Title Page
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Site conducted
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Student Name
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Conducted on
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Prepared by
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Location
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Job Description
Risk Assessment
Risk Assessment
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Is there a completed Risk Assessment on site?
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Please complete the risk assessment for this job. Click the + button below to add a hazard and answer all questions. Please ensure you document all hazards applicable.
Risk Matrix and Hierarchy of Controls
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Risk Matrix Reference:
Hazard
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Description of hazard
- Working at height
- Slips, Trips and Falls
- Dust/Fumes
- Noise/Vibration
- Moving Parts
- Falling Objects
- Manual Handling
- Material Handling
- Tools Handling
- Harmful Substances
- Unshielded Processes
- Other People
- Poor Lighting
- Electricity
- Heat/Fire/Explosion
- Other (State Below)
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Photo of hazard
Risk Rating (Prior to control measures)
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Likelihood
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Severity
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Risk Rating is - 25 = Extreme
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Risk Rating is - 20 = Extreme
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Risk Rating is - 15 = Extreme
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Risk Rating is - 10 = High
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Risk Rating is - 5 = High
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Severity
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Risk Rating is - 20 = Extreme
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Risk Rating is - 16 = Extreme
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Risk Rating is - 12 = High
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Risk Rating is - 8 = High
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Risk Rating is - 4 Moderate
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Severity
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Risk Rating is - 15 = Extreme
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Risk Rating is - 12 = Extreme
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Risk Rating is - 9 = High
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Risk Rating is - 6 = Moderate
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Risk Rating is - 3 = Low
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Severity
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Risk Rating is - 10 Extreme
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Risk Rating is - 8 = High
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Risk Rating is - 6 = Moderate
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Risk Rating is - 4 = Low
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Risk Rating is - 2 = Low
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Severity
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Risk Rating is - 5 = High
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Risk Rating is - 4 = High
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Risk Rating is - 3 = Moderate
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Risk Rating is - 2 = Low
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Risk Rating is - 1 = Low
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Comments/ observations
Risk Rating (After control measures)
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Control Measure to be implemented
- two man working
- Barriers
- Fall arrest system
- Boots
- Masks/Respirator
- Gloves
- Goggles
- Overalls
- Training
- MEWP
- Scissor Lift
- Dust Extraction
- Signage
- Marshall
- Isolation LOTO
- Additional Lighting
- Other (Please State Below)
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Likelihood
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Severity
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Risk Rating is - 25 = Extreme
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Risk Rating is - 20 = Extreme
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Risk Rating is - 15 = Extreme
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Risk Rating is - 10 = High
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Risk Rating is - 5 = High
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Severity
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Risk Rating is - 20 = Extreme
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Risk Rating is - 16 = Extreme
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Risk Rating is - 12 = High
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Risk Rating is - 8 = High
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Risk Rating is - 4 Moderate
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Severity
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Risk Rating is - 15 = Extreme
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Risk Rating is - 12 = Extreme
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Risk Rating is - 9 = High
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Risk Rating is - 6 = Moderate
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Risk Rating is - 3 = Low
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Severity
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Risk Rating is - 10 Extreme
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Risk Rating is - 8 = High
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Risk Rating is - 6 = Moderate
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Risk Rating is - 4 = Low
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Risk Rating is - 2 = Low
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Severity
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Risk Rating is - 5 = High
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Risk Rating is - 4 = High
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Risk Rating is - 3 = Moderate
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Risk Rating is - 2 = Low
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Risk Rating is - 1 = Low
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Comments/ observations
Completion
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Signature
Completed
Student Signature
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By the act of making this submission I am declaring that this is all my own work and that: • The work has not, in whole or in part, been knowingly submitted elsewhere for assessment • Where the submission includes work from a previous assessment this has been identified • Where materials have been used from other sources it has been properly acknowledged • If this statement is untrue, I acknowledge that an assessment offence has been committed Attention is drawn to the plagiarism, collusion and cheating policies of both the centre and of the awarding body. Proven incidents of plagiarism, collusion or cheating can result in a student being withdrawn from a qualification. I confirm that I have read and understood the above statements on plagiarism and collusion. I confirm that I have not committed plagiarism when completing the work contained in this evidence, nor have I colluded with another student in the preparation and production of this work. I am satisfied with the way the learning activity/Assessment(s) was conducted and with the outcome(s). I agree that the information provided here is an accurate account of what has taken place
Expert Witness Signature
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As the expert witness I can confirm that all the work carried out in this unit has been done by the student named above under my supervision to the required standards.
Work Based Tutor Signature
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I agree that the information provided here is an accurate account of what has taken place.