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.
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
Description of hazard
Add photograph where possible
Likely severity of injury should an incident occur.
- Extraordinary injury
- Serious lost time injury
- Minor medical treatment
- First aid treatment only
Frequency and duration of exposure to the hazard
- Hourly - 5
- Daily - 4
- Weekly - 3
- Monthly - 2
- Less - 1
Probability of occurrence of a hazardous event
- Certain - 5
- Likely - 4
- Possible - 3
- Unlikely - 2
- Negligible - 1
Possibility of avoiding harm should a hazardous event occur
- 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
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.