CCCC MARINE RISK ASSESSMENT FORM

(1.0) Assessment Code & No. (1.1) Revision No

(1.2) Assessment Type (tick). New Review

(2.0) Subject of Assessment. (2.1) Location of Activity.

(2.2) Person Responsible.

(2.3) Brief Description of Activity.

(2.4) Persons Doing Work. (2.5) Main Equipment Involved. (2.6) Other Personnel at Risk.

(2.7) Number and Competence of People Required for Main Tasks.

 (3.0) Hazard Category Select all hazards that are applicable.

Does this activity involve?

(2.8) How Could This Activity Affect the Safety of the Vessel / Safety of Personnel.

(2.9) How Could This Activity Cause Environmental Harm.

(2.10) Identify Additional Assessments That Must be Completed / Referred to Prior to Work Commencing.

Identify Any Permit to Work / Safe Systems of Work that Apply (As identified under section 3.0)
Manual Handling Activities*3 Manoeuvring of heavy loads at sea

Loads being transported overhead Use of small boats

Working with ships rails lowered Use of divers*3

Use of scientific equipment on deck Use of hand held power tools

Use of electricity on deck Use of hand / foot operated machinery

Inexperienced staff involvement Use of hand tools

Hot work (welding, cutting, burning)*2 Repetitive movements

Use of hydraulic / pneumatic systems Slips / Trips / Falls

Use of compressed gases / cryogenics*1 Collapse of structure

Use of flammable / oxidising / explosive Sharp objects (knives, razors, medical sharps
substances*1 etc)

Use of toxic / corrosive substances** Violence / harassment / bullying

Use of radionuclides*1 Lone working / Out of hours*2

Work in extremes of temperature Carrying equipment up the gangway

Production of hazardous waste*1 Environmental pollution*1

Handling of glass Fumes

Working at heights*2 Low light levels

 Use of moving machinery / entanglement risk Anticipated extended periods of adverse
weather

Hazardous noise levels*3 Compressed air

Work in confined / enclosed spaces*2 Excessive vibration

Work in areas with reduced ventilation*2 Stacking / storing

Use / handling of hazardous chemicals*1 Work on ships electrical supply*2

Use of specialist protective equipment Towing operations

Increased security hazards (due to Anticipated working of excessive hours or

operational area / equipment)*3 other fatigue causing operations

*1 Separate COSHH Assessment is required *2 Permit to Work required

*3 - Additional Specific Risk Assessment is required

(3.1) Identify Any Additional Hazards Not Already Covered.

PLEASE USE THE TABLE OVERLEAF TO DESCRIBE THE CONTROL MEASURES TO BE PUT IN PLACE
TO REDUCE THE RISK FROM THE IDENTIFIED HAZARDS
(4.0) Assess the Level of Risk (refer risk matrix 6.0 overleaf) (4.1) Control Measures and Re-Assessment (refer risk matrix 6.0 overleaf)
Hazard Likelihood: Risk Rating: Revised Revised Revised
Consequence:
(b) = (a) x (b) (a) (b) = (a) x (b)
(a)
Description of Activity and 3 Major Controls to be Implemented:
Associated Uncontrolled Hazards 3 High High (6 to 9) 3 Major 3 High High (6 to 9)
2 Serious
2 Med Med (3 to 4) 2 Serious 2 Med Med (3 to 4)
1 Slight
1 Low Low (1 to 2) 1 Slight 1 low Low (1 to 2)

H, M, L H, M, L

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(5.0) Assessor Details

Name of Assessor

Signature

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Date

Name of Line
Manager

Signature

Date

(5.1) Assessment Review

Name of Reviewer Date of Review Review No. Reviewers Comments

(a) Hazard Consequence (a) Hazard Consequence (a) Hazard Consequence

(6) Matrix for Risk Evaluation Low (1) Medium (2) High (3)

(b) Likelihood 3 6 9
High (3) Medium High High
(b) Likelihood 2 4 6
Medium (2) Low Medium High
(b) Likelihood 1 2 3

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 Low (1) Low Low Medium

NOTE: IF AFTER THE CONTROL MEASURES HAVE BEEN APPLIED THE RISK REMAINS HIGH THEN THE OPERATION
MUST BE RE-ASSESSED AND WORK MUST NOT COMMENCE UNTIL THE RISK HAS BEEN LOWERED.

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