Audit

Department / Proses:

Date assess/review:

HIRADC Assessor:

HIRADC Assessment

Activity

Activity

Activity:

Add media
Hazard

Hazard Classification

Hazard Description

Effect

Existing Control

Probability

Severity

Risk Rating

Significant Hazard

Control Measure

Control Measure

Due date:

Departmental Program?

Person in charge:

Status of the Program

Department Head/Representative Approval
Approved by:
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.