HBT FO Quick Risk Assessment Form Rev 00

Title Page

SBE
Conducted on
Name
Scope of visit
Field visit site
Field visit type
Duration of visit
- 1 day
- < 1 Week
- < 1 Month
- < 3 Month
- < 6 Month
- < 1 Year
- > 1 year
Location

INSTRUCTIONS

1. Please answer the questions provided below.
2. Add Photos and Notes by clicking on the Paperclip icon.
3. To add a Corrective Measure click on the Paperclip icon then ""Add Action"", provide a description, assign to a member, set priority, and due date.
4. Complete audit by providing digital signature.
5. Share your report to your Manager by exporting as PDF, Word, Excel or Web Link.

Other Information

Field Visit Purpose /Project Title (Name of customer/dealer + Purpose of visit)
Brief task description (List the details about scope of work at customer site)
Supporting links:
Detailed Risk assessment form for High Risk
5.3.1 GUIDELINES TO COMPLETE RISK ASSESSMENT FORM
Incident reporting Procedure
Safety observation System
Learning Hub
HBT Field Operations SharePoint

Quick Risk Assessment Tool - High Risk Activities

Energized or Pressurized Equipment Refer machine specific Lockout & Tag out procedure Check with customer for energy sources of equipment . Apply LOTO for zero energy to all energy sources of the equipment Anticipate residual pressure or fluid Avoid auto-refrigeration when depressurizing Check and ensure zero energy before working on equipment. Check for residual energy in equipment. Authorize & trained employees only allowed to perform this task. Follow Zero energy work permit as applicable. Any Question do reach out to your Manager or Regional HSE leader.
Confined Space Entry (e.g.: tanks, trash compactors, ventilation systems) Discuss confined space entry safe work practice Conduct atmospheric testing Monitor access or entry Develop rescue plan Follow Confined space work permit Requirements, Mandatory confined space training Detailed Risk assessment require before performing this task. Do reach out to your Manager or HSE leader. Inform to your Manager about the activity.
Work at Heights > 1.2m or 4 ft. Or any work on roof or above False celling Conduct detailed fall risk assessment Discuss working at heights safe work practice Use Fall protection and Safety Helmet Verify fall restraint and arrest equipment certification Follow Work at height Permit Requirments Mandatory online HSE Working at Height training Detailed Risk assessment require before performing this task. Do reach out to your Manager or HSE leader. Inform to your Manager about the activity.
High Energy or High Voltage Live Work Restrict access Discharge equipment and make electrically dead, LOTO Authorized & qualified employee to work on electrical system. Use of Arch flash PPE suit Follow Live electrical work permit Requirements Detailed Risk assessment require before performing this task. Do reach out to your Manager or HSE leader. Inform to your Manager about the activity. Use of electrical hand gloves of require class before performing the task.
Hot work (example: Welding, Grinding) Establish safe distance from combustible material. Fire watch identified Inspect and use suitable machines/ equipment’s Firefighting equipment availability at site for emergency Follow Hot Work Permit (Refer Hyperlink)
Work in Asbestos-Containing areas Confirm with customer where is asbestos may be present Ensure it is clearly identified & communicate to all team members Ensure any asbestos is in a safe condition (Bonded /Encapsulated etc.). If in any doubt then cease work and leave the area immediately. Ensure no Asbestos has the potential to be disturbed from activity performed by Honeywell employees.

Quick Risk Assessment Tool - Medium Risk Activities

Use of portable Electrical Equipment Inspect equipment for condition and test date Protect electrical leads from impact or damage Only Trained and authorized personnel permitted to operate Portable electrical equipment.
Use of Hand tools Ensure that the correct tools are available and used for the job. Inspect hand tool before each use. Do not use the defective or non standard tools.
Work on Ladders or elevated platforms > 1.2 m or 4 ft. and < 3m or 10 ft. Discuss safe work practices: - 4:1 climbing angle, - facing the ladder ,- prevent ladder slipping and tripping - maintain 3 points of contact Use the right kind of ladder or platform Check & ensure ground surface is level. Inspect the ladder or platform before use Use Safety Helmet , Ladder attendant
Working on false floor Inspect the floor condition for unsafe condition like loose tiles or broken tiles. Install barricading & Place caution sign for unsafe areas & for edge protection. Mandatory use of safety shoes & Safety Helmet.
Material Lifting Confirm lifting equipment & operator condition and certification Use signs and barriers to restrict entry Do not walk on the mobile equipment path. Don not operate unless authorized
Accessing the under construction site/Operation area Understand & follow the customers site specific Safety rules. Use of Safety helmet & safety shoes mandatory. Do not access restricted or work in progress areas. Check for unsafe conditions & unsafe actions around you & highlight to the customer or dealer representative. Stop work & leave the site immediately if unsafe.
Lone working Communicate work schedule. Let people know where you are working Ensure a Lone Working Risk Assessment is conducted before visit. Refer Lone working procedure FO HSEMS 64 in HBT field operation SharePoint.

Quick Risk Assessment Tool - Low Risk activity

Visit to Customer office for office work Understand & follow the customers site specific rules & regulations. Know the Emergency response plan Know the safe assembly area & emergency exit. Report any safety observations Follow & adhere to the HSE Cardinal rules.
Driving on Company Business Plan your Journey Follow the Driving safety norms Check the condition of vehicle & its tyres before travelling Follow the speed limit Do not operate the vehicle unless authorized
Material Handling/Ergonomics Do not carry or lift heavy weight or material individually. Follow the correct material handling techniques Avoid direct bending & twisting of back Maintain the correct body posture while working.
Potential Hazards - Spot the hazard on field /Site *(Ensures necessary actions/controls before proceeding)
Slips, Trips, and Falls
Hot or Cold Surface
Poor Lighting or visibility
Moving Equipment
Unprotected floor
Severe weather condition
Uneven surface
Simultaneous Operations
Suspended load
Mobile Plant/Equipment
Opening on floor
Other
Please specify hazard observed
Identified PPE
Hard hat
Eye protection
Face shield
Welding mask
Respirator
Dust mask
Ear protection
Safety footwear
Task specific Hand Gloves
Protective clothing
Full body Harness for work at Height
Other
Please specify hazard observed

Completion

Field visit Risk level assessment (Refer above activities under High/Medium/ Low risk level) before selection.
- High Risk
- Medium Risk
- Low Risk
Conduct detailed Risk Assessment prior to performing the task
Consult with Manager and/or HSE. Follow the work permit format
Ensure effective control measures listed in Quick risk assessment form are implemented prior to work being undertaken.
Execute the job by following site specific rules & regulations
Inspector Sign Off