Information

  • HAZARDOUS MANUAL TASKS RISK ASSESSMENT

  • Task/Assessment Title

  • HMT Number

  • Conducted on

Part A - ASSESSMENT SUMMARY

  • Date Risk Assessment Date Completed

  • Task/Job Description/Name (Assessment Title):

  • HMT No.

  • Location

  • RISK ASSESSMENT TEAM

  • Name

  • Position

  • Signature

  • Date

  • RISK ASSESSMENT TEAM

  • Name

  • Position

  • Signature

  • Date

  • RISK ASSESSMENT TEAM

  • Name

  • Position

  • Signature

  • Date

  • Department Manager/Coordinator:

  • Select date

  • WHS Representative (HSR)

  • Select date

Part C - RISK RATING & ACTION PLAN

  • Can this task/job or process be eliminated entirely?

  • List identified hazards from the Hazardous Manual Tasks Risk Assessment Checklist and detail measures taken or that need to be taken to address the hazards

  • Basic Task Step and Hazard Description

  • Code Reference/s from Checklist (e.g. B3 or E3)

  • Existing or Current Controls in Place

  • Identified/Potential Hazard/s (expanded explanation from checklist)

  • Likelihood

  • Consequence

  • Risk Rating (please select the one applicable which match up Likelihood and Consequnce)

  • Proposed Additional Controls (List those relevant to this hazard)

  • Likelihood

  • Consequence

  • Residual Risk (once controls are in place or implemented)

  • Person Responsible

  • Enter date for control to be completed by

  • List identified hazards from the Hazardous Manual Tasks Risk Assessment Checklist and detail measures taken or that need to be taken to address the hazards

  • Basic Task Step and Hazard Description

  • Code Reference/s from Checklist (e.g. B3 or E3)

  • Existing or Current Controls in Place

  • Identified/Potential Hazard/s (expanded explanation from checklist)

  • Likelihood

  • Consequence

  • Risk Rating (please select the one applicable which match up Likelihood and Consequnce)

  • Proposed Additional Controls (List those relevant to this hazard)

  • Likelihood

  • Consequence

  • Residual Risk (once controls are in place or implemented)

  • Person Responsible

  • Enter date for control to be completed by

  • List identified hazards from the Hazardous Manual Tasks Risk Assessment Checklist and detail measures taken or that need to be taken to address the hazards

  • Basic Task Step and Hazard Description

  • Code Reference/s from Checklist (e.g. B3 or E3)

  • Existing or Current Controls in Place

  • Identified/Potential Hazard/s (expanded explanation from checklist)

  • Likelihood

  • Consequence

  • Risk Rating (please select the one applicable which match up Likelihood and Consequnce)

  • Proposed Additional Controls (List those relevant to this hazard)

  • Likelihood

  • Consequence

  • Residual Risk (once controls are in place or implemented)

  • Person Responsible

  • Enter date for control to be completed by

  • List identified hazards from the Hazardous Manual Tasks Risk Assessment Checklist and detail measures taken or that need to be taken to address the hazards

  • Basic Task Step and Hazard Description

  • Code Reference/s from Checklist (e.g. B3 or E3)

  • Existing or Current Controls in Place

  • Identified/Potential Hazard/s (expanded explanation from checklist)

  • Likelihood

  • Consequence

  • Risk Rating (please select the one applicable which match up Likelihood and Consequnce)

  • Proposed Additional Controls (List those relevant to this hazard)

  • Likelihood

  • Consequence

  • Residual Risk (once controls are in place or implemented)

  • Person Responsible

  • Enter date for control to be completed by

  • List identified hazards from the Hazardous Manual Tasks Risk Assessment Checklist and detail measures taken or that need to be taken to address the hazards

  • Basic Task Step and Hazard Description

  • Code Reference/s from Checklist (e.g. B3 or E3)

  • Existing or Current Controls in Place

  • Identified/Potential Hazard/s (expanded explanation from checklist)

  • Likelihood

  • Consequence

  • Risk Rating (please select the one applicable which match up Likelihood and Consequnce)

  • Proposed Additional Controls (List those relevant to this hazard)

  • Likelihood

  • Consequence

  • Residual Risk (once controls are in place or implemented)

  • Person Responsible

  • Enter date for control to be completed by

  • List identified hazards from the Hazardous Manual Tasks Risk Assessment Checklist and detail measures taken or that need to be taken to address the hazards

  • Basic Task Step and Hazard Description

  • Code Reference/s from Checklist (e.g. B3 or E3)

  • Existing or Current Controls in Place

  • Identified/Potential Hazard/s (expanded explanation from checklist)

  • Likelihood

  • Consequence

  • Risk Rating (please select the one applicable which match up Likelihood and Consequnce)

  • Proposed Additional Controls (List those relevant to this hazard)

  • Likelihood

  • Consequence

  • Residual Risk (once controls are in place or implemented)

  • Person Responsible

  • Enter date for control to be completed by

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