Information
-
Risk Assessment Form
-
Document No.
-
Company Name
-
Operation
-
Conducted on
-
Prepared by
Risk Assessment
-
Risk
Hazards
-
Hazards
- Falls or falling objects from height
- Slips, trips and falls
- Trapping
- Entanglement
- Protruding objects
- Cuts or abrasions
- Chemicals
- Moving parts
- Moving vehicles
- Hot or cold surfaces
- Manual handling
- Collapse
- Overturning
- Electricity
- Environmental contamination
- Fumes or dusts
- Flying particles
- Fire / flammable atmospheres
- Bursting / explosion / over pressure
- Vibration
- Noise
- Exposure to radiation
- Oxygen enrichment
- Asphyxiation
- Engulfment
- Drowning
- Adverse weather
- Poor Lighting
- Bacteria or Virus
- Pedestrians
-
List other hazards here
Details of Possible Harm
-
Harm
- Death
- Head Injury
- Headache
- Broken Bones
- Burn/Scald
- Spinal Injury
- Laceration
- Amputation
- Eye Injury
- Eye Strain
- Infection
- Bruising
- Crushing
- Puncture Wound
- Industrial Disease
- Sprain / Strain
- Hearing Loss
- Dislocation
- Foreign Body
- Internal Injury
- Respiratory Condition
- Mental Stress
- Electrocution
- Electric Shock
- Soft Tissue Injury
- Poisoning
- Hyperthermia
- Skin Cancer
- Heat Stroke
- Heat Exhaustion
- Bites
- Hand Arm Vibration Syndrome
-
List other harmful outcomes here
Initial Risk Rating
-
Risk Level
- Very Low
- Low
- Moderate
- High
- Very High
- Critical
Control Measures
-
Turn on guidance
-
List the appropriate control measures for the task
-
Elimination Measures
-
Substitution Measures
-
Isolation Measures
-
Engineering Measures
-
Administration Measures
-
Choose PPE appropriate to the task
- Hard Hat
- Hearing Protection
- Gloves
- Visor
- Respirator
- Safety Footwear
- Hi Viz Vest
- Safety Glasses
- Safety Googles
- Chaps
- Dust Mask
- Respirator
- BA Set
- Overalls
- Sunscreen
- Harness
- Knee Pads
- Arm Guard
- Waterproof Clothing
- Gum Boots
- Fireproof Clothing
Plant & Equipment
-
Choose the plant and equipment required for the job
- Air Compressor
- Angle Grinder
- Barriers
- Battery Drill
- Biscuit Jointer
- Blower/Vac
- Bobcat
- Chainsaw
- Compound Mitre Saw
- Cones & Tape
- Crane
- Digger
- Direction Drill
- Drone
- Edge Protection
- Electric Drill
- Electric Jigsaw
- Electric Planer
- Elevated Work Platform
- Fencing
- Forklift
- Grader
- Hand Tools
- Jackhammer
- Ladder
- Man Cage
- Mobile Scaffold Tower
- Morticer
- Nail Gun
- Oxyacetylene Torch
- Panel Saw
- Piling Rig
- Post Hole Digger
- Push Mower
- Radial Arm Saw
- Ride on Mower
- Rope/Slings
- Router
- Safety Nets
- Safety Signage
- Sander
- Scissor Lift
- Scaffolding
- Skill Saw
- Soldering Iron
- Sprayer
- Stepladder
- Strops
- Table Saw
- Telehandler
- Telescopic Mop
- Tie Down Straps
- Weedeater
- Welder
- Waterblaster
-
List any other plant and equipment here
Residual Risk Rating
-
Risk Level
- Very Low
- Low
- Moderate
- High
- Very High
- Critical
Review Date
-
Enter Review Date
Approvals
Manager/Supervisor Approval
-
Form Authorised By
-
Review Date