Risk Assessment

• Conducted on

  Date

• Task description

• Prepared by

• Location
  Address

• Hazard 1 description

Hazard 1 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity of harm)

Action to be taken

• Describe actions to be taken to reduce risk score

Hazard 1 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity of harm)

• Hazard 2 description

Hazard 2 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity of harm)

Action to be taken

• Describe actions to be taken to reduce risk score

Hazard 2 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity of harm)

• Hazard 3 description

Hazard 3 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity of harm)

Action to be taken

• Describe actions to be taken to reduce risk score

Hazard 3 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity of harm)

• Hazard 4 description

Hazard 4 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity of harm)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 4 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity of harm)

• Hazard 5 description

Hazard 5 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity of harm)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 5 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity of harm)

• Hazard 6 description

Hazard 6 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 6 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 7 description

Hazard 7 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 7 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 8 description

Hazard 8 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (Likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 8 risk score AFTER action

• Likelihood of hazard occuring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 9 description

Hazard 9 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 9 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 10 description

Hazard 10 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 10 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 11 description

Hazard 11 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 11 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 12 description

Hazard 12 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 12 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 13 description

Hazard 13 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 13 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 14 description

Hazard 14 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 14 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 15 description

Hazard 15 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 15 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 16 description

Hazard 16 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 16 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 17 description

Hazard 17 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 17 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 18 description

Hazard 18 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 18 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 19 description

Hazard 19 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 19 risk score AFTER action

• Likelihood of hazard occuring

• Severity of harm

• Total risk score (likelihood x severity)

• Hazard 20 description

Hazard 20 risk score BEFORE action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

Action to be taken

• Describe action to be taken to reduce risk score

Hazard 20 risk score AFTER action

• Likelihood of hazard occurring

• Severity of harm

• Total risk score (likelihood x severity)

• Once complete, please sign here

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