Mckenzie and Co Ltd. Take 5

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

STOP AND THINK

• Do we have the required skills and knowledge to do the job safely?

• Do we have the correct PPE?

• Do we understand the steps required to do the work?

• Do we have a safe work procedure for the job?

• IF ANY OF THESE ARE UNCHECKED DO NOT PROCEED AND SEE YOUR MANAGER

HAZARDS

• Are you at risk from operation of plant or machinery?

  Yes

  No

  N/A

JOB HAZARD ANALYSIS

Checklist items for the Task being conducted

• Spotter required

• Barricading

• Traffic Management

• Working at Heights

• Confine Space Entry

• Signage

• Machinery/ Personnel Interface

• Emergency PLan

• Scaffolding

• Hazardous Materials (MSDS)

• Manual Handling

Type of Work Permits (tick appropriate)

• Confined Space

• Excavation/ Dig Permit

• Working at Heights

• Work near Powerlines

• Permit to Work

Type of Personnel Protection Equipment (PPE) required (Tick appropriate)

• Hi-Vis Vest

• Safety Glasses

• Safety Helmet

• Hearing Protection

• Drinking Water

• Sun Protection

• PVC Plastic Coveralls

• Full Face Shield

• Respiratory Protection

• Safety Harness (heights)

• Rubber Boots

• 

• List the Tasks/ Activities of the job in the space below with the associated Hazards and Inherent Risk Rating

• Task/ Activity 1:

• Existing and Potential Hazards (associated with task 1)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 1 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 2:

• Existing and Potential Hazards (associated with task 2)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 2 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 3:

• Existing/ Potential Hazards associated with Task 3

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 3 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 4:

• Existing and Potential Hazards (associated with task 4)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 4 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 5:

• Existing and Potential Hazards (associated with task 5)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 5 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 6:

• Existing and Potential Hazards (associated with task 6)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 6 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Are you working on or near a road?

  Yes

  No

  N/A

• Refer to the following NZTA website for instructions specifically section D7.6 "Inspections and non-invasive works" JHA to be completed.
  https://www.nzta.govt.nz/assets/resources/code-temp-traffic-management/docs/Section-D-mobile-operations-copttm-4th-ed-july2015.pdf

JOB HAZARD ANALYSIS

Checklist items for the Task being conducted

• Spotter required

• Barricading

• Traffic Management

• Working at Heights

• Confine Space Entry

• Signage

• Machinery/ Personnel Interface

• Emergency PLan

• Scaffolding

• Hazardous Materials (MSDS)

• Manual Handling

Type of Work Permits (tick appropriate)

• Confined Space

• Excavation/ Dig Permit

• Working at Heights

• Work near Powerlines

• Permit to Work

Type of Personnel Protection Equipment (PPE) required (Tick appropriate)

• Hi-Vis Vest

• Safety Glasses

• Safety Helmet

• Hearing Protection

• Drinking Water

• Sun Protection

• PVC Plastic Coveralls

• Full Face Shield

• Respiratory Protection

• Safety Harness (heights)

• Rubber Boots

• 

• List the Tasks/ Activities of the job in the space below with the associated Hazards and Inherent Risk Rating

• Task/ Activity 1:

• Existing and Potential Hazards (associated with task 1)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 1 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 2:

• Existing and Potential Hazards (associated with task 2)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 2 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 3

  Yes

  No

  N/A

• Existing and Potential Hazards (associated with task 3)

  Yes

  No

  N/A

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 3 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 4:

• Existing and Potential Hazards (associated with task 4)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 4 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Will you be working near water (over 1m deep)?

  Yes

  No

  N/A

JOB HAZARD ANALYSIS

Checklist items for the Task being conducted

• Spotter required

• Barricading

• Traffic Management

• Working at Heights

• Confine Space Entry

• Signage

• Machinery/ Personnel Interface

• Emergency PLan

• Scaffolding

• Hazardous Materials (MSDS)

• Manual Handling

Type of Work Permits (tick appropriate)

• Confined Space

• Excavation/ Dig Permit

• Working at Heights

• Work near Powerlines

• Permit to Work

Type of Personnel Protection Equipment (PPE) required (Tick appropriate)

• Hi-Vis Vest

• Safety Glasses

• Safety Helmet

• Hearing Protection

• Drinking Water

• Sun Protection

• PVC Plastic Coveralls

• Full Face Shield

• Respiratory Protection

• Safety Harness (heights)

• Rubber Boots

• 

• List the Tasks/ Activities of the job in the space below with the associated Hazards and Inherent Risk Rating

• Task/ Activity 1:

• Existing and Potential Hazards (associated with task 1)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 1 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 2:

• Existing and Potential Hazards (associated with task 2)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures Task 2 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 3:

• Existing and Potential Hazards (associated with task 3)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures task 3 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 4:

• Existing and Potential Hazards (associated with task 4)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures task 4 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/Activity 5:

• Existing and Potential Hazards (associated with task 5)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures task 5 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 6:

• Existing and Potential Hazards (associated with task 6)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures task 6 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Will you be working near open trenches deeper than 1m?

  Yes

  No

  N/A

JOB HAZARD ANALYSIS

Checklist items for the Task being conducted

• Spotter required

• Barricading

• Traffic Management

• Working at Heights

• Confine Space Entry

• Signage

• Machinery/ Personnel Interface

• Emergency PLan

• Scaffolding

• Hazardous Materials (MSDS)

• Manual Handling

Type of Work Permits (tick appropriate)

• Confined Space

• Excavation/ Dig Permit

• Working at Heights

• Work near Powerlines

• Permit to Work

Type of Personnel Protection Equipment (PPE) required (Tick appropriate)

• Hi-Vis Vest

• Safety Glasses

• Safety Helmet

• Hearing Protection

• Drinking Water

• Sun Protection

• PVC Plastic Coveralls

• Full Face Shield

• Respiratory Protection

• Safety Harness (heights)

• Rubber Boots

• 

• List the Tasks/ Activities of the job in the space below with the associated Hazards and Inherent Risk Rating

• Task/ Activity 1:

• Existing and Potential Hazards (associated with task 1)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 2:

• Existing and Potential Hazards (associated with task 2)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures task 2 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 3:

• Existing and Potential Hazards (associated with task 3)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures task 3 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 4:

• Existing and Potential Hazards (associated with task 4)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures task 4 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/Activity 5:

• Existing and Potential Hazards (associated with task 5)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures task 5 (Implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Task/ Activity 6:

• Existing and Potential Hazards (associated with task 6)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Control Measures task 6 (implement to reduce the level of risk to acceptable levels)

• Likelihood

  A-Almost Certain

  B-likely

  C-Possible

  D-Unlikely

  E-Rare

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Moderate Risk

• High Risk

• High Risk

• Extreme Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Consequence

  1-Insignificant

  2-Minor

  3-Moderate

  4-Major

  5-Catastrophic

• Low Risk

• Low Risk

• Moderate

• High Risk

• High Risk

• Will you be working at height or confined space?

  Yes

  No

  N/A