣﺗوي ﻋﻠﻰ ﺟﻣﯾﻊ اﻻدوات اﻟﻣطﻠوب ؟‬
‫( ﺗﺳﻣﺢ ﺑﺎﻟدﺧول واﻟﺧروج‬.. ‫اﻟﺳﻼﻟم‬, ‫اﻟطرﯾﻖ‬, ‫ﻛل اﻟوﺳﺎﺋل )ﻣﺛل اﻷﺑواب‬
4- Is there a certified fire fighter at the site?
5- Is there a safe distance from overhead electrical cables? ‫وﺟود ﻣﺳﺎﻓﺔ آﻣﻧﮫ ﻣن ﻛﺎﺑﻼت اﻟﻛﮭرﺑﺎء‬ ‫ھل ﯾوﺟد ﺷﺧص ﻣؤھل ﻟﻣﻛﺎﻓﺣﮫ اﻟﺣرﯾﻖ ؟‬
6- Is the site free of animals, snake, and other harmful attacks? ‫اﻟﻣوﻗﻊ ﺧﺎﻟﻲ ﻣن اﻟﺣﯾواﻧﺎت واﻟﺛﻌﺎﺑﯾن واي ﺣﯾواﻧﺎت اﺧري ﺿﺎرة‬ 5- Is there a properly maintained 3kg fire extinguisher with the team?
7- Is electromagnetic risk controlled? ‫ھل ﺗم اﻟﺗﺣﻛم ﻓﻲ ﺧطر اﻟﻛﮭروﻣﻐﻧﺎطﯾﺳﻲ‬ ‫ ﻛﺞ ؟‬3 ‫ھل ﯾوﺟد طﻔﺎﯾﺔ ﺣرﯾﻖ اﻗل وزن ﻟﮭﺎ‬
Emergency Response

General Site Conditions

6- Is there a certified working at height rescuer at the site?
8- Have electrical conductors and apparatus passed visually inspection "isolated and working properly" (e.g. wires, ‫ھل ﯾوﺟد ﺷﺧص ﻣدرب ﻋﻠﻰ اﻻﻧﻘﺎذ ﻓﻲ ﺣﺎﻟﺔ اﻟﻌﻣل ﻋﻠﻰ ارﺗﻔﺎﻋﺎت ؟‬
cables, switches, controls, generator, transformers, lamps, batteries, fuses, D.B protection, earth means installed 7- Is there a properly maintained recuse kit and prepared to use?
..etc.)? ‫ھل ﺗوﺟد ﻋدة اﻧﻘﺎذ ﻣﻧﺎﺳﺑﮫ ﺟﺎھزة ﻟﻼﺳﺗﺧدام ؟‬
(... ‫اﻷرﺿﻲ‬, ‫ اﻟﻔﯾوزات‬, ‫ اﻟﻣﺻﺎﺑﯾﺢ‬, ‫ اﻟﻣوﻟدات‬, ‫ اﻟﻣﻔﺎﺗﯾﺢ‬, ‫اﻟﻛﺎﺑﻼت‬, ‫ﻛل اﻟﺗوﺻﯾﻼت اﻟﻛﮭرﺑﯾﺔ ظﺎھره وﻣﻌزوﻟﺔ وﺗﻌﻣل ﺑﺻورة ﻣﻧﺎﺳﺑﺔ )ﻣﺛل اﻻﺳﻼك‬
9- Is there any further unsafe condition observed in site?
‫ھل ﺗوﺟد أي ﻣﻼﺣظﺎت ﻋﻠﻰ أي ﺣﺎﻻت ﻏﯾر آﻣﻧﮫ ﻓﻲ اﻟﻣوﻗﻊ‬
1- Is manual lifting used in accordance with rigging& lifting SOP (e.g. planned, enough competent persons ,
appropriate pulley's system used, drop zones marked, secured and done under supervision…etc.)
(‫ﺗم ﺗﺣت اﻻﺷراف‬, ‫ ﻧﻘﺎط ھﺑوط ﻣﻌﻠوﻣﺔ‬,‫ ﻧظﺎم ﺑﻛﺎرات ﻣﻧﺎﺳﺑﮫ‬,‫ھل اﻟرﻓﻊ اﻟﯾدوي ﺗم طﺑﻘﺎ ﻟﻠطرﯾﻘﺔ اﻟﺳﻠﯾﻣﺔ ) ﻣﺧطط‬
2- Are lifting operations planned before being undertaken and using suitable equipment, competent operator who
has a valid license and applying good work practices?
‫ وﺟود ﻋﺎﻣل ﻣﺧﺗص ﻟدﯾﮫ ﺷﮭﺎدة وﺻﻼﺣﯾﮫ ﻟﻠﻘﯾﺎم ﺑﺎﻟرﻓﻊ‬,‫ واﺳﺗﺧدام ادوات ﻣﻧﺎﺳﺑﮫ‬,‫ھل ﻋﻣﻠﯾﺎت اﻟرﻓﻊ ﻣﺧطط ﻟﮭﺎ ﻗﺑل اﻟﺑدء‬
3- Are appropriate controls for WAH applied (e.g. only by trained and physically proven, two riggers minimum, using
fall arrestor or fall restraint system properly ...etc.?
‫ ﻣﺗﺳﻠﻘﯾن ﻋﻠﻲ اﻻﻗل ( ؟‬2 , ‫ھل ﺗم ﺗطﺑﯾﻖ اﻟﺗﺣﻛم اﻟﻣﻧﺎﺳب ﻓﻲ اﻟﻌﻣل ﻋﻠﻰ ارﺗﻔﺎﻋﺎت ) ﻣدرب وﻗﺎدر ﺟﺳﻣﺎﻧﯾﺎ‬

Activity
4- Is the rooftop safe (e.g. roof edge protected, no skylight, no fragile roof, no weak points)?
( ‫ ﻋدم وﺟود ﻧﻘﺎط ﺿﻌﯾﻔﺔ‬,‫ ﻏﯾر ھش‬,‫ ﻋدم وﺟود ﻓﺗﺣﺎت‬,‫ھل ﺳطﺢ اﻟﻣوﻗﻊ أﻣن )ﺣدود اﻟﺳطﺢ ﻣﺣﻣﯾﮫ‬
5- Safe load limits are calculated prior to start the work?
‫ھل ﺗم ﺣﺳﺎب اﻻﺣﻣﺎل اﻷﻣﻧﮫ ﻗﺑل اﻟﺑدء ﻓﻲ اﻟﻌﻣل؟‬
6- Is the area under loading clear and allow safe movements? Is drop zone barricaded?
‫ھل اﻟﻣﻧطﻘﺔ ﺗﺣت اﻟﺣﻣل ﺧﺎﻟﯾﮫ واﻣﻧﮫ ﻟﻠﺣرﻛﺔ؟ ھل ﺗم وﺿﻊ ﺷرﯾط ﺗﺣذﯾري ﺣول ﻣﻧطﻘﮫ اﻟﺣﻣل؟‬
7- Rigging equipment for material handling is inspected prior to use in each shift?
‫ھل ﺗم ﻓﺣص ادوات اﻟﺗﺻﺑﺑﯾن ﻗﺑل اﻟﺑدء ﻓﻲ اﻟﻌﻣل؟‬
 Site Risk Assessment Checklist

Residual Risk Register

Form 3/3

Severity Likelihood Risk

A Death/Major injury or major damage to 1 Likely to occur A1/A2/B1 Unacceptable, Stop the work, immediate
property or equipment action to reduce the risk, apply more
Reportable injury (I.e. Over 3 days A3/B2/C1
B absence) or damage to property or 2 Possible to occur Urgent attention to reduce risk
equipment
C Minor injury or minor damage to property 3 Slight chance of occurring B3/C2/C3 Attention is required, Frequent review to
or equipment ensure risk is controlled

Additional Control Risk Evaluation

Identified Hazards (uncontrolled) Measures Severity Likelihood Priority

Contractor: Assessment Date:

Site ID:
Site Name:
Site type: Roof top / Monopole / Palm Tree / Shelter / G.F Tower / Other: …………..
Assessor Name: Title: Signature: