Title Page
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Document No.
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Conducted on
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Assessor
- Nick Dorrington Team Leader
- John Milne Team Leader
- Christopher Scott Base Operative
- Adam Gribble Base Operative
- John Henderson Base Operative
- Daniel Murdoch Base Operative
- Steven Buchan Base Operative and Crane Operator
- Liam Murray HSSEQ Manager
- Mike Munro Operations Director
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Location
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Description of Task
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Reason for assessment
Completion Activities
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Assessor Signature
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Date discussed with employees
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Review Date
Completion Instructions
Load Weight/Frequency Graphs
Lifting Operations
Carrying Operations
Assessment
Load/Weight Risk Level of Activity
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LOW LEVEL OF RISK
The vulnerability of special risk groups (e.g. pregnant women, young workers etc.) should be considered where appropriate.
MEDIUM LEVEL OF RISK
Examine tasks closely
HIGH LEVEL OF RISK
Prompt action needed This may expose a significant proportion of the working population to risk of injury.
VERY HIGH LEVEL OF RISK
Such operations may represent a serious risk of injury and should come under close scrutiny, particularly when the entire weight of the load is supported by one person. -
Risk Level
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SWL of access equipment (KG)
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Maximum combined weight of operator(s), tools and materials (KG)
Declaration
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Are there mechanical aids available to prevent or limit the need to perform manual handling activity?
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Mechanical aids where available should always be used in preference to manual handling (aids must be suitable to the task and the weight of load)
Detailed Assessment of Task
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Does the task involve:
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Holding load away from trunk
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Level of Risk
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Twisting/Leaning
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Level of Risk
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Vertical Lift Region
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Level of Risk
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Long carrying distances
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Level of Risk
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Strenuous pushing or pulling
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Level of Risk
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Repetitive handling
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Level of Risk
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Insufficient rest or recovery
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Level of Risk
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Insufficient rest or recovery
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Level of Risk
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Insufficient rest or recovery
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Level of Risk
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The Task: Comments and Control Measures
Detailed Assessment of Load
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The Load- are there:
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Heavy
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Level of Risk
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Bulky/Unwieldy
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Level of Risk
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Difficult to Grasp
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Level of Risk
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Unstable/Unpredictable (e.g. contain moving parts/liquid)
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Level of Risk
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Harmful (e.g. sharp/hot)
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Level of Risk
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The Load: Comments and Control Measures
Detailed Assessment of the Working Environment
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The working environment: are there
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Constraints on posture
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Level of Risk
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Floor conditions
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Level of Risk
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Variations in level
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Level of Risk
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Obstacles on route
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Level of Risk
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Hot, cold or humid conditions
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Level of Risk
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Strong air movements
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Level of Risk
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Poor lighting conditions
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Level of Risk
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Working Environment: Comments and Control Measures
Detailed Assessment of the Individual
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The Individual: Does the job
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Require unusual capability
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Level of Risk
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Present a hazard to those with health problems
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Level of Risk
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Present a hazard to those who are pregnant
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Level of Risk
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The Individual: Comments and Control Measures
Other Factors
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Is movement or posture hindered by:
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Clothing
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Level of Risk
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Personnel Protective Equipment
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Level of Risk
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Other Factors: Comments and Control Measures
Control Measures
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Measures in place
- Instruction and training
- Supervision
- Health Surveilance
- Emergency Plans
- Other
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Other Measures (Specify)
Additional Measures Required
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Additional Measure
Measure
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Details
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Responsible
- Nick Dorrington Team Leader
- John Milne Team Leader
- Christopher Scott Base Operative
- Adam Gribble Base Operative
- John Henderson Base Operative
- Daniel Murdoch Base Operative
- Steven Buchan Base Operative and Crane Operator
- Liam Murray HSSEQ Manager
- Mike Munro Operations Director
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Date Due
