Information
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Site conducted
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Document No.
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Audit Title
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Site/Facility Code
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Conducted on
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Conducted By
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Prepared by
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Location
1.0 Entanglement
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1.1 Can clothing, gloves, jewellery or any other items become entangled in the moving parts of this item?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk Score with controls?
2.0 Crushing - can anyone be crushed due to?
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2.1 Material falling off plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls?
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2.2 Uncontrolled or unexpected movement of plant or its load?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls?
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2.3 Lack of capacity for the plant to be slowed, stopped or immobilised?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls?
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2.4 The plant tipping or rolling over?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls?
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2.5 Parts of the plant collapsing?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls?
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2.6 Coming in contact with moving parts of the plant during testing inspection, operation & maintenance?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls?
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2.7 Cleaning or repair?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls?
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2.8 Being thrown off or under the plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls?
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2.9 Being trapped between the plant and materials or fixed structures?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls?
3.0 Friction & Abrasion
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3.1 Can anyone be burnt due to contact with moving parts or material handled by the plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls?
4.0 Shear
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4.1 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?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures in place?
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Risk score with controls
5.0 Cutting, Stabbing & Puncturing - Can anyone be cut, stabbed or punctured due to?
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5.1 Coming in contact with sharp or flying objects
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current Control Measures
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Risk score with controls
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5.2 Coming in contact with moving parts of the plant during testing, inspection, operation, maintenance, cleaning or repair of the plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current Control Measures
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Risk score with controls
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5.3 The plant, parts of the plant work pieces disintegrating?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current Control Measures
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Risk score with controls
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5.4 Work pieces being ejected?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current Control Measures
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Risk score with controls
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5.5 The mobility of the plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current Control Measures
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Risk score with controls
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5.6 Uncontrolled or unexpected movement of the plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current Control Measures
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Risk score with controls
6.0 Striking - Can anyone be struck by moving objects due to?
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6.1 Uncontrolled or unexpected movement of or material handled by the plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
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6.2 The plant, part of the plant work pieces disintegrating?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
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6.3 Work pieces being ejected?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
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6.4 Mobility of the plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
7.0 High Pressure Fluid
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7.1 Can anyone come into contact with fluids under high pressure, due to plant failure or misuse of the plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures
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Risk score with controls
8.0 Electrical - Can anyone be injured by electrical shock or burn due to?
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8.1 The plant contacting live electrical conductors?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
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8.2 The plant working in close proximity to electrical conductors?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
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8.3 Over loads of electrical circuits?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
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8.4 Damaged or poorly maintained electrical leads and cables?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
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8.5 Damaged electrical switches?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
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8.6 Any water near electrical equipment?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
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8.7 Lack of isolation procedures?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures?
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Risk score with controls?
9.0 Explosion
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9.1 Can anyone be injured by explosion of gases, vapours, liquids, dust or other substances, triggered by the operation of the plant or by material handled by the plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures
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Risk score with controls
10.0 Slipping, Tripping & Falling - Can anyone using plant or in the vicinity of plant, slip or fall due to?
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10.1 Uneven or slippery work surfaces?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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10.2 Obstacles placed in the vicinity of the plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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10.3 Poor housekeeping eg. offcuts, cables, hoses, obstructing walkways, piles not cleaned up?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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Any other factors not mentioned?
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Can anyone fall from a height due to the following:
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10.5 Lack of proper work platform?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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10.6 Lack of proper stairs or ladders?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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10.7 Lack of guard-rails or other suitable edge protection?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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10.8 Unprotected holes, penetrations or gaps?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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10.9 Poor floor or walking surfaces such as the lack of slip-resistant surfaces?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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10.10 Steep walking surfaces?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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10.11 Collapse of supporting structure?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
11.0 Ergonimics / Manual Handling - Can anyone be injured due to?
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11.0 Poorly designed seating?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures
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Risk score with controls
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11.2 Poorly designed operators controls?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures
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Risk score with controls
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11.3 Repetitive body movement?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures
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Risk score with controls
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11.4 Awkward body posture or the need for excessive effort?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures
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Risk score with controls
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11.5 Design deficiency causing mental or psychological stress?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures
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Risk score with controls
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11.7 Vibration?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures
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Risk score with controls
12.0 Extremes of Temperature
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12.1 Can anyone come into contact with objects at high temperatures?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures
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Risk score with controls
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12.2 Can anyone suffer ill-health due to high or low temperatures?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk Score
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Current control measures
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Risk score with controls
13.0 Chemicals, Noise Vibration & Airborne Contaminants - Can anyone be injured or suffer ill-health from exposure to?
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13.1 Chemicals?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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13.2 Biological?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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13.3 Toxic gases or vapours?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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13.4 Fumes?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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13.5 Dusts?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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13.6 Noise?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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13.7 Vibration?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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13.8 Radiation?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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13.9 Pressure or vacuum?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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13.10 Hazardous materials? eg. Asbestos
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
14.0 Traffic - Can anyone be injured by exposure to traffic when?
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14.1 Working at the site (traffic within 3 metres of worksites)
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
15.0 Combination of Hazards - Can anyone be injured due to unexpected start-up, unexpected over-run/overspeed from?
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15.1 Failure/disorder of the control systems? eg hydraulic system
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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15.2 Restoration of energy supply after interruption?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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15.3 External influences on electrical equipment?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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15.4 Errors made by the operator?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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15.5 Errors in software?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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Any other environmental factors? eg wind, gravity
16.0 Other Hazards - Can anyone be injured due to?
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16.1 Entry into confined space?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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16.2 Failure to select plant that is suitable for its intended use?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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16.3 Contact with hot or cold parts of plant?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls
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16.4 Lack of operator competency?
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Gippsland Water Corporate Risk Matrix
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Likelihood
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Consequence
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Risk score
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Current control measures
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Risk score with controls