Information

  • Site conducted

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Material falling from plant?

  • Lack of capacity for the plant to be slowed, stopped or immobilised?

  • The plant tipping or rolling over?

  • Uncontrolled or unexpected movement of the plant or its load?

  • Parts of the plant collapsing?

  • Coming in contact with moving parts of the plant during testing, inspection, use, maintenance, cleaning or repair?

  • Being thrown off or under the plant?

  • Being trapped between the plant and materials or fixed structures?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(2). Entanglement

  • Can be entangled due to:

  • Body parts, clothing, equipment or other materials being in contact with moving parts of the plant?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(3). Cutting, Stabbing and Puncturing

  • Can anyone be cut, stabbed or punctured due to?

  • Coming in contact with sharp or flying objects?

  • Coming in contact with moving parts of the plant during testing, inspection, operation, maintenance, cleaning or repair of the plant?

  • Parts of plant disintegrating?

  • The mobility of the plant?

  • Uncontrolled or unexpected movement of the plant?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(4). Shearing / Burning / Friction

  • Can anyone’s body parts be:

  • Burnt, gain abrasions, etc?

  • Sheared in operation of plant?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(5). Striking

  • Can anyone be struck by moving objects due to:

  • Uncontrolled or unexpected movement of the plant or material handled by the plant?

  • Plant, parts of the plant or work pieces disintegrating?

  • Work pieces being ejected?

  • Mobility of the plant?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(6). High Pressure Fluid /Gases

  • Can anyone come into contact with?

  • Fluids/Gases under high pressure in normal use?

  • In the instance of plant failure?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(7). Electrical

  • Can anyone be injured by electrical shock due to:

  • The plant contacting live electrical conductors?

  • Electrical Leads on the ground

  • Plant working close to electrical conductors?

  • Overload of electrical circuits?

  • Damaged or poorly maintenance electrical components &/or cables?

  • Water near electrical equipment?

  • Lack of isolation procedures?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(8). Gases or Vapors

  • Can anyone’s health be affected by exposure to:

  • Gases, vapours, liquids, dusts or other hazardous substances by the operation of the plant?

  • Other factors?

  • Other factors?

  • Add media

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(9). Slips, Trips or Falls

  • Can anyone using the plant, or in the vicinity of the plant, slip, trip or fall due to:

  • Uneven or slippery work surfaces?

  • Poor housekeeping, such as shavings in the vicinity of the plant, spillage not cleaned up?

  • Obstacles being placed in the vicinity of the plant?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(10). Manual Handling

  • Does use of the plant or equipment involve repetitive or sustained postures?

  • Does use of the plant or equipment involve high force actions?

  • Does use of the plant or equipment involve an jerking actions?

  • Has there been a report of musculoskeletal disorder associated with the task?

  • Does this task require employees to be working with their hands above their shoulder?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(11). Suffocation

  • Can anyone be suffocated due to:

  • lack of oxygen

  • Atmospheric contamination?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(12). Temperature

  • Can anyone’s health be affected by extreme temperatures by:

  • Coming into contact with objects at high temperature?

  • Coming into contact with objects at Low temperature?

  • Other factors?

  • Other factors?

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(14). Light

  • Is lighting acceptable in this area?

  • undefined

  • undefined

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

Noise

  • Is noise acceptable in this area?

  • undefined

  • undefined

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

(13). Other Hazards

  • Could the plant create hazardous conditions other than above mentioned categories including:

  • Explosions?

  • undefined

  • undefined

  • 1. Elimination. 2. Substitution. 3. Engineering Controls. 4. Isolation. 5. Administrative Controls. 6. PPE

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  • Most probable result of the potential accident. <br> <br><br><br><br><br>

  • CLASSIFICATION1. FACTOR

1. CONSEQUENCE

Most probable result of the potential accident.

  • a. Catastrophe; numerous fatalities; major disruption of activities 100

  • b. Disaster; multiple fatalities; 50

  • c. Very serious; Fatality; 25

  • d. Serious; serious injury (amputation, permanent disability) 15

  • e. Important; disabling injury; 5

  • f. Noticeable; minor cuts, bruises, bumps; minor damage. 1

2. EXPOSURE

The frequency of exposure to the hazard.

  • a. Continuously (or many times daily) 10

  • b. Frequently (approximately once daily). 6

  • c. Occasionally (from once per week to once per month) 3

  • d. Infrequent (from once per month to once per year). 2

  • e. Rarely (it has been known to occur) 1

  • f. Very rarely (not known to have occurred) 0.5

3. PROBABILITY

Likelihood that the consequence will occur once the individual is exposed to the hazard.

  • a. Almost certain likely or expected result; 1 in 10 chance. 10

  • b. Quite possible/not unusual; 1 in 10 to 1 in 100 chance 6

  • c. Would be an unusual sequence or coincidence; 1 in 100 to 1 in 1000 chance 3

  • d. Would be a remotely possible coincidence 1 in 1000 to 1 in 10,000 chance. 1

  • e. Has never happened after many years of exposure, but is conceivably possible; 1 in 10 000 to 1 in 100,0000 0.5

  • f. Practically impossible sequence (has never happened) 1 in 100,000 chance or lower 0.1

Risk Score: CONSEQUENCE X EXPOSURE X PROBABILITY. = RISK SCORE

RISK SCORE DEFINITION ACTION

  • 500 Very high risk Immediate action required. HIGH PRIORITY.

  • 300- 499 High risk Management attention needed. Hazards NOT adequately controlled.

  • 150- 299 Substantial risk Management attention needed. Hazards NOT adequately controlled.

  • 60- 149 Moderate risk Hazard must be examined against current standards

  • 0- 59 Low risk Manage by routine procedures.

Hierarchy of Risk Controls

1. Eliminate

  • - Is it possible to eliminate the risk?

2. Reduce

  • - Is it possible to reduce the level of risk posed by the hazard by (priority order.

  • · Substitution (using less hazardous alternatives)

  • · Isolation (separating the operator from the risk)

  • · Engineering controls (re-designing plant or equipment).

3. Administration

  • - Is it possible to reduce the level of risk posed by the hazard by changing operating procedures, training, supervision, providing information etc

4. Personal Protection

  • - Is it possible to reduce the level or risk posed by the hazard by wearing personal protective equipment and clothing?

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Risk Control Action Plan Risk 1

  • Completed by date/time

  • Responsibility

  • Issue identified. Comment on progress/update for actions

Risk Control Action Plan Risk 2

  • Completed by date/time

  • Responsibility

  • Issue identified. Comment on progress/update for actions

Risk Control Action Plan Risk 3

  • Completed by date/time

  • Responsibility

  • Issue identified. Comment on progress/update for actions

Risk Control Action Plan Risk 4

  • Completed by date/time

  • Responsibility

  • Issue identified. Comment on progress/update for actions

Risk Control Action Plan Risk 5

  • Completed by date/time

  • Responsibility

  • Issue identified. Comment on progress/update for actions

Risk Control Action Plan Risk 6

  • Completed by date/time

  • Responsibility

  • Issue identified. Comment on progress/update for actions

Risk Control Action Plan Risk 7

  • Completed by date/time

  • Responsibility

  • Issue identified. Comment on progress/update for actions

Risk Control Action Plan Risk 8

  • Completed by date/time

  • Responsibility

  • Issue identified. Comment on progress/update for actions

Risk Control Action Plan Risk 9

  • Completed by date/time

  • Responsibility

  • Issue identified. Comment on progress/update for actions

Risk Control Action Plan Risk 10

  • Completed by date/time

  • Responsibility

  • Issue identified. Comment on progress/update for actions

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  • Auditor to sign here

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The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.