Title Page

  • Company Name

  • Inspection Date

  • Prepared by

  • Location

Plant Risk Assessment

Plant Information

  • Plant Name

  • Plant Identification Details (Model/ Make/ Serial)

  • Plant Task Description

  • Is the plant designed to perform the task?

  • Is the plant in good working condition and free of weeds and mud?

References

  • Risk Matrix Reference

    Risk_Matrix.png
  • Hierarchy of Controls Reference

    OSH toolkit noise - hierachy of controls.jpg

Explosion/Fire

  • Can anyone be injured by an explosion of gas, vapours, liquids, dusts or other substances, triggered by plant operation?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Suffocation

  • Can anyone be suffocated due to lack of oxygen or atmospheric contamination?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Pressurized Content

  • Can anyone be injured by fluids or gases under high pressure due to plant failure or misuse?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial Risk Rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual Risk Rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Electricity Contact

  • Can anyone be injured by electrical shock or burnt due to damaged or poorly maintained leads, switches or equipment?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Cutting

  • Can anyone be cut, stabbed or punctured by coming in contact with moving plant or parts?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Crushing

  • Can anyone be crushed due to falling, uncontrolled or unexpected movement of plant or its load?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Entanglement

  • Can anyone’s hair, clothing, gloves, necktie, jewellery, rags and other materials become entangled with moving parts of plant, or materials in motion?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Slips, Trips, Falls

  • Can anyone slip, trip, or fall due to:<br>• uneven, slippery, or steep surfaces, <br>• obstacles or poor housekeeping<br>• ladders, stairs, platforms, or lack of guardrails

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Ergonomics

  • Can anyone be injured due to poorly designed work area, repetitive body movement, poor light placing, or other ergonomic issues?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Radiation

  • Can anyone in the plant's vicinity suffer injury or illness due to exposure to radiation in the form of infra-red, ultra violet light, or microwaves?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Noise

  • Can anyone in the plant's vicinity suffer injury or illness due to exposure to noise?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Vibration

  • Can anyone in the plant's vicinity suffer injury or ill-health due to exposure to vibration?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Temperature/Moisture

  • Can anyone be injured or suffer ill-health due to exposure to:<br>• high or low temperatures<br>• objects of high or low temperatures<br>• moisture

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Interlocking of Moveable Guards

  • 1. Are movable guards protected with the safety rated interlocks?<br>2. Do pneumatic and hydraulic systems have auto dump valves to release residual energies when interlocks are broken?<br>3. Are there any obvious single points of failure of the safety system (I.e. -1 mechanical interlock switch on a guard door, 1 Air valve, etc.)?<br>4. Does the safety system appear to be the appropriate CATEGORY for the equipment and it's hazards?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Fixed Guarding

  • 1. Is there NO ACCESS to moving parts or dangerous conditions, during normal or abnormal operations?<br>2. Are fixed guards robust, securely anchored with fasteners that require the use of tools to remove? <br>3. Are all parts (Drives, chains, gears, shafts, etc.) adequately covered by a guard?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Initial risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Other Risks

  • Other risks that can cause injury or ill-health?

Hazard

  • Activity

  • Description of hazards identified

  • Photo of hazard (optional)

  • Persons at risk

Initial risk rating

  • Initial consequence

  • Initial likelihood

  • Initial risk rating

Residual risk rating

  • Residual consequence

  • Residual likelihood

  • Residual risk rating

Controls

  • Select control measures

  • Enter other control measures

  • Enter description of control measures

Completion

  • Recommendations

  • Name and Signature

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