Health and
Safety
Quality and
Hygiene

Compliance

Environment and
Sustainability
Product Safety



Task / Topic:
Area:

Date:
Time:

These must be completed at the beginning of every working day and at change of task during the same working day
QUESTION
YES
NO
COMMENTS
Do I know the TASK?
Can I GET TO IT and AWAY from it?
Is the area TIDY and do I have enough ROOM to work?
Do I have the right DOCUMENTS (SOPs, SPLs, etc.)?
Do I know where to dispose of WASTE?
EMERGENCY ITEMS (Exits, extinguishers, BGUs, etc.)?
FIRST AID KITS (including eyewash points)?
Could I FALL from HEIGHT or SAME LEVEL?
Do I have the suitable TOOLS?
Are they in GOOD ORDER and CONDITION?
Am I wearing the right PPE and is it clean?
Do I have to use CHEMICALS?
Are OTHER PEOPLE or OTHER TASKS affected by my work?
Is the work area CLEAN and TIDY?
Is it HOT or SHARP or HEAVY?
Could it MOVE, LEAK, HIT ME or OTHERS?
Other unsafe situation?
Is there a risk of contamination to finished product?
Is there risk of a quality issue to finished product?
RISKS IDENTIFIED?
IMPORTANT: IF ANY RISKS IDENTIFIED ARE NOT
RESOLVED THEN DO NOT COMMENCE THE TASK
UNTIL THEY HAVE BEEN REPORTED TO YOUR
MANAGER/SUPERVISOR AND AS A MINIMUM,
CONTAINMENT ACTIONS ARE IN PLACE
Completed By:
CORRECTIVE ACTIONS?
Action sign off by Manager or
Supervisor (if applicable)
Sign:
Print:
Signature:
pg. 1
NL2023
Health and
Safety
Quality and
Hygiene


Compliance
Product Safety

Environment and
Sustainability


Product Description:
Product Code:

Date:
Time:

These must be completed at the beginning of every working day and at change of task during the same working day
QUESTION
YES
NO
COMMENTS
Am I TRAINED to carry out this operation?
Do I know the PRODUCT?
Do I have the PID Sheet?
Is the product line set to SPECIFICATION?
Are there any ALARMS sounding?
Do I have the COLOUR SPECIFICATION?
Do I have the right SHEET?
Do I have the right PACKAGING?
Do I know what GOOD looks like?
Are there APPROVED samples available?
Am I TRAINED in all the quality checks?
Do I have the right TOOLS for checking?
Are the tools WORKING?
RISKS IDENTIFIED?
CORRECTIVE ACTIONS?
Completed By:
Signature:
pg. 2
MR2020