Title Page
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Task / Process Reviewed
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Site
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Risk Assessment No. / Risk Manager Review No.
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Conducted on
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Scope of Assessment
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Assessment Leader and Team Members
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Description of area/process/equipment/task:
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Take a picture of the plant/equipment being assessed
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For each identified hazard, use the tables below to assess the risk and assist in the selection of appropriate controls.
Entanglement
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Can a person's hair, clothing, gloves, necktie, jewellery, cleaning brush or rag become entangled with moving parts of the plant or equipment?
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Crushing
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Can a person be crushed due to:<br>a) Falling objects/materials?<br>b) Uncontrolled or unexpected movement of the plant, equipment or loads?<br>c) Lack of capacity for plant or machinery to be slowed, stopped or immobilised?<br>d) Plant or equipment tipping or rolling over?<br>e) Parts of the plant or equipment collapsing?<br>f) Coming into contact with moving parts during testing, inspection, operation, maintenance, cleaning or repair?<br>g) Being thrown off or under the plant or equipment?<br>h) Being trapped beneath plant, materials or fixed structures?<br>If yes for mobile plant, complete traffic management risk assessment (03-20-04) and insert assessment number.<br> <br>If yes for stacking and/or racking of materials, complete stacking (03-19-07) and/or racking(03-19-06) risk assessment and insert assessment number.
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Cutting or Stabbing
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Can anyone be cut, stabbed or punctured due to:<br>a) coming into contact with sharp or flying objects?<br>b) coming into contact with moving parts of the plant during testing, inspection, operation, maintenance, cleaning or repair of the plant?<br>c) the plant, parts of the plant or work pieces disintegrating?<br>d) work pieces being ejected?<br>e) the mobility of the plant?<br>f) uncontrolled or unexpected movement of the plant?
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Shearing
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Can anyone’s body parts be sheared between any two parts of the plant, or between a part of the plant and a work piece or structure?
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Friction
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Can anyone be burnt due to contact with moving parts or surfaces of the plant, or material handled by the plant?
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Striking
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Can anyone be struck by moving objects due to:<br>a) uncontrolled or unexpected movement of the plant?<br>b) the plant, parts of the plant or work pieces disintegrating?<br>c) work pieces being ejected?<br>d) mobility of the plant?<br> <br>If yes for mobile plant, complete traffic management risk assessment (03-20-04) and insert assessment number.
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
High Pressure Fluid or Gas
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Can anyone come into contact with fluids or gas under high pressure, due to plant failure or misuse of the plant?
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Electrical
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Can anyone be injured by electrical shock or burn due to:<br>a) the plant contacting live electrical conductors?<br>b) the plant working in close proximity to electrical conductors?<br>c) overload of electrical circuits?<br>d) damaged or poorly maintained electrical leads and cables?<br>e) damaged electrical switches?<br>f) water near electrical equipment?<br>g) lack of isolation procedures?
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Explosion
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Can anyone be injured by explosion of gasses, vapours, liquids, dusts or other substances, triggered by the operation of the plant or by material handled by the plant?<br><br>
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Slipping and Tripping
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Can anyone using the plant, or in the vicinity of the plant, slip, trip or fall due to:<br>a) uneven or slippery work surfaces?<br>b) poor housekeeping e.g. offcuts, cables, hoses obstructing walkways, spills not cleaned up?<br>c) obstacles being placed in the vicinity of the plant?
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Falling
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Can anyone fall from a height due to:<br>a) lack of a proper work platform?<br>b) lack of proper stairs or ladders?<br>c) lack of guardrails or other suitable edge protection?<br>d) unprotected holes, penetrations or gaps?<br>e) poor floor or walking surfaces, such as the lack of a slip-resistant surface?<br>f) steep walking surfaces?<br>g) collapse of the supporting structure?<br>If yes, complete working at heights risk assessment (03-10-04) and insert assessment number.
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Manual Tasks
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Can anyone be injured due to:<br>a) poorly designed seating?<br>b) poorly designed operator controls?<br>c) high forces?<br>d) repetitive movements? <br>e) awkward body posture or the need for excessive effort?<br>f) Vibration?<br>If yes, complete manual tasks risk assessment (03-01-04) and insert assessment number.
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Confined Spaces
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Does the area/task involve a confined space?<br>If yes, complete confined space risk assessment (03-08-05) and insert assessment number.
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Temperature (thermal comfort)
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Can anyone suffer ill health due to extreme temperature or change of weather?<br>If yes, complete working in extreme temperatures risk assessment (03-22-03) and insert assessment number.
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Chemicals
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Can anyone suffer ill health or health loss due to exposure to chemicals?<br>If yes, complete chemical risk assessment (03-35-04a/b) for each identified chemical and insert assessment number.
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Other Hazards
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Can anyone be injured due to:<br>a) noise?<br>b) inadequate or poorly placed lighting?<br>c) failure to select plant that is suitable for its intended use?<br>d) contact with hot or cold parts of plant?<br>e) exposure radiation or other emissions released by the plant?<br>f) lack of operator competency?<br>g) Exposure to asbestos?<br>h) Other factors not mentioned above?
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What is the hazard description?
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What are the current controls?
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What is the current risk score?
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What action is required? (Include proposed controls)
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What is the future risk score?
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What is the risk manager action item number?
Persons Consulted
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What are there names?
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How did you consult with them? (Email, meeting, phone call or toolbox etc.)
Reviewer Details
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Name;
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Position;
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Add signature
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Select date
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Scheduled Re-assessment
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Risk Manager Action ID;