Information
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Site conducted
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RAMS Conducted on
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This document will assist you in completing the Risk Assessment. Please take a few minutes to complete all elements within this assessment. Once complete ensure you sign off the document and also include any other Team Members who are involved in the task/activity. Once complete please forward to your Supervisor / Manager. Thank you for your co-operation.
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Machine Model
- LJ5139
- Metrotrak
- Premiertrak 300
- Premiertrak 400X
- Premiertrak 600
- Premiertrak 600E
- J1170 Direct Drive
- J1170
- J1175
- J1175 Dual Power
- J1160
- J960
- J1480
- Bison 220
- Bison 280
- Other
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Other Machine Model (if not listed in previous question)
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Machine Serial Number
- TRXL5139JOMK60901
- TRXEQ380KOML11964 - B220
- PIDPR40XLOMI67238
- PIDPT40XCOMKA1456
- TRX1170DLOMG82738
- Other
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Other Serial Number (if not listed in previous question)
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Site location
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Risk Assessment & Method Statement carried out by
Site & Machine Information
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Please provide a job description of the work your are going to carry out to support this Hazard Assessment
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Other Work (If not listed in previous question)
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Number of Team Members working on this activity?
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Team Members must not carry out any lone working on any machinery or equipment. If a work activity present a lone working situation Team Members must contact their Manager or Supervisor immediately to make arrangements.
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Please ensure that the contents of this risk assessment are shared with all those TM's involved in this activity.
Risk Assessment
- Method Statement:
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Electrical Testing
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Identify Hazards
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If you have selected "Other" hazards, please state below
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Who might be harmed?
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How many people are at risk?
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Probability Rating Task 1
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Severity Rating Task 1
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Please multiply both figures to gain the overall Risk Rating Priority. (Severity x Probability)
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Enter result (Severity x Probability)
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Please state countermeasures taken to reduce hazard
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Identify Hazard
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If you have selected "Other" hazards, please state below
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Who might be harmed?
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How many people are at risk?
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Probability rating Task 2
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Severity Rating Task 2
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Please multiply both figures to gain the overall Risk Rating Priority. (Severity x Probability)
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Enter result (Severity x Probability)
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Please state countermeasures taken to reduce hazard
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Identify Hazard
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If you have selected "Other" hazards, please state below
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Who might be harmed?
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How many people are at risk?
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Probability rating Task 3
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Severity Rating Task 3
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Please multiply both figures to gain the overall Risk Rating Priority. (Severity x Probability)
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Enter result (Severity x Probability)
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Please state countermeasures taken to reduce hazard
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Do you want to add more hazards?
- Yes I have identified more hazards
- No I am happy to continue
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Identify Hazard
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If you have selected "Other" hazards, please state below
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Who might be harmed?
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How many people are at risk?
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Probability Rating Task 4
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Severity Rating Task 4
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Please multiply both figures to gain the overall Risk Rating Priority. (Severity x Probability)
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Enter result (Severity x Probability)
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Please state countermeasures taken to reduce hazard
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Do you want to add more hazards?
- Yes I have identified more hazards
- No I am happy to continue
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Identify Hazard
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If you have selected "Other" hazards, please state below
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Who might be harmed?
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How many people are at risk?
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Probability Rating Task 5
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Severity Rating Task 5
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Please multiply both figures to gain the overall Risk Rating Priority. (Severity x Probability)
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Enter result (Severity x Probability)
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Please state countermeasures taken to reduce hazard
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Do you want to add more hazards?
- Yes I have identified more hazards
- No I am happy to continue
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Identify Hazard
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If you have selected "Other" hazards, please state below
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Who might be harmed?
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How many people are at risk?
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Probability Rating Task 6
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Severity Rating Task 6
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Please multiply both figures to gain the overall Risk Rating Priority. (Severity x Probability)
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Enter result (Severity x Probability)
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Please state countermeasures taken to reduce hazard
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Do you want to add more hazards?
- Yes I have identified more hazards
- No I am happy to continue
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Identify Hazard
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If you have selected "Other" hazards, please state below
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Who might be harmed?
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How many people are at risk?
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Probability Rating Task 7
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Severity Rating Task 7
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Please multiply both figures to gain the overall Risk Rating Priority. (Severity x Probability)
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Enter result (Severity x Probability)
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Please state countermeasures taken to reduce hazard
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Do you want to add more hazards?
- Yes I have identified more hazards
- No I am happy to continue
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Identify Hazard
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If you have selected "Other" hazards, please state below
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Who might be harmed?
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How many people are at risk?
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Probability Rating Task 8
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Severity Rating Task 8
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Please multiply both figures to gain the overall Risk Rating Priority. (Severity x Probability)
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Enter result (Severity x Probability)
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Please state countermeasures taken to reduce hazard
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Do you want to add more hazards?
- Yes I have identified more hazards
- No I am happy to continue
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Identify Hazard
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If you have selected "Other" hazards, please state below
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Who might be harmed?
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How many people are at risk?
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Probability Rating Task 9
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Severity Rating Task 9
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Please multiply both figures to gain the overall Risk Rating Priority. (Severity x Probability)
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Enter result (Severity x Probability)
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Please state countermeasures taken to reduce hazard
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Do you want to add more hazards?
- Yes I have identified more hazards
- No I am happy to continue
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Identify Hazard
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If you have selected "Other" hazards, please state below
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Who might be harmed?
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How many people are at risk?
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Probability Rating Task 10
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Severity Rating Task 10
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Please multiply both figures to gain the overall Risk Rating Priority. (Severity x Probability)
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Enter result (Severity x Probability)
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Please state countermeasures taken to reduce hazard
Method Statement
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Have you reported to the site office / staff to make them aware you are on site?
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Please make sure that people within the site know you are working in the area, and ensure you have a point of contact within the job site before commencing job.
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Have you completed the site induction?
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Are you aware of the customers site safety rules, emergency procedures and rescue plans including Lockout/Tagout? If not ask what the site emergency action plan and site specific procedures are.
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Have you identified the energy sources to be isolated? E.g. Electricity, Chemical, Hydraulic, Mechanical, Thermal, Pneumatic, Gravitational.
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Have you received training in the Control of Hazardous Energy (LOTO)?
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Has each individual working on the machine fitted their individual lock to the hasp? The individual who fitted the lock to the lock out hasp must retain their key (and NOT give the key to anyone else). Once work is completed, The last person to remove their lock should be the first person who initially imitated the lock out.
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Have you attached a warning label (tag out) on the isolator handle (or lock) advising others of the work in progress e.g. “Danger Do Not Operate (DNO tag)”
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Have you tested the equipment once isolated to ensure the equipment cannot be energised?
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Do not proceed if you have answered "NO" to any of the above. Contact your supervisor to determine next steps.
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Are you suffering from fatigue?
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You should immediately consult with your manager and discuss your well being and agree the next course of action. Your manager should also contact the customer and provide feedback.
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Do you have all the necessary tools/equipment to work safely?
- Yes I have all the tools required
- No I do not have the tools required
- Power Tools not required for the job
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Are any power tools to be used in a good and safe condition?
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Please remove tools from service and inform manager of the defaults.
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Please indicate what tools/equipment are required to complete the work safely?
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If using hazardous substances, are you aware of all the relevant safety data sheets and hazardous information?
- Not required for job
- Data Sheets are available
- Required for job but no data Sheets
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Please contact your manager and request the COSHH document
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Is there clear access & egress around the working area?
- Yes the area I am working in is clear
- No the area is not clear
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Please indicate how you intend to limit the hazards while working around a congested area
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Can I spill or pollute something?
- Yes, I have a spill kit available
- No I wont spill or pollute anything
- Yes, but I do not have a spill kit
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Ensure substances are secure and material is in the correct container, to prevent spills or pollute the environment you are working in. Understand the sites spills process and how to clean up, ensure spill kits are close by.
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Is there sufficient natural light/arificial lighting to work safely?
- Yes the lighting around the work area is good
- No the lighting is not sufficient to work safely
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Please contact your manager immediately and inform him/her of the situation
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Are you equipped with the suitable PPE?
- Yes I have all the appropriate PPE required for the task
- No I have not got the suitable PPE required
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Please select the PPE required for this job
- Safety Footwear
- Overalls
- Gloves
- Safety Helmet
- Safety Glasses
- Ear Protection
- Fall Arrest Harness and Lanyard
- High Vis Clothing
- Waterproofs
- Visor
- Goggles
- Dust Mask
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Please select those that are missing
- Safety Footwear
- Overalls
- Gloves
- Safety Helmet
- Safety Glasses
- Ear Protection
- Fall Arrest Harness and Lanyard
- High Vis Clothing
- Waterproofs
- Visor
- Goggles
- Dust Mask
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WARNING - If you are not able to ensure your own safety to any of the above questions, JOB PAUSE, ASSESS and RESOLVE the issue. If this is not possible then escalate this to your relevant supervisor/manager.
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Team Members must not carry out any lone working on any machinery or equipment.
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Sketch of site if required depicting any hazards that could come at your, in other words, line of fire hazards. (Look up, look down, look out, look around)
Life Saving Behaviors
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Am I secure in the vehicle that I am operating? Does it have a seatbelt? The vehicle I am driving is correct for any loads and weight being hauled?
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Is the equipment that I am working on cleared of hazardous energy including other equipment?
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Job PAUSE and take the appropriate safe action to clear hazardous energy from equipment. If in doubt contact your supervisor
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If I did a control of hazardous energy procedure (lockout/tag out or other) did I remember to verify that the energy is isolated?
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Can I stand clear of the danger zone from unstable / suspended loads?
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Contact site manger and your supervisor/manager to plan a safer method of working
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Is there a risk on site of anything falling and causing injury to others?
- Yes, there is a risk of objects falling
- No
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Please review your work area and remove those items that could fall on others.
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Does the job involve lifting?
- Yes a lift(s) is required for the job
- No lift(s) is required to complete the job
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Have you a lifting plan? No Plan, No Lift!
- Yes I have a lifting plan
- No, there is no lifting plan available for this job
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Contact manager to arrange for lifting plan to be emailed, or discuss the next steps to take.
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Enter the Lifting plan number.
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If there are any interlocks or guarding on the machine, can I confirm they work correctly?
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Am I working in a safe zone in relation to moving equipment? The equipment I am working on or other equipment nearby?
- Yes I can position myself in a safe zone
- No I cannot position myself in a safe zone
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Contact the site manager to arrange a safer way of working.
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Do I need to work at height?
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Have I been properly trained to do this work at height? If No, Do not proceed if untrained.
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Can i minimize the risk of falling?
- Yes I can minimize the risk of falling
- No I cannot minimize the risk of falling
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Please indicate methods used to minimize the risk of falling at height
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Is the Working at Height equipment appropriate for the job and in an acceptable condition? Do not proceed if you have answered No.
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Am I protected from falling?
- Yes I can protect myself
- No I cannot protect myself
- No working at height is required
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Do not proceed. Contact your supervisor to determine a solution and agree next steps.
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Are there any confined spaces that I might enter and would need authorisation through a permit?
- No working in confined space required
- Yes, working in confined space is required
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List the person responsible for coordinating a rescue plan.
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Please select the rescue equipment
- Crane
- Digger
- Scissor lift
- MWEP
- Winch
- Harness
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Where is the equipment located?
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What method of communication is in place?
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Do I have the correct tools and equipment? Are those tools and equipment in good working order? Do all the tools and equipment have the correct guarding in place and functional?
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Is there any reason that I should pause the job and re-evaluate? Is there anything out of the ordinary? If assistance is required please contact your supervisor to discuss the Job Pause and re-evaluate.
Confirmation
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Are you happy that you can proceed with this job in a safe manner?
- Yes, the job is safe for me to carry on
- No, I do not feel the job is safe enough to continue
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If any conditions are unsuitable or you feel are unsafe contact your manager and discuss next steps.
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Acknowledgement of Receipt: I hereby declare I understand the nature of the work to be carried out, the hazards involved and the precautions required. Only plant and equipment specified in this document will be worked on and no attempt will be made by me or anyone under my control to use or work on any other plant/equipment. All personnel involved in the work will be competent to undertake the task delegated to them and all plant, machinery and appliances will be in a worth condition with current relevant certificates. All site notices, rules and instructions will be observed in full.
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Engineer/Assessor Signature:
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Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:
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Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:
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Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:
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Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:
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Additional Team Member / Customer / Dealer / Contractor / Supplier / Visitor Signature:
Near Misses
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Accidents are sadly a feature of everyday life; they are not planned and certainly not wanted.
The company is committed to best practice in HSE performance to meet its responsibilities for the health, safety and wellbeing of its team members, visitors and others who may be affected by its work activities.
DEFINITIONS
Hazard – Something with the potential to cause harm, including ill health, injury, loss of product and/or damage to plant and property.
A Near Miss - An undesired event in which there was no injury; however, under slightly different circumstances could have resulted in personal harm – Terex
An Accident - an undesired event which results in:
Harm to people (fatality, occupational injury or occupational illness) and/or
Damage to vehicles, assets, facilities and/or
Damage to the environment -
Please state any accidents, near misses or Hazards experienced while completing this job.
