Analytical Risk Assessment Form

Analytical Risk Assessment

• Management of Health and Safety at Work Regulations 1999

• 

• Document No.

• Subject (Details of task / operation being assessed)

• Directorate

  Resilience

  Other

• Specify

• Department / Function

  HART

  Other

• Specify

• Risk Assessor's Name:

  Select Greg Leeson Gareth Knights Paul Hudson Greg Garrett Phil Russell James Hubbard Andy Weston Christian Wiggin Nick Spence Caroline Condron Other

  • Greg Leeson
  • Gareth Knights
  • Paul Hudson
  • Greg Garrett
  • Phil Russell
  • James Hubbard
  • Andy Weston
  • Christian Wiggin
  • Nick Spence
  • Caroline Condron
  • Other

• State

• Others involved

  Off

  On
• Location
  Address

• Assessment date

  Date

• Date of last assessment

  Date

• Review date

  Date
• Location
  Address

Hazard Identification

• Enter identified hazard

Hazard

Description of Hazard

Existing Controls

Risk Rating

• Consequence / Impact

  Negligible (1)

  Low (2)

  Moderate (3)

  Significant (4)

  Catastrophic (5)

• Likelihood

  Rare (1)

  Unlikely (2)

  Possible (3)

  Likely (4)

  Almost Certain (5)

• Risk rating = Likelihood x Consequence

• Low Risk (1-10)
  Action - Continue but review periodically to ensure control measures remain effective

• Calculation error

• Low Risk (1-10)
  Action - Continue but review periodically to ensure control measures remain effective

• Calculation error

• Moderate Risk (12)
  Action - Continue but implement additional reasonably practicable controls where possible and monitor regularly
  Identify additional controls in Action Plan (next section)

• Calculation error

• Significant Risk (15-25)
  Action - Identify new controls. Activity must not proceed until risk are reduced to a low or moderate level

• Calculation error

• Significant Risk (15-25)
  Action - Identify new controls. Activity must not proceed until risk are reduced to a low or moderate level

• Calculation error

• Significant Risk (15-25)
  Action - Identify new controls. Activity must not proceed until risk are reduced to a low or moderate level

Further Controls

• Required

  No

  Yes

Revised Risk Rating

• Revised Risk Rating = Likelihood x Consequence

• Low Risk (1-10)
  Action - Continue but review periodically to ensure control measures remain effective

• Calculation error

• Low Risk (1-10)
  Action - Continue but review periodically to ensure control measures remain effective

• Calculation error

• Moderate Risk (12)
  Action - Continue but implement additional reasonably practicable controls where possible and monitor regularly
  Identify additional controls in Action Plan (next section)

• Calculation error

• Significant Risk (15-25)
  Action - Identify new controls. Activity must not proceed until risk are reduced to a low or moderate level

• Calculation error

• Significant Risk (15-25)
  Action - Identify new controls. Activity must not proceed until risk are reduced to a low or moderate level

• Calculation error

• Significant Risk (15-25)
  Action - Identify new controls. Activity must not proceed until risk are reduced to a low or moderate level

Further Information

• Photo / Video

  Off

  On

• Add media

  Media

• Diagram / Sketch

  Off

  On

• Add drawing

  Drawing

• Notes

  Off

  On

Action Plan