Audit
Plant Item
Plant Identification Details (Model/ Make/ Serial)
Plant Owner Name
Plant task description
Is the plant designed to perform the task?
Is the plant in good working condition and free of weeds and mud?
Risk Matrix Reference
Hierarchy of Controls Reference
Can anyone be injured by an explosion of gas, vapours, liquids, dusts or other substances, triggered by plant operation?
Activity
Description of hazards identified
Persons at risk
Initial consequence
Initial likelihood
Initial risk rating
Residual consequence
Residual likelihood
Residual risk rating
- Elimination
- Substitution
- Engineering Controls
- Administrative Controls
- PPE
- Other
Enter description of control measures
Can anyone be injured by electrical shock or burnt due to damaged or poorly maintained leads, switches or equipment?
Activity
Description of hazards identified
Persons at risk
Initial consequence
Initial likelihood
Initial risk rating
Residual consequence
Residual likelihood
Residual risk rating
- Elimination
- Substitution
- Engineering Controls
- Administrative Controls
- PPE
- Other
Enter description of control measures
Can anyone be cut, stabbed or punctured by coming in contact with moving plant or parts?
Activity
Description of hazards identified
Persons at risk
Initial consequence
Initial likelihood
Initial risk rating
Residual consequence
Residual likelihood
Residual risk rating
- Elimination
- Substitution
- Engineering Controls
- Administrative Controls
- PPE
- Other
Enter description of control measures
Can anyone’s hair, clothing, gloves, necktie, jewellery, rags and other materials become entangled with moving parts of plant, or materials in motion?
Activity
Description of hazards identified
Persons at risk
- Elimination
- Substitution
- Engineering Controls
- Administrative Controls
- PPE
- Other
Enter description of control measures
Initial consequence
Initial likelihood
Initial risk rating
Residual consequence
Residual likelihood
Residual risk rating
Can anyone be crushed due to falling, uncontrolled or unexpected movement of plant or its load?
Activity
Description of hazards identified
Persons at risk
Initial consequence
Initial likelihood
Initial risk rating
- Elimination
- Substitution
- Engineering Controls
- Administrative Controls
- PPE
- Other
Enter description of control measures
Residual consequence
Residual likelihood
Residual risk rating
Recommendations