Hazard Identification and Risk Assessment HIRA

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Operating Hazards

• Material falling off the plant?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Uncontrolled or unexpected movement of the plant or associated materials?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Brake Failure?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Roll over?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Part of the plant collapsing?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Being caught between parts of the plant or other objects?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Plant, parts or plant or work pieces disintegrating?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Contact with sharp or flying objects at any time?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Other?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Stored Energy

• Can anyone using the plant or in the vicinity of the plant be injured due to the uncontrolled /unexpected release of stored energy?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Friction / Heat

• Can a person be burnt due to contact with plant or associated material that is hot due to friction or other sources?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

High pressure fluids/gases/compressed air

• Can anyone come into contact with fluids or gases under high pressure due to failure or misuse of the plant?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Can anyone be injured due to flammable hydraulic fluid coming into contact with hot metal?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Explosions

• Can anyone be injured by explosion of gases, vapours, liquids, dusts molten metal or other substances triggered by the operation of the plant or by material handled by the plant?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Electrical

• Can anyone be injured by electrical shock or burnt from arcing due to working in close proximity to electrically alive conductors?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Can tools or equipment be affected by unexpected behaviour?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Earth Potential?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Area Hazards

• Can anyone using the plant or in the vicinity of the plant slip, trip or fall?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Falls

• Do fall exposures exit?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Isolations

• If task requires isolation can anyone be injured due to isolations?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Mobile Equipment

• Is anyone using the plant or in the vicinity of the plant exposed to movements of mobile equipment?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Confined Space

• Can anyone be injured due to confined spaces? I.e. lack of risk assessment, procedures other hazards.

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Guarding

• Can anyone be injured due to guards, barricades and shields not installed/ poor condition or exposed?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Ergonomics

• Can anyone be injured due to poor ergonomics?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Noise

• Can anyone be affected by noise?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Safe Access / Exit

• Can anyone be injured due to restricted space, inadequate emergency stops or poor access or exit from plant or equipment?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Emergency Planning & Response

• Are personnel exposed to risk due to lack of emergency exits, fire extinguishers, fire detection systems to training?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Workplace Conditions

• Can anyone be suffocated due to lack of oxygen, atmospheric conditions, temperature extremes or radiation?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Chemicals / Hazardous Materials & Wastes

• Can anyone be affected due to exposure to dusts, fumes, asbestos or other chemicals?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Administration

• Are permits required for any work completed?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Are inspections processes in place for routine checks on equipment used in task?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Environmental Aspects & Impact

• Is there potential for air emission? (dusts, fumes, gas, odour or vapour)

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Is there potential for a surface water emission?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Is there potential for soil contamination?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

• Is there potential for flora or fauna injury or damage?

  Safe

  At Risk

  N/A

• Level of Risk (1 Low / 2 Moderate / 3 Significant / 4 High)

Approval Section

• Construction Manager Approval

  Yes

  No

  N/A

• Add signature

  Sign

• Health and Safety department Approval

  Yes

  No

  N/A

• Add signature

  Sign

• Client Approval

  Yes

  No

  N/A

• Add signature

  Sign