SVPHM Equipment Risk Assessment (draft)

• Document No.

• Equipment being assessed

• Prepared by

Equipment Details

• Risk assessment conducted by:

• Risk assessment commenced on:

  Date

• Location of equipment

• Fitzroy

• East Melbourne

• Kew

• Offsite / other

• Location

• Equipment being assessed

• Equipment reference no.

• Manufacturer

• Model / serial no.

• Safe working limit or other details

• Equipment use

• Specified High Risk Plant (refer to OHS Regulations)

  no

  yes

• Registration no.

• Operator Ticket/Licence required?

  yes

  no

• Ticket/licence no.

Exposure to the equipment

• Department and/or person(s) exposed to Equipment

• Frequency of equipment use

  Continuous

  2-3 times per day

  Several times per week

  Once or twice a month

• Duration of use

  8hrs/day

  3 or 4 hrs/day

  1 or 2hrs/day

  15 mins/occasional

• Identified hazards

• Moving parts

• Hazardous substances

• Manual handling

• Noise

• Electricity

• Height

• Vibration

• Pressure

• Potential roll over

• Confined space

• Thermal heat / radiation

• Machine guard removed

• Other

• Other identified Hazards:

Risk Assessment

• All hazards identified must be assessed for risk

• Risk Consequences Guide:
  MINIMAL = Harm, injuries, ailments not requiring immediate medical treatment, near miss.
  MINOR = Minor harm or injury where treatment or first aid is required.
  MEDIUM = Serious harm / injury or illness causing hospitalisation or multiple medical treatments.
  MAJOR = Life threatening injury or illness causing hospitalisation.
  SERIOUS = Death or life threatening injuries.

• Likelihood Guide:
  FREQUENTLY = Likely to occur most weeks or months
  LIKELY = Probably occur several times a year
  POSSIBLE = May happen every one to two years
  UNLIKELY = May happen every two to five years
  RARE = May happen less than once every five years

• Hazards identified

Hazard

• Hazard

• Consequences

  Minimal

  Minor

  Medium

  Major

  Serious

• Likelihood

  Frequently

  Likely

  Possible

  Unlikely

  Rare

• Current controls:

Control

• Current control

• Are current controls adequate to manage the risk.?

  Yes

  No

  N/A

• What are the control options required to be implemented?

Control option

• Person responsible for implementing control

• Date when control to be implemented by

  Date

PPE options

• Tick relevant boxes below

• Respirator mask

• Clothing

• Gloves

• Glasses

• Other

• Other PPE required

Actions required / implemented

• Tick the relevant boxes below

• Above controls implemented

• No further action required

• Develop Emergency Procedures

• What emergency procedures are required?

• Emergency procedures implemented.

• Ongoing Monitoring

• What is required to be monitored?

• Training required

• What training is required?

• Seek expert help

• Who is required to assist / help?

• Manufacturers Controls Implemented

• Further controls required?

• What further controls are required?

Controls

• Control

• Equipment is approved / not approved for use. All required actions have been taken:

  Yes

  No

  N/A

• Name

  Sign

• Position

• Date risk assessment completed

  Date

• This equipment risk assessment should be reviewed on:

  Date