Hazard Identification and Risk Assessment (HIRA)

Activity shall not commence until suitable and adequate risk assessment has been carried out.

HIRA carried out?

HIRA Document Number:

HIRA control measures implemented?

Activity shall not commence until all identified control measures are in place and effective.


If response is NO to any statement and the concern cannot be safely rectified by activity lead, report to supervisor for guidance (details to be confirmed in remarks below).

Confirm ALL personnel understand the hazards, risks and controls associated with activity/task.
Confirm ALL necessary Permit(s) to Work (PTW) are complete and displayed in accordance with operator policy and procedure.
Confirm ALL personnel have read and understand Permit to Work (PTW) requirements.
Confirm ALL personnel hold in-date induction training relevant to the area(s) of operation.
Confirm ALL personnel hold in-date documentation required to gain access to the area(s) of operation.
Confirm ALL personnel understand area arrangements for emergency evacuation, preparedness and response.
Confirm arrangements for safe access/egress to, from and throughout area(s) of operation.
Confirm tools and equipment are suitable for use and in-date mandatory servicing and inspection.
Confirm ALL personnel hold suitable and adequate training, competence and experience for the task(s) assigned.
Confirm risk from simultaneous operations (SIMOPS) is controlled.
Confirm that all significant risk within area(s) of operation has been identified as part of task risk assessment.

Provide details of the nature of the task to be carried out and: • Answers of No to any statement as part of assessment. • General Health, Safety and Environmental feedback. • Additional hazards, level of risk and control measures implemented.

DRA is to be carried out by an individual at the following times:
• Before starting a new task or tasks that involve a PTW and/or a revision to extant PTW.
• At the start of a shift for ongoing tasks.
• Where control measures for a task change.
• If assessments become invalid due to changes in circumstances.

Negative responses must be identified and resolved prior to commencement of operations for which this DRA is associated.

Completed DRA form returned to supervisor and HSEQ Lead?

All completed DRA forms to be returned to supervisor and HSEQ Lead.

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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.