2013 CIT - Hazard Report

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Description of Hazard

• Type of Hazard

  Select Manual Task Slip/Trip/Fall Electricity Machinery & Equipment Guards

  • Manual Task
  • Slip/Trip/Fall
  • Electricity
  • Machinery & Equipment
  • Guards

• Explain the hazard and the context in how the hazard poses a risk

• Media

Assess the risk

• What would a reasonable foreseeable outcome be if an incident occurred?

• Consequence

  Select Low Minor Moderate Major Catastrophic

  • Low
  • Minor
  • Moderate
  • Major
  • Catastrophic

• Likelihood

  Select Almost certain Likely Possible Unlikely Rare

  • Almost certain
  • Likely
  • Possible
  • Unlikely
  • Rare

• Risk Rating

  Select Low Medium High Extreme

  • Low
  • Medium
  • High
  • Extreme

Control the hazard

• Describe what you have done to make the hazard safe!

• Add media

  Media

Recommendations

• What are your recommendation to correct the hazard.

Send report to your line Manager and OSH Consultants (Mick Pentreath and Ryan Johnston). If it requires maintenance, please send copy to Facilities Manager.

• Select date

  Date

• Person completing the report

  Sign