Assessors Name: Assessors signature: Location of Date of Review date:

Method
task/operation being Task Carried assessment: Ongoing
Statement Action by
Sajimon KK assessed: out by? 15 January 09
by When?
Site
Ref No: Rev – 02 – RA – 2009 - Depa Cross reference to N.B. Residual risk:
SSOW/method Other on site The risk left
statement: (Highlight SSOW/Method statement control measures after all control
one below) Ref No: may be required measures have
Page No: due to weather been put in
YES NO M/S 001 conditions/other place – see
Risk Persons at risk reasons at time risk matrix at
severity of footer:
E C P Oth
(before task/operation:
Activity/ Significant ers
controls Control measures Work must not
Operation hazard
are in required: start until the
place) risks have
been assessed:

04 Flying High Yes Yes Yes  Only the competent Project Site Engineer Medium
particle or No and trained personnel. Manager
Bitumen debris Supervisor
Coating  To be followed the Construction
COSHH assessment. Manager Foreman

 To be briefed about the Site Manager Charge hand

activity prior to the
activity. HSE Manager Workers

 Use proper PPE. Helpers

Expose to High Yes Yes Yes

chemicals
Low

RISK RATING MATRIX 1 E = employees

C = contractors/subcontractors
Likelihood: 5 very likely 4 likely 3 fairly likely 2 unlikely 1 very unlikely P = Public
Severity: 5 catastrophic 4 major 3 moderate 2 minor 1 insignificant QMS – Rev – 02 – RA – 2009
Sajimon KK – January 09