Risk Assessment Report.

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Identified Hazard 1

• Identify hazard

• Add media

  Media

• Why is this a hazard?

• What is the potential risk rating to the public and or workers?

  No Risk

  Moderate Risk

  High Risk

• Can this hazard be reduced in the short term?

  Yes

  No

  N/A

• What short term action is required to remove or reduce the risk?

• Can this hazard be reduced in the long term?

  Yes

  No

  N/A

• What long term action is required to remove or reduce the risk?

• Has this hazard been reported to property management?

  Yes

  No

  N/A

• Who was this hazard reported to?

• What was their response to the hazard and suggested short and or long term action required to reduce or remove the risk?

• When will this hazard be reviewed?

  Date

Item 2

Item 3

Item 4

Item 5

Signatory

• I hereby acknowledge this report to be a fair and accurate reflection of the inspected site and that the customer has been contacted to discuss the above listed items.

  Sign