• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Work Activity

  • Advise the work activity that appears to be a risk

  • Enter details of activity

Risks Identified

  • List all the risks identified in relation to the particular activity

  • Take picture of risk if possible

Who might be harmed?

  • Who can be harmed or affected by these risks?


  • Advise description of risks

Probability of Occurance

  • Indicate the Probability of Occurance

Risk Rating

  • Indicate the impact level of this risk from HIGH (Castrophical) - MEDIUM (Critical) or LOW (Marginall)

Existing Measures

  • Were there any existing measures in place to control this risk? If yes, please advise in detail


  • Indicate if this risk can be controlled immediately or not

Implementation Plan

  • Who will action the implementation ?

  • When will this be actioned and completed by?


  • Risk assessment has been completed

  • Risks reported have been resolved and completed

  • Date of Risk Assessment

  • Date of Completion

  • WHS Representative Signature

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