SSF 003 Risk Assessment Template

• Job Number

• Site

  Select

• Conducted on

  Date

• Site Supervisor

• Location
  Address

Risk Assessment

• Risk is assessed in accordance with the HSE Guidance Note INDG163 (Rev 4) & assessments must be suitable and sufficient.
  Significant findings are to be recorded with risk eliminated as far as is reasonably practicable - this means balancing the level of risk against the measures needed to control the real risk in terms of money, time or trouble. However, you do not need to take action if it would be grossly disproportionate to the level of risk.

• Risk Assessments are to be reviewed if there are improvements that can be made, if there are problems, significant changes to processes, conditions or anything is learnt from accidents or near-misses.

• Briefly describe the Activity/Task/Process being undertaken

• A hazard is anything that may cause harm, such as chemicals, electricity, working from ladders, etc.

• The risk is the likelihood, high or low, that someone could be harmed by these and other hazards, together with an indication of the severity of the harm.

  

• What is the Hazard(s)?

• Who might be harmed and How?

• Control Measures in place

• PPE Required for the task

  Select Safety Footwear (EN ISO 20345:2011) Safety Helmet (EN 50365:2002) Eye Protection (EN 166 1FT) Gloves (EN 388:2003: 3141, EN 388:2016: 3131X) High visibility waistcoat (EN ISO 20471:2013) Safety Gloves Cut 5 (EN 388:2003 4543, EN 388:2016: 4X43D Burners Gauntlets (EN 407) Silicone Half Mask (EN 140:1998) with P3R Filters (EN143:2000) Disposable type 5&6 Coveralls (EN340, EN13982, EN13034, EN1073) Tinted Visors (EN 166) Safety Goggles (EN166) Ear Protection (EN 352:1) Safety Harnesses (EN 361:2002)

  • Safety Footwear (EN ISO 20345:2011)
  • Safety Helmet (EN 50365:2002)
  • Eye Protection (EN 166 1FT)
  • Gloves (EN 388:2003: 3141, EN 388:2016: 3131X)
  • High visibility waistcoat (EN ISO 20471:2013)
  • Safety Gloves Cut 5 (EN 388:2003 4543, EN 388:2016: 4X43D
  • Burners Gauntlets (EN 407)
  • Silicone Half Mask (EN 140:1998) with P3R Filters (EN143:2000)
  • Disposable type 5&6 Coveralls (EN340, EN13982, EN13034, EN1073)
  • Tinted Visors (EN 166)
  • Safety Goggles (EN166)
  • Ear Protection (EN 352:1)
  • Safety Harnesses (EN 361:2002)

• What additional PPE is required (not listed)

  Select Safety Footwear (EN ISO 20345:2011) Safety Helmet (EN 50365:2002) Eye Protection (EN 166 1FT) Gloves (EN 388:2003: 3141, EN 388:2016: 3131X) High visibility waistcoat (EN ISO 20471:2013) Safety Gloves Cut 5 (EN 388:2003 4543, EN 388:2016: 4X43D Burners Gauntlets (EN 407) Silicone Half Mask (EN 140:1998) with P3R Filters (EN143:2000) Disposable type 5&6 Coveralls (EN340, EN13982, EN13034, EN1073) Tinted Visors (EN 166) Safety Goggles (EN166) Ear Protection (EN 352:1) Safety Harnesses (EN 361:2002)

  • Safety Footwear (EN ISO 20345:2011)
  • Safety Helmet (EN 50365:2002)
  • Eye Protection (EN 166 1FT)
  • Gloves (EN 388:2003: 3141, EN 388:2016: 3131X)
  • High visibility waistcoat (EN ISO 20471:2013)
  • Safety Gloves Cut 5 (EN 388:2003 4543, EN 388:2016: 4X43D
  • Burners Gauntlets (EN 407)
  • Silicone Half Mask (EN 140:1998) with P3R Filters (EN143:2000)
  • Disposable type 5&6 Coveralls (EN340, EN13982, EN13034, EN1073)
  • Tinted Visors (EN 166)
  • Safety Goggles (EN166)
  • Ear Protection (EN 352:1)
  • Safety Harnesses (EN 361:2002)

• What is the likelihood of Harm?

  5 - Almost Certain

  4 - Very Likely

  3 - Likely

  2 - Unlikely

  1 - Remote

• What could be the Severity?

  5 - Fatality

  4- Severe Injury

  3 - Lost Time Injury

  2 - Minor Injury

  1 - No Injury

• (Likelihood x Severity) = Risk Level

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • 21
  • 22
  • 23
  • 24
  • 25

• Tolerable - Consideration may be given to a more cost-effective solution or improvement that imposes no additional cost burden. Monitoring is required to ensure that the controls are maintained.

• Moderate - Efforts should be made to reduce the risk. Risk reduction measures should be implemented with a defined time period. Where the moderate risk is associated with extremely harmful consequences further assessment may be necessary.

• Substantial - Work should not be started or access permitted until the risk has been reduced. Considerable resources may have to be allocated to reduce the risk.

• Intolerable - Work should not be started, continued or access permitted until the risk has been reduced. If it is not possible to reduce the risk, even with unlimited resources, work has to remain prohibited.

Site Supervisor Sign-Off

• The Control Measures will be relayed to all relevant operatives on site and registered via a Toolbox Talk prior to commencing.

• Site Supervisor

  Sign

• C. G. Comley & Sons Limited T/A Comley Demolition. Registered office: Southern Way, Rye Common, Odiham, Hook, Hampshire, RG29 1HU. Telephone: 01256 702178. Email: comley@comleydemolition.co.uk Company Registration Number: 01672195