Take5 – Monadelphous Monos - Take 5 Contact ORIGINALFirst NameSurnameTaskDateVisual ObservationsPHOTO UPLOAD Am I fit for work and ready? Y NIf NO - please provide detailsAm I in the area where the task is being performed? Y NIs there anything new or different? Y NAm I new to the task or working with anyone new? Y NCould I be in the line of fire? Y NDo I need to isolate? Y NDo I have the correct PPE/Tools? Y NBASED ON YOUR ABOVE CHOICES - Complete the followingWhat can injure me? (Hazards)What can I do about it? (Controls) I have read & agree to the Terms and Conditions of this Take 5.Submit Form
