Hazard Indentification/Risk Assessment

• Description of Hazard OR Work Process

• Document No.

• Location

• Date Identified

  Date

• Hazard Identified By :

• Conducted By :

Hazard Category

• Eliminate

• Isolate

• Minimise

Risk of Injury

• High

• Medium

• Low

Hazard Controls

• Control 1

• Control 2

• Control 3

• Control 4

• Control 5

Control Implementation

• Controls Implementation Date

  Date

• Implemented By

  Sign

Hazard Control Review

• Is Control Satisfactory

  Select Yes No N/A

  • Yes
  • No
  • N/A

• If no , what action should be taken

• Review Date

  Date

• Reviewed By

  Sign

Annual Review

• Select date

  Date

• Add signature

  Sign