Hazard Identification Questionnaire Template
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Hazard Identification Questionnaire

Name: [Your Name]

Date of Assessment: [Month Day, Year]

The purpose of this Hazard Identification Questionnaire is to assess potential hazards in the construction site managed by ABC Construction Services for safety compliance.

Describe the work activities being assessed.

Hazard Categories

1. Please check all applicable hazard categories below:

  • Chemical Hazards

  •  Physical Hazards

  •  Biological Hazards

  •  Ergonomic Hazards

  •  Psychosocial Hazards

  •  Other (Specify): ________________________

Hazard Identification

2. For each hazard category selected in the first section, please identify and describe potential hazards related to the work activities.

Chemical Hazards (if applicable)

  • Flammable Substances

  • Toxic Substances

  • Corrosive Substances

  • Reactive Substances

Risk Assessment

3. For each identified hazard, assess the level of risk as:

  • Low

  • Moderate

  • High

Existing Controls

4. Describe any existing controls or safety measures in place to mitigate the identified hazards.

                                                                                                                                                                                                                                                                                  

Additional Comments

5. Provide any additional comments or observations related to hazard identification.
                                                                                                                                                                                                                                                                                  

    

This Hazard Identification Questionnaire has been reviewed and approved by:

Name: [Your Name]

Date: June 15, 2053

Please ensure that this Hazard Identification Questionnaire is completed accurately and thoroughly. Regular reviews and updates may be necessary to ensure ongoing safety compliance in your workplace.

[Your Company Name] reserves the right to use the information provided for safety and compliance purposes.

This questionnaire is designed to help identify potential hazards in the workplace and should be conducted regularly to ensure the safety of employees and compliance with US health and safety standards.



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