LINE OF FIRE FIELD LEVEL HAZARD ASSESSMENT (FLHA) For each question below, ask yourself “Are the existing safeguards satisfactory to reduce the risk to manageable level?” Fall Protection Does your task require fall protection? ☐Yes ☐No If Yes - Review and follow fall protection plan Confined Space Does your task require confined space? ☐Yes ☐No If Yes - Are the correct control measures in place? Specialized PPE Do you require any special PPE gloves or respirators etc? ☐Yes ☐No If Yes - Do you have the right PPE for the task? Right Tools Do you have the proper tools for the task? ☐Yes ☐No If Yes - Have you reviewed applicable Safe Work Practice (SWP)? Lifting Are you doing any lifting of hoisting? ☐Yes ☐No If Yes - Plan and follow proper rigging practices (SWP) Overhead Work Are you doing any overhead work? ☐Yes ☐No If Yes - Are controls in place with workers below or above? Environmenta l Does your work have potential to impact environment? ☐Yes ☐No If Yes - Are you prepared for spill potential Isolation Verification (Initial Required) Mechanical Supervisor Tradesperson N/A All mechanical energy sources have been isolated Drain points assessed as adequate zero energy confirmed Single isolation procedure/Risk Assessment performed, reviewed and documented Verified by the Company and operations First break required / single isolation Isolation points completed and verified by the Company Electrical Supervisor Tradesperson N/A All electrical energy sources have been isolated Bump test witnessed to confirm zero energy Maintenance locks & tags installed Bump test written on permit All three questions need to be checked prior to work commencing Supervisor Tradesperson N/A Confirmed correct equipment & location as per permit?