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V9

RISK ASSESSMENT
ACTIVITY

HAZARD

RISK
H/M/L

PRECAUTIONS

IN
PLACE

REVIEW
DATE
rd

Yes

23 Jan
15

Make sure wires are hidden away

Yes

23rd Jan
15

Make sure mats are in a sensible


place

yes

23rd jan
15

Working out on the machines

Hurting yourself on the


equipment

Make sure we are safe when using


the equipment

Cables from plugs

Tripping over the wires

Safety mats on the floor

Tripping over the mats

Please leave this section blank:


Risk Assessment checked by: Name Callum Palmer..

REVIEWER

Callum

Signed CP.

Date

KEY:

Activity :
Hazard :
Risk:
Precautions:
In Place:
Review Date:
Reviewer:

V9/PALL/sspi/reviewedOct2010

Describe the component part of your pursuit.


List the things you anticipate might cause harm or the things associated with your activity that have the potential to cause harm. Consider the likely
harm.
Assess the risk as either H (High), M (Medium) or L (Low). When concluding your assessment consider all of the circumstances.
Consider what you could do to minimise / negate the risk.
Will the precautionary measures be in place at the time of the activity?
When would it be reasonable to review your assessment? Remember it might be whilst you are undertaking the activity.
Name of the person responsible for completing the risk assessment.
A copy of this form should be taken on the activity or visit by the Reviewer.

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