DYNAMIC RISK ASSESSMENT

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location

  Select NATIONAL OFFICE ZONE 1 WALTHAM LODGE ZONE 2 HACHIKO ZONE 3 ENDAL ZONE 4 LYNX ZONE 5 JAGUAR ZONE 6 LEOPARD ZONE 7 BETSY ZONE 8 NURSERY ZONE 9 LAB BLOCK ZONE 10 APOLLO ZONE 11 WPSI MAIN OFFICE ZONE 12

  • NATIONAL OFFICE ZONE 1
  • WALTHAM LODGE ZONE 2
  • HACHIKO ZONE 3
  • ENDAL ZONE 4
  • LYNX ZONE 5
  • JAGUAR ZONE 6
  • LEOPARD ZONE 7
  • BETSY ZONE 8
  • NURSERY ZONE 9
  • LAB BLOCK ZONE 10
  • APOLLO ZONE 11
  • WPSI MAIN OFFICE ZONE 12

• ANY OTHER PEOPLE OR AREAS AFFECTED

  Yes

  No

  N/A

• Managers and unit leaders in the affected areas must be informed before work commences.

  Yes

  No

  N/A

• Give a brief detailed description of the job or task, include the job number if it has one. Add the additional permit number if it requires one.

• Electricity

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Manual Handling

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Slips, trips and falls

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Restricted access

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Compressed air/gases

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Confined space

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Fire risk

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Moving parts

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Water/Fluids

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Working at height

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Falling objects

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• High/Low temperatures

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Stored energy

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Steam

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Biological

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Fumes/Gas

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Dust

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Environment

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Contamination (foreign body risk to pets)

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Hazardous substances (COSHH)

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Excavation/Demolition

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Static

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Workplace transport

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Any other hazards

  Yes

  No

  N/A

• Risk level/Probibilty/Severity

  Select 1 - Safe - Negligible - Very unlikely - Very minor Injury 2 - Minor - Unlikely - Light Injury 3 - Moderate - Possible - Minor Injury 4 - Major - Likely - Serious Injury 5 - Fatality - Likely/Probable - Fatal Injury

  • 1 - Safe - Negligible - Very unlikely - Very minor Injury
  • 2 - Minor - Unlikely - Light Injury
  • 3 - Moderate - Possible - Minor Injury
  • 4 - Major - Likely - Serious Injury
  • 5 - Fatality - Likely/Probable - Fatal Injury

• Control measures in place

  Select Training - competence Lock out test out - group protection Stored energy controlled and prevented COSHH assessment required - use of chemicals Hand tools and correct tooling for the task Ventilation - exhaust Work environment Time limited task and duration Controlled access/Limited access Barriers and signage Multi person task/Extra supervision Isolation of compressed air Isolation of hydraulics Cleaning and removal of waste - hazards Safe operating procedures - followed and adhered to Safe systems of work - Understood and followed Correct and appropriate PPE Other

  • Training - competence
  • Lock out test out - group protection
  • Stored energy controlled and prevented
  • COSHH assessment required - use of chemicals
  • Hand tools and correct tooling for the task
  • Ventilation - exhaust
  • Work environment
  • Time limited task and duration
  • Controlled access/Limited access
  • Barriers and signage
  • Multi person task/Extra supervision
  • Isolation of compressed air
  • Isolation of hydraulics
  • Cleaning and removal of waste - hazards
  • Safe operating procedures - followed and adhered to
  • Safe systems of work - Understood and followed
  • Correct and appropriate PPE
  • Other

• Description of additional hazards

Do any of the control measures or hazards identified require an additional work permit?

• Yes

  No

  N/A

• Add the relevant additional permits to safely perform the tasks

  Select Hot work permit Confined space permit/risk assessment Sprinkler/alarm/pumps impairment Working at height permit Ionising radiation sources Live electrical work High voltage work LOTO or LOTO exception Excavation (Permit required if more than 200mm depth) Demolition High risk or non routine task Hazardous substances/fluids/COSHH Risk of contact with Asbestos Risk of Legionella Access to a fragile roof or platform Potential explosive atmosphere Environmental - including working outdoors/weather/working near rivers/railway tracks Lifting operations - Manual handling/use of lifting equipment

  • Hot work permit
  • Confined space permit/risk assessment
  • Sprinkler/alarm/pumps impairment
  • Working at height permit
  • Ionising radiation sources
  • Live electrical work
  • High voltage work
  • LOTO or LOTO exception
  • Excavation (Permit required if more than 200mm depth)
  • Demolition
  • High risk or non routine task
  • Hazardous substances/fluids/COSHH
  • Risk of contact with Asbestos
  • Risk of Legionella
  • Access to a fragile roof or platform
  • Potential explosive atmosphere
  • Environmental - including working outdoors/weather/working near rivers/railway tracks
  • Lifting operations - Manual handling/use of lifting equipment

• Are risk assessments and method statements required?

  Yes

  No

  N/A

• Risk assessment and method statements completed and task specific

  Yes

  No

  N/A

I am happy all the necessary measures are in place to safely carry out the job/tasks outlined on this risk assessment

• Add signature

  Sign

• The working area/unit is clean and free of any debris or foreign objects which could be harmful to pets and people. (Photo evidence can be used with the media option if required)

  Yes

  No

  N/A

Job completed

• The job is complete and the area/equipment safe to use

  Sign