Take 5 Safety Template — Pre-Task Hazard Check
Generate professional Take 5 documents in minutes. No training required.
A Take 5 template that captures the five-step pre-task check every worker should run before starting any new task: stop, look, assess, control, proceed. Built for US industrial, oil & gas, mining and construction sites where Take 5 is mandated by the operator or general contractor, and aligned with the OSHA expectation that hazards are evaluated before exposure.
Designed for: Industrial operators, oil & gas field crews, mine workers, electrical workers, maintenance technicians and construction tradespeople in the US
US (JSA) example document — Roof Tear-Off & Re-Cover — 482 Sandalwood Drive, Boise. Client: Sandalwood Homeowners Association. Site: 482 Sandalwood Drive, Boise, ID 83702. Scope: Tear-off of 2,400 sq ft of 3-tab asphalt shingles, replacement of damaged decking, installation of ice-and-water shield, synthetic underlayment and GAF Timberline HDZ architectural shingles. Works programmed over 6 working days with a crew of 4 roofers and 1 ground operative.
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Complete Guide to Take 5 (US)
What is a Take 5?
Take 5 (sometimes called 5-Point Safety, SLAM — Stop Look Assess Manage, or Last Minute Risk Assessment) is a structured pre-task hazard check completed by the individual worker — or the crew leader — in the 30–60 seconds before starting any new task or returning to work after a break. The five steps: Stop and think; Look at the work area; Assess hazards and risks; Control hazards before starting; Proceed safely. The output is a written or app-based card that proves the check was done and what was found.
When is it legally required?
Most US heavy industrial operators (refineries, petrochemical, mining, power generation, paper mills) require a documented Take 5 from every worker before starting any new task. Major oilfield service companies (Schlumberger/SLB, Halliburton, Baker Hughes) build Take 5 into their behaviour-based safety program. On construction sites, Take 5 is increasingly required by GCs as a supplement to the daily Pre-Task Plan (PTP) — used when conditions change, when the worker moves to a new area, or after a break.
Who is responsible?
Take 5 is the individual worker's responsibility — it's a personal check before exposure. The supervisor or competent person verifies that Take 5 cards are being completed and reviews them during walk-arounds. The contractor or employer is responsible for training workers in how to complete a Take 5 properly and for collecting completed cards as evidence of the program.
Where is it commonly used?
US refineries, petrochemical plants, mines, power stations, paper mills, oil and gas wellsites, pipeline construction, electrical utility work, industrial maintenance and increasingly on commercial construction sites where the GC's safety program mandates it. Pocket cards, electronic kiosks at site entry, and mobile apps are all standard formats.
What a Complete Take 5 Includes
- Worker name, date, time, location, task
- Step 1 — Stop: confirm authorisation to work (permit, PTP, supervisor sign-off)
- Step 2 — Look: walk the work area, identify other trades, energy sources, change in conditions
- Step 3 — Assess: list the hazards present and their severity/likelihood
- Step 4 — Control: list the controls in place AND any controls still required
- Step 5 — Proceed: only if all controls confirmed; otherwise stop and escalate
- Energy sources identified — electrical, hydraulic, pneumatic, gravity, chemical, thermal, mechanical, radiation
- Permits referenced — hot work, confined space, LOTO, energized work
- PPE confirmed for the specific hazards
- Trade/area interface noted — who else is in the space
- Stop-work trigger — what would make me stop?
- Worker signature confirming the check is real
What's included in this template
Header
Worker, date, time, location, task.
Stop
Confirm authorisation: permit, PTP, supervisor sign-off.
Look
Walk the area, identify other trades, energy sources, condition changes.
Assess
List hazards, severity, likelihood, energy sources.
Control
Controls in place + controls still required, in hierarchy order.
Proceed
Only if all controls confirmed — otherwise stop and escalate.
Stop-Work Trigger
What single condition would cause you to stop work right now?
Sign-Off
Worker signature, time started.
US Requirements and Best Practice
Legal expectations
- ● Hazards evaluated before work begins — OSHA General Duty Clause Section 5(a)(1)
- ● Competent person identifies and corrects hazards — 29 CFR 1926.20(b)(2)
- ● Training to recognize and avoid hazards — 29 CFR 1926.21(b)(2)
- ● PPE based on hazard assessment — 29 CFR 1910.132(d) / 1926 Subpart E
- ● Stop-work authority for every worker — increasingly required by operator and GC safety programs
- ● Documentation of pre-task hazard checks — operator/GC contract requirement
What inspectors typically look for
- ● Is the worker carrying a current Take 5 card for the task they're doing?
- ● Did they complete it for THIS task, or is it from earlier in the shift?
- ● Did they identify the energy sources present?
- ● Are the listed controls actually in place?
- ● Was a permit pulled where required, and is it cross-referenced on the card?
- ● Has the worker been trained to recognize the hazards listed?
- ● Does the operator/GC have evidence Take 5 is happening across the site, not just on paper?
Common compliance mistakes
- Pre-filled Take 5 cards distributed at toolbox talk — defeats the purpose
- Worker fills out one Take 5 at 7am and uses it all day, ignoring scope changes
- Generic hazards listed with no energy source or specific control identified
- Step 4 (control) left blank or 'PPE' as the only control
- Permits required but not referenced or pulled
- Worker not trained on how to do a Take 5 properly — it becomes a tick-box exercise
- Cards collected and never reviewed, so leading indicators are missed
Example Use Cases
Valve change on a live process line, Gulf Coast refinery
Operator completes Take 5 before approaching the valve: stops to confirm the work permit and LOTO is in place, looks at the surrounding hot work being done 40 ft away and the confined space crew working in the bottoms of the column upstream, assesses chemical exposure risk and stored energy in the line, confirms isolation verified at two points and pressure bled, lists FR clothing and chemical gloves as PPE, names the stop-work trigger (any pressure on the gauge before breaking the flange).
Service tech on a wellsite, Permian basin
Field service tech completes Take 5 at the wellhead before connecting a pressure test pump: stops to verify the JSA and pre-job meeting outputs, looks at the iron in place and the active flowback line 30 ft away, assesses the pressure release path and overhead lifting from the crane, confirms the red zone is established and barricaded, names the stop-work trigger (any unexpected pressure rise or rig-floor radio chatter about a kick).
Electrician changing a breaker in a live MCC, Midwest plant
Electrician completes Take 5 at the MCC door before opening it: stops to confirm the LOTO permit is pulled and the bucket de-energised, looks at the adjacent live buckets and the arc-flash boundary, assesses the residual energy and capacitor discharge timing, confirms FR clothing matched to the calculated arc-flash incident energy, names the stop-work trigger (any indication of voltage on the test meter after isolation).
How to use this template
- 1
Stop and think
Stand back from the task. Confirm you're authorised to do this work right now — permit pulled, PTP signed, supervisor briefed.
- 2
Look at the work area
Walk it. What's changed since the morning briefing? Who else is in this area? What energy sources are present?
- 3
Assess the hazards
Not a generic list — what hazards are present for THIS task in THIS area right now? Energy sources first, then chemical/biological/ergonomic.
- 4
Control the hazards
Apply hierarchy of controls: Eliminate → Substitute → Engineering → Administrative → PPE. List what's in place and what's still missing.
- 5
Proceed only when ready
If a control is missing, stop and escalate — don't downgrade or omit. Stop-Work Authority belongs to every worker.
- 6
Name your stop-work trigger
What single condition would cause you to stop right now? Naming it before you start makes you 10x more likely to stop when you see it.
- 7
Redo when conditions change
New task, new area, after a break, after a near-miss, after a permit change — repeat the Take 5.
Common mistakes to avoid
- Pre-filled Take 5 cards distributed at toolbox talk
- One Take 5 at 7am, used all day across scope changes
- Generic hazards with no energy source identified
- Step 4 (control) left blank or 'PPE' as the only control
- Permits required but not referenced or pulled
- Worker not trained on how to do a Take 5 — becomes a tick-box
- Cards collected but never reviewed — leading indicators wasted
- No stop-work trigger named — Stop-Work Authority becomes theoretical
Share or Use This Template
This Take 5 template is free to use and share. Feel free to reference it with your team, include it in training materials, or link to it from your own resources.
Why templates have limitations
Templates provide a solid starting point, but they require manual editing to match your specific site conditions, hazards, and work activities. This can be time-consuming and important site-specific risks may be missed if sections are left generic.
For projects where accuracy and speed matter, many contractors prefer tools that generate structured documents automatically based on real project inputs.
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