Scenario Number: Equipment Number: Scenario Title:

Date Description Probability Frequency (per year)

Consequence
description / category
Risk Tolerance Criteria
(Category or Frequency)
Initiating Event
(typically a frequency)
Enabling Event or
Condition
Conditional Modifiers (if applicable)
Probability of ignition
Probability of personnel in affected area
Probability of fatal injury
Others
Frequency of unmitigated consequences
Independent protection layers
BPCS
Human Intervention
SIF
Pressure Relief Device
Other Protection Layers
(must justify)

Safeguards (non IPLs)

Total PFD of all IPLs

Frequency of Mitigated Consequence
Risk Tolerance Criteria Met? (Yes / No)
Risk Reduction Factor Required

Actions Required to Meet

Risk Tolerance Criteria

Notes

References (links to
originating hazard review,
PFD, P&ID, etc.)
LOPA Analyst and team
members (if applicable)