Information
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Document No.
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LINE/ASSET
- A1151
- A1152
- F1151
- F1152
- Maint. Crib
- QC Lab
- Office
- WIP
- Loading Docks
- Electrical Room
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Activity/Job
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Conducted on
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Prepared by
Hazards
Hazard Identification:
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Entanglement
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add Media if required
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Risk is not Okay
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Add media if required
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Cutting,stabbing or Puncturing
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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Striking
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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Shearing/Burning/Friction
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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High Pressure (Fluid/Gases)
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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Electrical
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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Gases or Vapours
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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Slips/Trips/Falls
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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Manual Handling/Ergonomics (Push, Pull, Lift)
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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Extreme of Temperature
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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Light/Laser Exposure
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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Noise
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
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Select the Likelihood of the Injury Occurring
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Risk is Okay
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Add media if required
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Risk is not Okay
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Add media if required
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Any other Hazard not listed
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Select who may be at risk.
- Employees
- Contractors
- Visitors
- Young Persons
- Members of the public
- Delivery Drivers
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Select the severity
-
Select the Likelihood of the Injury Occurring
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Risk is Okay
-
Add media if required
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Risk is not Okay
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Add media if required
Existing Controls
Hazard Selection
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Hazard
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- Entanglement
- Cutting/Stabbing/Puncturing
- Striking
- Shearing/Burning/Friction
- High Pressure (Fluids/Gases)
- Electrical
- Gases or Vapours
- Slips/Trips/Falls
- Manual Handling
- Extreme of Temperature
- Light
- Noise
- Other Hazard
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Contributing Factors
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Existing Contols
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Risk Status
Risk Control Action Plan
Hazard Rectification
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Hazard
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- Entanglement
- Cutting/Stabbing/Puncturing
- Striking
- Shearing/Burning/Friction
- High Pressure (Fluids/Gases)
- Electrical
- Gases or Vapours
- Slips/Trips/Falls
- Manual Handling
- Extreme of Temperature
- Light
- Noise
- Other Hazard
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Further Controls/Actions required
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Who is responsible for actions?
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Date by when actions should be completed
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Date when actions are completed
Assessor Detail:
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Assessed by:
