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Risk Assessment for _________Project

Project Name: Contract Ref:

Sub- Con Logo RA No.
RA Rev No.
Contract
Task Description
Task Site Location

RISK SCORE CALCULATOR

Use Risk Score Calculator to determine level of risk for each hazard
What is the PROBABILITY of an occurrence? Hierarchy of Controls
What would the SEVERITY of an occurrence
be? Severity Almost Very Can the hazard be Eliminated or removed from the work
Very Likely Likely Unlikely
Rating Certain Unlikely place?
Catastrophic
Multiple Fatalities/
High High High Med Med Can the product or process be substituted for a less
Environmental release with detrimental effects 5
25 20 15 10 5 hazardous alternative?
requiring external emergency services/ >10m
AED
Major
Single Fatality/ Multiple LTI’s/ Major Illness or High High High Med Low
4 Can the hazard be engineered away with guards or barriers?
Injury, disability/ Environmental release with 20 16 12 8 4
minimal off site impact/ 1-10m AED
Moderate
Single LTI/ Serious but non-permanent injury or
ill health High High Med Med Low Can Administrative Controls be adopted
3
Work days lost/ 15 12 9 6 3 i.e. procedures, job rotation etc.
On site release requiring environmental
emergency plan to be activated/ 100k-1m AED
Minor
Medical attention needed. Med Med Med Low Low Can Personal Protective Equipment & Clothing be worn to
2
No work restrictions/ Local on-site environmental 10 8 6 4 2 safeguard against hazards?
release treated locally/ 10-100k AED
Negligible
Minor cuts & bruises or sickness/ Med Low Low Low Low RISK RATING (Probability x Severity)
1
Nuisance release with no adverse impact/ 1-10k 5 4 3 2 1 1-4 LOW RISK (No further action required)
AED 5-10 MEDIUM RISK (Procedure to be available)
12-25 HIGH RISK (Full time supervision present)
Probability Rating 5 4 3 2 1

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Risk Assessment for _________Project

Risk Assessed Residual Risk

Consequence Risk Risk Risk Risk
SI No. Task Step Hazard Details P S Current Control Measures P S Additional Control Measures
Details Score Rating Score Rating

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Risk Assessment for _________Project

Assessor’s Name Position Signature

Reviewed By Position Signature
Approved By Position Signature

Risk Assessment Date of Next

Review Period 03 Months
Date Review

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