General Risk Assessment

• Conducted on

  Date

• Prepared by

• Location
  Address

General

• Enter description of procedure, task or worksite being assessed

Hazards, Risks and Controls

• Click Add Hazard (+) after you have observed and identified a hazard

Hazard

Hazard

• Description of hazard

• Photo of hazard (optional)

  Media

Initial risk rating

• Initial consequence

  Catastropohic

  Critical

  Marginal

  Negligible

• Initial likelihood

  Frequent

  Probable

  Occasional

  Remote

  Improbable

• Initial risk rating

  High

  Serious

  Medium

  Low

Controls

• Select control measures

  Select Elimination Substitution Engineering Controls Administrative Controls PPE Other

  • Elimination
  • Substitution
  • Engineering Controls
  • Administrative Controls
  • PPE
  • Other

• Enter other control measures

Residual risk rating

• Residual consequence

  Catastropohic

  Critical

  Marginal

  Negligible

• Residual likelihood

  Frequent

  Probable

  Occasional

  Remote

  Improbable

• Residual risk rating

  High

  Serious

  Medium

  Low

References

• Risk Matrix Reference

  

• Exposure Descriptions

  

• Hierarchy of Controls Reference

  

Completion

• Recommendations

• Inspector's Full Name & Signature

  Sign