TCLH Risk Matrix for Risk Assessment

• Name of Project

• Conducted On

  Date

• Prepared By

• Location
  Address

Risk Matrix

Starting work is not at Step#1

• Have you completed your step 7

  Yes

  No

  N/A

• What hazards have you identified for this impending task - Name at least 3

Risk Matrix: Likelihood

• Likelihood of Risk

  Select Almost Certain (Expected) Likely (Will probably occur) Moderate (Might occur has previously happend) Unlikely (could occur known to have happened Rare (Practically impossible)

  • Almost Certain (Expected)
  • Likely (Will probably occur)
  • Moderate (Might occur has previously happend)
  • Unlikely (could occur known to have happened
  • Rare (Practically impossible)

Risk Matrix: Consequence

• Impact of Risk

  Low

  Minor

  Moderate

  Major

  catastrophic

Risk Matrix: Level of Risk

• Risk Level

  Select E01, E02, E03, E04, E05, E06 H07, H08, H09, H10, H11 M12, M14, M15, M16, M16, M17, M18 L20, L21, L22, L23, L24, L25

  • E01, E02, E03, E04, E05, E06
  • H07, H08, H09, H10, H11
  • M12, M14, M15, M16, M16, M17, M18
  • L20, L21, L22, L23, L24, L25

Upon the Level of Risk what controls can you place on the identified hazards to lower the risk

• Name 3 controls for these identified hazards

Risk Matrix: Residual Risk (After Controls have been discussed and implemented)

• undefined

  Select E01, E02, E03, E04, E05, E06 H07, H08, H09, H10, H11 M12, M14, M15, M16, M16, M17, M18 L20, L21, L22, L23, L24, L25

  • E01, E02, E03, E04, E05, E06
  • H07, H08, H09, H10, H11
  • M12, M14, M15, M16, M16, M17, M18
  • L20, L21, L22, L23, L24, L25

Completion

• Recommendation

• Sign-off

  Sign