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FLHA — Field Level Hazard Assessment
Complete BEFORE every task. Sign at end of shift.
Dirt School
dirtschool.ca
PPE Required for This Task
Hard hat
Safety glasses
Hi-vis (Class __)
Steel-toe boots
Gloves (type: ___)
Hearing protection
Respirator (type: ___)
Fall arrest
Fire extinguisher
Gas monitor
Spotter
Other: _______
Permits / Authorizations Required
Hot work permit
Confined space entry
Excavation / dig permit
Lockout-tagout (LOTO)
Working at heights
Crane / lift plan
Utility locates verified
Energized work permit
Hazard Identification & Controls
# Task Step Hazard Identified Risk (L/M/H) Control / Mitigation Final Risk
1
2
3
4
5
6
7
8
Hierarchy of Control: 1) Eliminate · 2) Substitute · 3) Engineer · 4) Administrative · 5) PPE. Apply highest control first. PPE is the last line, not the first.
Emergency Response
Crew Sign-Off — All Workers

I have reviewed this FLHA, understand the hazards and controls, and will stop work if conditions change.

Print Name
Signature
Time
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