Pinnacle Construction Materials - Site Specific Risk Assessment

• Client / Site

• Contract No

• Start Date

  Date

• Prepared by

• Location
  Address

• Instructions:
  -------------------------------------
  
  1. Answer "Yes", "No", "N/A" for the questions below.
  2. Fill out required fields and answer other questions as needed.
  3. Add photos and notes by clicking on the paperclip icon.
  4. To add a Corrective Measure, click on the paperclip icon then choose "Add Action". Provide a description, assign it to a member, set priority and set the due date.
  5. Complete the audit by providing a digital signature.
  6. Share your report by exporting as PDF, Word, Excel or Web Link.
  
  

RISK ASSESSMENT

• 

• Risk After Control Measures Guide:
  
  

  

• Are there any overhead electricity cables within the site?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Are there any other overhead cables within the site?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Are there any other overhead obstructions (trees, bridges, gantries etc)?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Is planning to be carried out > 100mm?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Are any other excavations required?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Has consideration been given to controlling pedestrians/ public?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Has a safe access and egress been identified?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Has a holding area been identified for delivery vehicles?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Are there any restrictions on vehicle access or safe operation?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Is any access required to property?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Are any permits to work required?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Has an approved traffic management company been assigned?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures
  

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Has traffic management been planned in accordance with the site requirements?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Have all required subcontractors been approved by Support Services?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Have subcontractors provided us with an adequate method statement and risk assessments for their works?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Are any slip/trip/fall hazards present?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Are any other works being carried out within the site?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Are there restrictions on the hours of working for the site?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Is the work to be carried out at night? If so has consideration been given to suitable lighting?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Are there any requirements for additional banksmen?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Have the induction arrangements been identified and arranged?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

• Are there any other hazards which are not listed above?

  Yes

  No

  N\A

• Who is at Risk?

• How is the risk to be controlled ?

• Risk After Control Measures

• Severity

  5 - Major

  4 - High

  3 - Medium

  2 - Low

  1 - Nil

• Probability

  5 - Likely

  4 - Probable

  3 - Possible

  2 - Remote

  1 - Improbable

• Risk

  Trivial

  Low Risk

  Medium Risk

  High Risk reconsider measures

COMPLETION

• Supervisor's Name and Signature

  Sign

• Foreman's Name and Signature

  Sign

• Assessment Carried out By :

  Sign