2 Hazardous Manual Tasks Risk Assessment (to be completed after Hazardous Manual Tasks Risk Assessment Checklist has been completed)

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