Title Page
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Document No.
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Department / Work Area
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Name of Plant/Equipment/Process/Task Performed:
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FP Number
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Reason for Assessment:
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Standard Operations or Maintenance Activities
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Audit Title
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Conducted on
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Personnel
Instructions
INSTRUCTIONS:
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- When assessing the standard operation you must consult with an operator who understands the process/equipment and must consider start-up and shut down steps, cleaning processes etc
- When assessing the maintenance processes you must consult with a maintenance person
- Answer EVERY question by selecting YES, NO or N/A. If there is a hazard identified use the Fonterra Risk Matrix to give the hazard a Risk Rating
- For every hazard identified appropriate control measures are to be implemented, list each hazard in the Risk Control Plan. Enter control actions into First Priority.
- Where a high risk hazard is identified a further Risk Assessment may be required eg Manual Handling, heights etc. this should be entered as an action.
- The Hierarchy of Control must be considered when implementing corrective actions.
- All participants are to sign off on completion.
Plant and Equipment
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NOTES eg Process steps. # employees, shifts, foreseeable concerns.
1. Can anyone become ENTANGLED with a moving part of the plant?
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For example, can anyone's hair, clothing, necktie, jewellery, cleaning brushes, rags, or other materials become entangled with moving parts of the plant eg. Gears, drive shafts, rollers, chains, sprockets, wheels etc?
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1.1 Can anyone become entangled with a moving part of the plant?
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Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
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Notes:
2. Can anyone be CRUSHED due to:
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2.1 Material falling off the plant?
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Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
2.2 Uncontrolled or unexpected movement of the plant or its load?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
2.3 Lack of capacity for the plant to be slowed, stopped or immobilised?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
2.4 The plant tipping or rolling over?
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Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
2.5 Parts of the plant collapsing?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
2.6 Being thrown off or under the plant?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
2.7 Being trapped between the plant and materials or fixed structures?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
2.8 Other crush factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
3. Can anyone be CUT, STABBED or PUNCTURED due to:
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3.1 Coming into contact with sharp or flying objects?
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Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
3.2 The plant, parts of the plant or work pieces disintegrating?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
3.3 Work pieces being ejected?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
3.4 The mobility of the plant?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
3.5 Uncontrolled or unexpected movement of the plant?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
3.6 Contact between the body and hard/sharp edges of tools or work surfaces?
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Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
3.7 Other sharp factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
4. Can body parts be SHEARED between two parts of the plant?
-
4.1 For example, can anyone's body parts be sheared between two parts of the plant or between a part of the plant and a work piece or structure?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
5. Can anyone receive a FRICTION burn due to contact with moving parts of the plant?
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5.1 For example, can anyone be burnt due to contact with moving parts or surfaces of the plant, or material handled by the plant?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
6. Can anyone be STRUCK by moving objects due to:
-
6.1 Uncontrolled or unexpected movements of the plant or material handled by the plant?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
6.2 The plant, parts of the plant or work pieces disintegrating?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
6.3 Work pieces being ejected?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
6.4 The mobility of the plant?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
6.5 Other striking factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
7. Can anyone come into contact with PRESSURISED FLUIDS, GASES OR STEAM?
-
7.1 Can anyone come into contact with pressurised fluid or gases due to plant failure or misuse of plant?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
7.2 Is there a safe isolation procedure?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
7.3 Are there appropriate isolation points available to safely isolate this equipment?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
7.4 Is there sufficient and appropriate bleed points provided to safely de-pressurise equipment for inspection and maintenance?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
7.5 Are tubes, hose fittings and connections suitable for the intended purpose, are they protected from accidental damage?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
7.6 Other factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
8. Can anyone be injured by ELECTRICAL shock or burnt due to:
-
8.1 The plant contacting live electrical conductors?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
8.2 The plant working in close proximity to electrical conductors?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
8.3 Overload of electrical circuits?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
8.4 Untagged, damaged or poorly maintained electrical leads and cables?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
8.5 Water near electrical equipment?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
8.6 Lack of isolation procedures?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
8.7 Other electrical factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
9. Can anyone be injured by EXPLOSION of gases, vapours, liquids, dust etc.
-
9.1 Is it possible for gasses to accumulate and reach LEL as a result of maintenance activities or accidental discharge?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
9.2 Is it possible for pressurised oil or other flammable liquids to be discharged in the proximity of an ignition source as a result of equipment failure or maintenance activity?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
9.3 Is there a risk of flammable solvents or their vapours igniting during maintenance or cleaning operations?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
9.4 Other factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
10. Does the INSTALLED LOCATION present a hazard from the following?
-
10.1 Does the location of the plant make it vulnerable to direct or consequential damage from vehicle accident?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
10.2 Does the location and nature of the plant near walk or access ways make it vulnerable to damage from persons carrying equipment or wheeling trolleys etc?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
10.3 Is there a direct or consequential risk of damage to the plant from failure of other equipment installed in the area?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
10.4 Is there a risk of direct or consequential damage from forklift traffic?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
10.5 Is there a risk of damage to the plant due to collapse of buildings or other nearby structures?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
10.6 Is there a risk to the site or adjacent properties should an over pressure safety device activate?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
10.7 Can environmental conditions cause to fall and/or collapse?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
10.8 Is the sufficient access and egress during normal maintenance and emergency conditions?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
10.9 Are there overhead hazards?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
10.10 Other factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
11. Guarding and Emergency Controls
-
If guarding is inadequate or not to Australian Standards (AS4024) refer to Roger Lim assessment of a specific Machine Guarding Risk Assessment in accordance with AS4024
-
11.1 Are all high risk areas adequately guarded?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
11.2 Are fixed guards secured where a specifically designed tool is required for access?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
11.3 Is interlocked guarding or sensing devices working effectively? I.e. Equipment is de-energised when activated?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
11.4 Do E-Stops adequately stop equipment?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
11.5 Do the operators understand what energy sources the controls isolate? ( E-Stops, interlocked guards, etc)
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
11.6 Are E-stops suitably positioned for ease of access by operators?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
11.7 Are E-stops appropriately designed and coloured in accordance with Australian Standards?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
11.8 Is the restarting of E-Stops buttons adequate?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
11.9 Other factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
Systems of Work
12. Can anyone using the plant or near the plant, SLIP, TRIP or FALL due to:
-
12.1 Uneven or slippery work surfaces?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
12.2 Poor housekeeping eg unused materials in the vicinity of the plant, spillage not cleaned up?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
12.3 Obstacles being placed in vicinity of the plant ?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
12.4 Other factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
13. Can anyone FALL FROM HEIGHT due to:
-
If a hazard is identified you must complete a Work at Heights Risk Assessment.
-
13.1 Lack of proper work platforms?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
13.2 Lack of proper stairs or ladders? (Refer to stairs assessment)
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
13.3 Lack of guard rails or other suitable edge protection?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
13.4 Unprotected holes, penetrations or gaps?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
13.5 Poor floor or walking surfaces, such as the lack or a slip resistant surface?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
13.6 Steep walking surfaces?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
13.7 Collapse of the supporting structure?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
13.8 Other factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
14. Hazardous Manual Handling. Are any of the following factors present?
-
If a hazard is identified you must complete a Manual Handling Risk Assessment
-
REPETITIVE means the movement or force is performed more than twice a minute.
SUSTAINED means the posture or force is held for more than 30 seconds at a time -
14.1 Twisting, stooping, awkward or one sided postures
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.2 Fixed, sustained, rigid, prolonged (including prolonged sitting) postures of part or all of the body
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.3 Unvaried, repetitive movements
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.4 Handling loads away from the body
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.5 Using high or sustained force
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.6 Handling heavy or awkward loads
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.7 Whole body vibration (eg driving where bumps occur, leaning on vibrating equipment) or upper limb vibration (eg using vibrating hand tools)
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.8 Continuous handling without a break
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.9 high speed or long duration or time pressures
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.10 Work environment factors (eg lighting, heat, cold, walking surfaces, steps, ladders)
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.11 Handling of people or animals
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
14.12 Other factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
15. Can anyone be SUFFOCATED due to lack of oxygen, restricted space or atmospheric contamination?
-
15.1 Uncontrolled discharge of gas in an enclosed area?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
15.2 Discharge of gas from a safety device?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
15.3 Failure of valves, Pipework or fittings?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
15.4 Is there an accessible means of escape from the area should an unexpected discharge of gas occur?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
15.5 Are there any 'confined spaces'? If yes complete a Confined Space Risk Assessment.
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
15.6 Other factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
16. Can anyone come in contact with objects at HIGH or LOW TEMPERATURES?
-
16.1 Can anyone be injured by contact with objects at high or low temperatures?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
16.2 Can anyone be injured by the release of steam?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
16.3 Can anyone be injured by exposure to fire?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
16.4 Other burn risks not considered?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
17. SIGNAGE
-
17.1 Are appropriate signs posted for hazards in the area (eg PPE required)?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
17.2 Are pipework, electrical conduits and switchboards colour coded or labelled?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
17.3 Are nip/pinch points identified by appropriate labels/signage?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
18. Does the SYSTEM OF WORK present a hazard from the following:
-
18.1 Insufficient or inadequate procedures provided by the designers and/or supplier of the plant?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
18.2 Insufficient competency of people using/operating the plant?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
19. Can anyone be injured or suffer Ill health from exposure to the following WORK ENVIRONMENT factors:
-
19.1 Inadequate air quality or ventilation?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
19.2 Hot conditions?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
19.3 Cold conditions?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
19.4 Noise? (Review Noise Assessment)
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
19.5 Inadequate lighting?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
19.6 Outdoor work?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
19.7 Radiation?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
19.8 Communicable diseases? Eg Zoonosis, influenza etc
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
19.9 Other work factors not mentioned?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
20. Can anyone be injured or suffer ill health from exposure to CHEMICALS:
-
20.1 Toxic gases, fumes, dusts or vapours?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
20.2 Hazardous substances?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
20.3 Dangerous goods?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
20.4 Contaminated equipment?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
20.5 Are Safety Data Sheets readily available? (If applicable)
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
21. Isolation / Lock Out Tag Out LOTO
-
21.1 Are lock out points accessible?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
21.2 Are there LOTO procedures in place?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
21.3 Are the operators familiar with LOTO requirements?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
22. Human Factors
-
22.1 Lack of training, qualifications, licensing or competency?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
22.2 Lack of supervision?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
22.3 Working alone?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
22.4 Stress, victimisation, bullying, harassment from internal or external sources?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
22.5 Consideration of human error or human behaviour?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
22.6 Fatigue related to shift work, pressure cycles, travelling or driving etc?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
22.7 Other hazards not listed on this form?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
23. Does the design consideration relating to human capabilities present a hazard from the following?
-
23.1 Warnings and signals/alarms easy to detect?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
23.2 Reaction time required to current situation reasonable, particularly in noisy environments?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
23.3 Information overload, particularly during an emergency?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
23.4 Use of more than one sense where information is vital in some situations. Eg visual and audible?
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
23.5 Is there a high reliance on any of the senses for operation, safety, that may be a hazard if a person is distracted, unwell, has a deficiency in characteristics, eg hearing, sight, smell etc
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
24. Any other hazards not mentioned?
-
24.1
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
-
24.2
-
Refer to Fonterra Risk Matrix, consider LIKELIHOOD and REASONABLY EXPECTED WORST CASE to determine Risk Rating
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Notes:
Risk Control Plan
RISK CONTROL PLAN
-
1. Eliminate. 2. Substitute. 3. Isolate. 4. Engineering. 5. Administration. 6. PPE
-
Hazard No.
-
Describe the Hazard and Possible Risk
-
Initial Risk Score
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Describe the Control Solutions to be Implemented
-
Responsible for Completing Action
-
Due Date
-
Residual Risk Score Assessed After Completion
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Hazard No.
-
Describe the Hazard and Possible Risk
-
Initial Risk Score
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Describe the Control Solutions to be Implemented
-
Responsible for Completing Action
-
Due Date
-
Residual Risk Score Assessed After Completion
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Hazard No.
-
Describe the Hazard and Possible Risk
-
Initial Risk Score
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Describe the Control Solutions to be Implemented
-
Responsible for Completing Action
-
Due Date
-
Residual Risk Score Assessed After Completion
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Hazard No.
-
Describe the Hazard and Possible Risk
-
Initial Risk Score
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Describe the Control Solutions to be Implemented
-
Responsible for Completing Action
-
Due Date
-
Residual Risk Score Assessed After Completion
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Hazard No.
-
Describe the Hazard and Possible Risk
-
Initial Risk Score
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Describe the Control Solutions to be Implemented
-
Responsible for Completing Action
-
Due Date
-
Residual Risk Score Assessed After Completion
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Hazard No.
-
Describe the Hazard and Possible Risk
-
Initial Risk Score
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Describe the Control Solutions to be Implemented
-
Responsible for Completing Action
-
Due Date
-
Residual Risk Score Assessed After Completion
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Hazard No.
-
Describe the Hazard and Possible Risk
-
Initial Risk Score
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Describe the Control Solutions to be Implemented
-
Responsible for Completing Action
-
Due Date
-
Residual Risk Score Assessed After Completion
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Hazard No.
-
Describe the Hazard and Possible Risk
-
Initial Risk Score
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
-
Describe the Control Solutions to be Implemented
-
Responsible for Completing Action
-
Due Date
-
Residual Risk Score Assessed After Completion
- L1
- L2
- L3
- L4
- L5
- L6
- M7
- M8
- M9
- M10
- M11
- M12
- M13
- S14
- S15
- S16
- S17
- S18
- S19
- H20
- H21
- H22
- H23
- H24
- H25
Review and Sign Off
REVIEW AND SIGN OFF
ASSESSMENT TEAM:
-
LEAD ASSESSOR:
-
Position:
-
CONSULTANT(S):
-
Position:
-
HSR(s):
-
Position:
-
OTHER:
-
Position:
CONSULTED WITH:
-
OPERATORS:
-
Position:
-
MAINTENANCE PERSONNEL:
-
Position:
-
OTHER:
-
Position:
REVIEWED BY:
-
AREA MANAGER:
-
Position:
-
SITE MANAGER:
-
Position:
-
HSW LEAD:
-
Position:
-
OTHER:
-
Position:
