Noise Risk Assessment

• Site

  Select

• Location

• Conducted on

  Date

• Prepared by

Survey Parameters

Employee

• Reason for survey

• Equipment used

Noise Survey and Exposure

• Click + to add equipment producing noise

Equipment

• Item Name

• Location of equipment

  Media

• Is the noise level below 80 dBA

  Yes

  No

• Noise level (dBA)

• EXPOSURE

• Exposure duration

Control Measures

• Is mandatory hearing protection required?

  Yes

  No

• Can the noise source be eliminated?

  Yes

  No

• Is additional maintenance required to reduce noise levels e.g. by lubrication, tightening, cleaning etc of equipment? (Reassess noise level after maintenance work is complete)

  Yes

  No

• Can the equipment be modified to reduce noise at source, e.g. damping, silencers, baffles etc fitted?

  Yes

  No

• Can inherently quieter components be selected e.g. slotted circular saw blades on woodworking equipment or quieter fans? (Reassess after replacement)

  Yes

  No

• Can the equipment be Isolated i.e. removed to another location away from people at work?

  Yes

  No

• Can the equipment be enclosed?

  Yes

  No

• Have operatives been informed of noise risks?

  Yes

  No

• Is health surveillance required?

  Yes

  No

Completion

• Recommendation

• Full Name and Signature of Assesor

  Sign