Eastek Hazard ID & Risk Assessment

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel on site

Hazard Identification and Risk Assessment Form

• Hazard Identification

Hazards

• Hazard - what could cause harm?

• Select to add photo if required

  Media

• Task or Area where hazard exists

• Select to add photo if required

  Media

• Potential Outcome - what could happen?

• Likelihood of injury occurring?

  Rare

  Unlikely

  Possible

  Likely

  Almost Certain

• Consequences if injury occurs?

  Insignificant

  Minor

  Moderate

  Major

  Catastrophic

• Risk Score, select to highlight score If risk is High or Extreme, consider if the task can be completed another way

  Drawing

• Control Measures required to reduce the risk of injury

• Frequency of monitoring or action date

• Person Responsible for managing hazard

• Revised Likelihood

  Rare

  Unlikely

  Possible

  Likely

  Almost Certain

• Revised Consequences

  Insignificant

  Minor

  Moderate

  Major

  Catastrophic

• Revised Risk Score, select to highlight score If risk is High or Extreme, consider if the task can be completed another way

  Drawing

• Assessment completed by

  Sign