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MRWA SAFETY INCIDENTS AND HAZARDS REGISTER

Risk Rating

Employee/
Contract Incident Worksite/ Location Description of Investigation Close Out
Date Contractor Subcontractor or Incident Type/ Hazard Contractor Trends Corrective Action Preventative Action Likelihood Consequence Risk Ranking
No: Number of Incident Incident or Hazard Report Provided (Date)
Public

Main Roads WA Contractor's Safety / Environmental Incidents and Hazards Register Page 1 of 5
MRWA SAFETY INCIDENTS AND HAZARDS REGISTER
Risk Rating

Employee/
Contract Incident Worksite/ Location Description of Investigation Close Out
Date Contractor Subcontractor or Incident Type/ Hazard Contractor Trends Corrective Action Preventative Action Likelihood Consequence Risk Ranking
No: Number of Incident Incident or Hazard Report Provided (Date)
Public

Main Roads WA Contractor's Safety / Environmental Incidents and Hazards Register Page 2 of 5
MRWA SAFETY INCIDENTS AND HAZARDS REGISTER
Risk Rating

Employee/
Contract Incident Worksite/ Location Description of Investigation Close Out
Date Contractor Subcontractor or Incident Type/ Hazard Contractor Trends Corrective Action Preventative Action Likelihood Consequence Risk Ranking
No: Number of Incident Incident or Hazard Report Provided (Date)
Public

Main Roads WA Contractor's Safety / Environmental Incidents and Hazards Register Page 3 of 5
MRWA EXAMPLE - SAFETY INCIDENTS AND HAZARDS REGISTER
Risk Rating

Employee/
Contract Incident Worksite/ Location Incident Type/ Description of Investigation Close Out
Date Contractor Subcontractor or Contractor Trends Corrective Action Preventative Action Likelihood Consequence Risk Ranking
No: Number of Incident Hazard Incident or Hazard Report Provided (Date)
Public

15-May-12 1/234 1 ABC Construction Employee Chainage 34200m Near Miss Ergonomics/Musculos While lifting fallen traffic sign, Traffic 16-May-12
Bunbury Highway keletal Controller strained shoulder. No treatment Unlikely Moderate Low
southbound required.
3-Jun-12 1/235 2 XYZ Plant Subcontractor Chainage 28200m Damage Machinery Incident Mini excavator was losing fuel from dripping 4-Jun-12
southbound hose. Mini excavator tagged out until hose Unlikely Minor Low
could be repaired
3-Jun-12 2/252 3 Main Roads Employee Power Street west Hazard Slips/Trips Manhole lid cracked and not seated flat Y 4-Jun-12
footpath adjacent to trench excavation. Has become Possible Major High
a trip hazard.

Insert Date Insert Insert Insert name of Select from drop Insert site location Select from drop Select from drop down Insert short description of the incident. Insert all preventive/ corrective actions to be If the Incident has a Insert Date Risk Rate select from the drop down menus for
d/mm/yyyy Contract Contract Organisation down list the where incident down list list the appropriate Stating: taken to reduce the risk of this incident re- risk rating of High d/mm/yyyy likelihood and consequence auto generating the risk
do not Number Incident appropriate name occurred appropriate Trend · what task was being performed; occurring. and a investigation do not rating. Refer to Tables
change date number description of · what happened to cause the incident; Stating changes to: report was change date
format Incident or Hazard. · what was the result of the incident; Induction; Training; Procedures; Work conducted. Send format
Note: Hazards can Do not use abbreviations environment; Equipment/ machinery modification/ the report with the
be identified maintenance; monthly safety
through site Do not use abbreviations reports
inspections or
reported by
workers
Consequence
Likelihood Insignificant Minor Moderate Major Catastrophic
Almost certain Low High High Very High Very High
Likely Low Medium High Very High Very High Table 1
Possible Low Low Medium High High
Unlikely Low Low Low Medium High
Rare Low Low Low Low Medium

Table 2

Table 3

Table 4