DESCRIPTION

  • Description of location:

  • Describe how the equipment/machinery is used:

  • Description of Work Equipment/Machinery:

  • Photograph(s) of equipment/machinery

Mechanical Hazards

  • Identify the mechanical hazards present

Non Mechanical Hazards

  • Identify the non mechanical hazards present

Use of Equipment/machinery

  • What is the duration/frequency of use of equipment/machine

  • Description of users of equipment (experience, age etc.)

CONTROL MEASURES

  • Identify Engineering Controls in place

  • Describe/outline the Engineering Controls

  • Describe/outline the Procedural and Behavioural Controls

  • PPE/RPE Required

  • Description of Type(s) of PPE/RPE required

ASSESSMENT OF RISK

  • Likelihood x Severity

  • Level of Risk

ADDITIONAL CONTROL MEASURES

  • Additional Control Measures required

  • Maintenance/cleaning Risk Assessment Required?

  • Noise or Vibration Risk Assessment required?

  • Manual Handling/Ergonomic Risk Assessment required?

  • COSHH Risk Assessment required? (if yes identify substance(s))

  • Other Risk Assessments Associated with Equipment

ENVIRONMENTAL

  • Environmental Risk Assessment Required?

  • Environmental controls for use and disposal:

SIGN OFF

  • Is action plan required for additional controls?

  • Select date

  • Assessor Name & Signature

  • Date for Re-assessment

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