Tetra Pak Risk Assessment

• Risk Assessment Title

• Document No.

• Client

• Location
  Address

• Personnel

• Conducted on

  Date

• Prepared by

• This risk assessment template is designed to be used in conjunction with the Tetra Pak Hazard & Control Check List.
  All hazards and working practices that were identified as AT RISK or lacking control, should be entered and assessed.
  Where the risk is identified as HIGH or VERY HIGH, work should be stopped until additional permanent or temporary control measures to reduce the risk to an acceptable level have been implemented. Use the RA matrix below to assess the risk of each identified hazard.

• 

• Definitions:
  Extra-ordinary Accident: Fatality or Permanent disability such as the loss of a body part or permanent deafness
  Serious Accident: Requiring professional medical treatment with more than 1 day of lost time
  Minor Accident: Requiring professional medical treatment but less than 1 day of lost time
  First Aid Injury: Requiring only non professional medical treatment

Hazards or work practices identified in the Tetra Pak Hazard & Control Checklist

• Assess each hazard

Hazard

• Description of hazard

• Add photograph where possible

  Media

• Likely severity of injury should an incident occur.

  Select Extraordinary injury Serious lost time injury Minor medical treatment First aid treatment only

  • Extraordinary injury
  • Serious lost time injury
  • Minor medical treatment
  • First aid treatment only

• Frequency and duration of exposure to the hazard

  Select Hourly - 5 Daily - 4 Weekly - 3 Monthly - 2 Less - 1

  • Hourly - 5
  • Daily - 4
  • Weekly - 3
  • Monthly - 2
  • Less - 1

• Probability of occurrence of a hazardous event

  Select Certain - 5 Likely - 4 Possible - 3 Unlikely - 2 Negligible - 1

  • Certain - 5
  • Likely - 4
  • Possible - 3
  • Unlikely - 2
  • Negligible - 1

• Possibility of avoiding harm should a hazardous event occur

  Select Impossible - 5 Possible - 3 Obvious - 1

  • Impossible - 5
  • Possible - 3
  • Obvious - 1

• What is the sum of the frequency, probability and avoidance?

• Using the RA matrix what is the level of risk

  Low

  Medium

  High

  Very high

• Define additional controls required to reduce risk to an acceptable level

Work Method Statement

• Describe the safe work method that will be adopted or identify where within the OEM maintenance manual this can be found.

• Add signature

  Sign