Information
-
Document No.
-
Audit Title
-
Site
- Bairnsdale
- Pakenham
- Auckland
- Adelaide
- Perth
- Brisbane
- Corporate
-
Conducted on
-
Prepared by
-
Personnel
-
Equipment Name?
-
PAT / Serial #
-
Assessment type?
-
Assessment Date?
Initial questions.
-
What is the scope or work of the plant/equipment?
-
undefined
-
Is the plant/equipment designed to perform the work outlined in the scope?
-
Is the plant/equipment in good condition?
-
Has the plant/equipment been modified from its original condition?
-
Likelihood
-
Consequence
-
Hierarchy of Controls
Risk Assessment Questions.
-
A. Can anyone become entangled in the plant? (e.g. Hair caught in moving parts, PPE or clothing caught in moving parts)
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions
-
undefined
-
Residual risk rating?
-
Person responsible for completing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
B. Can anyone be crushed by or during the operation of the plant? (e.g. Material falling off the plant, plant falling over, being trapped).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for completing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
C. Can anyone be cut, stabbed or punctured? (flying objects, moving parts, pinch points).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for completing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
D. Are there any shearing hazards present? (between two moving parts).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for completing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
E. Can injuries related to friction occur? (continuous contact with moving surfaces or parts).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for completing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
F. Is there a chance that anyone can be struck by the plant/equipment, by moving parts or by items being ejected/thrown from the plant?
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
G. Can a hazardous pressure be produced? (e.g. hydraulic, pneumatic pressure).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
H. Can an electrical hazard be created? (e.g. Lack of insulation, contact with electrical conductors, poor earthing, overheard power lines).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
I. Can an explosion occur? (e.g. gas emissions, combustible dusts, flammable vapours).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
J. Can anyone using or near the plant slip, trip or fall? (e.g. uneven surfaces, falls from heights, tripping hazards).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
K. Are there manual handling hazards associated with the plant? (e.g. poor posture, repetitive movements, awkward positions, strained movements).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
L. Are there ergonomic hazards associated with control of the plant? (e.g. difficult to understand controls, inappropriate colouring, function not identified).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
M. Can anyone be suffocated? (e.g. lack of oxygen, contaminated atmosphere).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
N. Does operation of the plant cause extreme thermal temperature changes? (e.g. fire, burns through conduction, convection, cryogenic burns).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
O. Can certain weather hazards create a hazard? (e.g. hypothermia, heat stroke, wet conditions).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for completing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective actions status?
-
P. Does vibration of the plant create a hazard? (e.g. plant becomes unstable, causes physical problems for the operator).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
Q. Can the plant emit toxic fumes or vapours? (e.g. exhaust fumes, chemicals).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
R. Does the plant emit radiation? (e.g. X-rays, EMR, Laser).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Completion date?
-
Corrective action status?
-
S. Can operation of the plant create dust? (e.g. explosive atmosphere, breathing hazard, reduced visibility).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Date for completion?
-
Corrective action status?
-
T. Can the plant become unstable during operation? (e.g. working on uneven ground, shifting load).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Date for completion?
-
Corrective action status?
-
U. Could loss of load occur? (e.g. failure of ropes/slings, overloading, entanglement in surrounding structures).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for completing control measures/corrective actions?
-
undefined
-
Date for completion?
-
Corrective action status?
-
V. Is there anything in the surrounding environment that may produce a hazard? (e.g. Power lines, low ceilings, other plant, MHE, third party traffic, pedestrians).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Date for completion?
-
Corrective action status?
-
W. Can chemicals create a hazard? (e.g. Leaking from plant, splashing, explosions).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Date for completion?
-
Corrective action status?
-
X. Are there any other hazards generated by or created during the use of the plant or any attachments?
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Date for completion?
-
Corrective action status?
Occupational hygiene.
-
Y. Is there a noise hazard associated with the operation of the plant/equipment?
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Date for completion?
-
Corrective action status?
-
Z. Is there risk associated with lighting? (e.g. poor visibility due to position of lighting, globes blown).
-
Risk rating?
-
Control measures?
-
undefined
-
Corrective Actions?
-
undefined
-
Residual risk rating?
-
Person responsible for implementing control measures/corrective actions?
-
undefined
-
Date for completion?
-
Corrective action status?
Additional Images of Plant
-
Add media
Signature
- Sign Off
-
Signature