Machinery Safety Risk Assessment

• Document No.

• Risk Assessment Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel Involved in Risk Assessment

DESCRIPTION

• Description of location:

• Describe how the equipment/machinery is used:

• Description of Work Equipment/Machinery:

• Photograph(s) of equipment/machinery

  Media

Mechanical Hazards

• Identify the mechanical hazards present

  Select Entrapment Entanglement Shearing Crushing Ejection Puncture/stab Impact Abrasion Cutting Contact None Present

  • Entrapment
  • Entanglement
  • Shearing
  • Crushing
  • Ejection
  • Puncture/stab
  • Impact
  • Abrasion
  • Cutting
  • Contact
  • None Present

Non Mechanical Hazards

• Identify the non mechanical hazards present

  Select Temperature Electricity Noise Vibration Dust High Pressure Chemicals Waste Allergens Radiation Ergonomic Gas/Fume/Vapour Manual Handling Optical Radiation Other None Present Biological Fire Explosion Gas Energy

  • Temperature
  • Electricity
  • Noise
  • Vibration
  • Dust
  • High Pressure
  • Chemicals
  • Waste
  • Allergens
  • Radiation
  • Ergonomic
  • Gas/Fume/Vapour
  • Manual Handling
  • Optical Radiation
  • Other
  • None Present
  • Biological
  • Fire
  • Explosion
  • Gas Energy

Use of Equipment/machinery

• What is the duration/frequency of use of equipment/machine

• Description of users of equipment (experience, age etc.)

CONTROL MEASURES

• Identify Engineering Controls in place

  Select Fixed Interlock Automatic Trip Adjustable Pressure Mat Light Beam/curtain Two Handed Other E Stop None Required Electrical Lock Off Distance/Isolation

  • Fixed
  • Interlock
  • Automatic
  • Trip
  • Adjustable
  • Pressure Mat
  • Light Beam/curtain
  • Two Handed
  • Other
  • E Stop
  • None Required
  • Electrical Lock Off
  • Distance/Isolation

• Describe/outline the Engineering Controls

• Describe/outline the Procedural and Behavioural Controls

• PPE/RPE Required

  Select Gloves Respiratory Protection Head Protection Eye Protection Hearing Protection Clothing Hi-Vis Other

  • Gloves
  • Respiratory Protection
  • Head Protection
  • Eye Protection
  • Hearing Protection
  • Clothing
  • Hi-Vis
  • Other

• Description of Type(s) of PPE/RPE required

ASSESSMENT OF RISK

• Likelihood x Severity

  Select Low Likelihood Medium Likelihood High Likelihood Low Severity Medium Severity High Severity

  • Low Likelihood
  • Medium Likelihood
  • High Likelihood
  • Low Severity
  • Medium Severity
  • High Severity

• Level of Risk

  Low

  Medium

  High

ADDITIONAL CONTROL MEASURES

• Additional Control Measures required

• Maintenance/cleaning Risk Assessment Required?

  Yes

  No

• Noise or Vibration Risk Assessment required?

  Yes

  No

• Manual Handling/Ergonomic Risk Assessment required?

  Yes

  No

• COSHH Risk Assessment required? (if yes identify substance(s))

  Yes

  No

• Other Risk Assessments Associated with Equipment

ENVIRONMENTAL

• Environmental Risk Assessment Required?

  Select Yes No

  • Yes
  • No

• Environmental controls for use and disposal:

SIGN OFF

• Is action plan required for additional controls?

  Yes

  No

• Select date

  Date

• Assessor Name & Signature

  Sign

• Date for Re-assessment

  Date