Burns & Ferrall

• Conducted on

  Date

• Client / Site

• Location
  Address

• Job number

• Personnel

• Take 5

  

• Definitions:
  
  Hazard: any source of potential damage, harm or adverse health effect on somneone or something.
  
  Risk: The possible harm, (injury, illness or death), that may occur when a person is exposed to a hazard
  
  Risk Control: action taken to elliminate health and safety risks, so far as reasonably practicable, and if that is not possible, action taken to minimise the risk, so far as reasonable practicable. Elminating a hazard will also elliminate any risks associated with that hazard.
  
  Hierarchy of Control: the order in which risk control measures are to be considered

• Risk Rating

  

• Hierarchy of Control:
  
  JBS aims to minimise risks to health and safety, by implementing risk control measures in accordance with the Hierarchy of Control.
  
  • Eliminating the hazard. Elminating a hazard will also elliminate any risks associated with that hazard.
  
  Where elimination of the risk is not possible, JBS aims to minimise risks, so far as is reasonably practicable, by implementing one or more of the following:
  
  • Substituting (wholly or partly) the hazard giving rise to the risk with something that gives rise to a lesser risk;
  
  • Isolating the hazard from any person exposed to it;
  
  • Implementing engineering controls.
  
  If a risk then remains, minimising the remaining risk, so far as is reasonably practicable, by implementing:
  
  • Administrative controls.
  
  If a risk then remains, minimising the remaining risk, so far as is reasonably practicable, by
  
  • Ensuring the provision and use of suitable Personal Protective Equipment.
  
  

  

C - Identify and address any hazards associated with each

• Mechanical Hazards

  Yes

  No

  N/A

• Add Risk

Risk

• Select Hazard Type

  Select Entanglement Crushing Cutting Shearing Friction HP Fluids Mobile Equipment Vibration Striking

  • Entanglement
  • Crushing
  • Cutting
  • Shearing
  • Friction
  • HP Fluids
  • Mobile Equipment
  • Vibration
  • Striking

• What is the likelihood of harm?

  1 - Very Likely (Could Happen Frequently)

  2 - Likely (Could Happen Occasionally)

  3 - Unlikely (Could Happen but Rare)

  4 - Very Unlikely (Could Happen, probably never will)

• What is the severity?

  1 - Extreme (Death or permanent disability)

  2 - Major (Serious bodily injury or serious work related illness)

  3 - Moderate (Injury or illness requiring casualty treatment)

  4 - Minor (Injury or illness requiring first aid only, no lost time)

• Using risk matrix what is the Severity x Likelihood

  Select 1 - ADDRESS RISK IMMEDIATELY 2 - ADDRESS RISK IMMEDIATELY 3 - ADDRESS RISK IMMEDIATELY 4 - ADDRESS RISK AS SOON AS POSSIBLE 5 - ADDRESS RISK AS SOON AS POSSIBLE 6 - No Action Required 7 - No Action Required

  • 1 - ADDRESS RISK IMMEDIATELY
  • 2 - ADDRESS RISK IMMEDIATELY
  • 3 - ADDRESS RISK IMMEDIATELY
  • 4 - ADDRESS RISK AS SOON AS POSSIBLE
  • 5 - ADDRESS RISK AS SOON AS POSSIBLE
  • 6 - No Action Required
  • 7 - No Action Required

• What Controls are Implemented?

• Rate the risk after controls put in place (Comment mandatory for scores of 5 and above)

  Safe

  At Risk

• Show risk matrix (for reference)

  Off

  On

• 

• Electrical Hazards

  Yes

  No

  N/A

• Add Risk

Risk

• Select Hazard Type

  Select Powerlines Faulty power leads Overloaded Circuits Fire Exposed circuitry Live Work

  • Powerlines
  • Faulty power leads
  • Overloaded Circuits
  • Fire
  • Exposed circuitry
  • Live Work

• What is the likelihood of harm?

  1 - Very Likely (Could Happen Frequently)

  2 - Likely (Could Happen Occasionally)

  3 - Unlikely (Could Happen but Rare)

  4 - Very Unlikely (Could Happen, probably never will)

• What is the severity?

  1 - Extreme (Death or permanent disability)

  2 - Major (Serious bodily injury or serious work related illness)

  3 - Moderate (Injury or illness requiring casualty treatment)

  4 - Minor (Injury or illness requiring first aid only, no lost time)

• Using risk matrix what is the Severity x Likelihood

  Select 1 - ADDRESS RISK IMMEDIATELY 2 - ADDRESS RISK IMMEDIATELY 3 - ADDRESS RISK IMMEDIATELY 4 - ADDRESS RISK AS SOON AS POSSIBLE 5 - ADDRESS RISK AS SOON AS POSSIBLE 6 - No Action Required 7 - No Action Required

  • 1 - ADDRESS RISK IMMEDIATELY
  • 2 - ADDRESS RISK IMMEDIATELY
  • 3 - ADDRESS RISK IMMEDIATELY
  • 4 - ADDRESS RISK AS SOON AS POSSIBLE
  • 5 - ADDRESS RISK AS SOON AS POSSIBLE
  • 6 - No Action Required
  • 7 - No Action Required

• What Controls are Implemented?

• Rate the risk after controls put in place (Comment mandatory for scores of 5 and above)

  Safe

  At Risk

• Show risk matrix (for reference)

  Off

  On

• 

• Chemical Hazards

  Yes

  No

  N/A

• Add Risk

Risk

• Select Hazard Type

  Select Explode Burn Inhale Absorb Inject Spill Seep Disposal

  • Explode
  • Burn
  • Inhale
  • Absorb
  • Inject
  • Spill
  • Seep
  • Disposal

• What is the likelihood of harm?

  1 - Very Likely (Could Happen Frequently)

  2 - Likely (Could Happen Occasionally)

  3 - Unlikely (Could Happen but Rare)

  4 - Very Unlikely (Could Happen, probably never will)

• What is the severity?

  1 - Extreme (Death or permanent disability)

  2 - Major (Serious bodily injury or serious work related illness)

  3 - Moderate (Injury or illness requiring casualty treatment)

  4 - Minor (Injury or illness requiring first aid only, no lost time)

• Using risk matrix what is the Severity x Likelihood

  Select 1 - ADDRESS RISK IMMEDIATELY 2 - ADDRESS RISK IMMEDIATELY 3 - ADDRESS RISK IMMEDIATELY 4 - ADDRESS RISK AS SOON AS POSSIBLE 5 - ADDRESS RISK AS SOON AS POSSIBLE 6 - No Action Required 7 - No Action Required

  • 1 - ADDRESS RISK IMMEDIATELY
  • 2 - ADDRESS RISK IMMEDIATELY
  • 3 - ADDRESS RISK IMMEDIATELY
  • 4 - ADDRESS RISK AS SOON AS POSSIBLE
  • 5 - ADDRESS RISK AS SOON AS POSSIBLE
  • 6 - No Action Required
  • 7 - No Action Required

• What Controls are Implemented?

• Rate the risk after controls put in place (Comment mandatory for scores of 5 and above)

  Safe

  At Risk

• Show risk matrix (for reference)

  Off

  On

• 

• Biological Hazards

  Yes

  No

  N/A

• Add Risk

Risk

• Select Hazard Type

  Select Handling of waste Contaminated Materials

  • Handling of waste
  • Contaminated Materials

• What is the likelihood of harm?

  1 - Very Likely (Could Happen Frequently)

  2 - Likely (Could Happen Occasionally)

  3 - Unlikely (Could Happen but Rare)

  4 - Very Unlikely (Could Happen, probably never will)

• What is the severity?

  1 - Extreme (Death or permanent disability)

  2 - Major (Serious bodily injury or serious work related illness)

  3 - Moderate (Injury or illness requiring casualty treatment)

  4 - Minor (Injury or illness requiring first aid only, no lost time)

• Using risk matrix what is the Severity x Likelihood

  Select 1 - ADDRESS RISK IMMEDIATELY 2 - ADDRESS RISK IMMEDIATELY 3 - ADDRESS RISK IMMEDIATELY 4 - ADDRESS RISK AS SOON AS POSSIBLE 5 - ADDRESS RISK AS SOON AS POSSIBLE 6 - No Action Required 7 - No Action Required

  • 1 - ADDRESS RISK IMMEDIATELY
  • 2 - ADDRESS RISK IMMEDIATELY
  • 3 - ADDRESS RISK IMMEDIATELY
  • 4 - ADDRESS RISK AS SOON AS POSSIBLE
  • 5 - ADDRESS RISK AS SOON AS POSSIBLE
  • 6 - No Action Required
  • 7 - No Action Required

• What Controls are Implemented?

• Rate the risk after controls put in place (Comment mandatory for scores of 5 and above)

  Safe

  At Risk

• Show risk matrix (for reference)

  Off

  On

• 

• Location Hazards

  Yes

  No

  N/A

• Add Risk

Risk

• Select Hazard Type

  Select Overhead Underneath Different Levels Climatic Conditions Excavations Surrounding Areas

  • Overhead
  • Underneath
  • Different Levels
  • Climatic Conditions
  • Excavations
  • Surrounding Areas

• What is the likelihood of harm?

  1 - Very Likely (Could Happen Frequently)

  2 - Likely (Could Happen Occasionally)

  3 - Unlikely (Could Happen but Rare)

  4 - Very Unlikely (Could Happen, probably never will)

• What is the severity?

  1 - Extreme (Death or permanent disability)

  2 - Major (Serious bodily injury or serious work related illness)

  3 - Moderate (Injury or illness requiring casualty treatment)

  4 - Minor (Injury or illness requiring first aid only, no lost time)

• Using risk matrix what is the Severity x Likelihood

  Select 1 - ADDRESS RISK IMMEDIATELY 2 - ADDRESS RISK IMMEDIATELY 3 - ADDRESS RISK IMMEDIATELY 4 - ADDRESS RISK AS SOON AS POSSIBLE 5 - ADDRESS RISK AS SOON AS POSSIBLE 6 - No Action Required 7 - No Action Required

  • 1 - ADDRESS RISK IMMEDIATELY
  • 2 - ADDRESS RISK IMMEDIATELY
  • 3 - ADDRESS RISK IMMEDIATELY
  • 4 - ADDRESS RISK AS SOON AS POSSIBLE
  • 5 - ADDRESS RISK AS SOON AS POSSIBLE
  • 6 - No Action Required
  • 7 - No Action Required

• What Controls are Implemented?

• Rate the risk after controls put in place (Comment mandatory for scores of 5 and above)

  Safe

  At Risk

• Show risk matrix (for reference)

  Off

  On

• 

• Other Hazards

  Yes

  No

  N/A

• Add Risk

Risk

• Select Hazard Type

  Select Interconnected Plant Disabled Safety Systems Partial Isolation Urgency Equipment Identification Hot equipment

  • Interconnected Plant
  • Disabled Safety Systems
  • Partial Isolation
  • Urgency
  • Equipment Identification
  • Hot equipment

• What is the likelihood of harm?

  1 - Very Likely (Could Happen Frequently)

  2 - Likely (Could Happen Occasionally)

  3 - Unlikely (Could Happen but Rare)

  4 - Very Unlikely (Could Happen, probably never will)

• What is the severity?

  1 - Extreme (Death or permanent disability)

  2 - Major (Serious bodily injury or serious work related illness)

  3 - Moderate (Injury or illness requiring casualty treatment)

  4 - Minor (Injury or illness requiring first aid only, no lost time)

• Using risk matrix what is the Severity x Likelihood

  Select 1 - ADDRESS RISK IMMEDIATELY 2 - ADDRESS RISK IMMEDIATELY 3 - ADDRESS RISK IMMEDIATELY 4 - ADDRESS RISK AS SOON AS POSSIBLE 5 - ADDRESS RISK AS SOON AS POSSIBLE 6 - No Action Required 7 - No Action Required

  • 1 - ADDRESS RISK IMMEDIATELY
  • 2 - ADDRESS RISK IMMEDIATELY
  • 3 - ADDRESS RISK IMMEDIATELY
  • 4 - ADDRESS RISK AS SOON AS POSSIBLE
  • 5 - ADDRESS RISK AS SOON AS POSSIBLE
  • 6 - No Action Required
  • 7 - No Action Required

• What Controls are Implemented?

• Rate the risk after controls put in place (Comment mandatory for scores of 5 and above)

  Safe

  At Risk

• Show risk matrix (for reference)

  Off

  On

• 

E- Safely Complete the Task

• Implement the controls and complete the task safely

• If the task cannot be performed safely, do NOT start, contact your supervisor.

• Sign off on completed risk assessment

  Sign