Hazard Identification Form

APPENDIX 1
HAZARD IDENTIFICATION FORM

Hazard Identification Form in PDF format
Hazard Identification Form in MS Word format

(to be filled out by trip leader and filed with LOC Safety Officer or
Appropriate Section/Division Head or designate prior to trip departure )

Example of a completed Hazard Identification Form


Field Trip Name          _________________________________________________

Date                           _________________________________________________

Field Trip Leader       _________________________________________________

Responsible Safety officer      ____________________________________________

General Hazards

Nature of Hazard Location of Hazard Mitigation



STOP _________

Nature of Hazard Location of Hazard Instructions to participants




STOP _________

Nature of Hazard Location of Hazard Mitigation



STOP _________

Nature of Hazard Location of Hazard Mitigation



STOP _________

Nature of Hazard Location of Hazard Mitigation



STOP _________

Nature of Hazard Location of Hazard Mitigation



STOP _________

Nature of Hazard Location of Hazard Mitigation



STOP _________

Nature of Hazard Location of Hazard Mitigation



STOP _________

Nature of Hazard Location of Hazard Mitigation



STOP _________

Nature of Hazard Location of Hazard Mitigation



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