HAZARD IDENTIFICATION AND RISK ASSESSMENT & REGISTER

Operating Area: Project Name

Contractors: Project Type: Contract No.:
Risk Assessment (Baseline and full RA)
TASK/ACTIVITY/PROCESS NAME: DEPARTMENT/AREA:
RA Number: DATE:
SEVERITY / CONSEQUENCE (Impact/Hazard Effect) (Where an event has more than one ' Loss Type ', choose the ' Consequence' with the highest rating)
Loss Type Additional "Loss Types" may exist for
an event: Identify & rate accordingly (1) Insignificant (2) Minor (3) Moderate (4) Major (5) Catastrophic
Medical Treatment Case Single Fatality or Loss of Quality of Life /
(S/H) Harm to People (Safety/Health) First Aid Case/Exposure to Minor Health Risk Exposure to Major Health Risk Loss Time Injury / Reversible Impact on Health Irreversible impact on Health Multiple Fatalities / Impact on health Ultimately Fatal

(EI) Environmental Impact Minimal environment harm incident with workplace Material Environment harm (RST) Material Environment harm (RST) Serious Major environmental incident (RLT) Major environmental harm – Incident Irreversible
environmental harm incident (RMT)
(BI/MD) Business Interruption / Material / Fire Damage & Brief Disruption to Operation / 10k SR to Less Than Partial Loss of Operation/1M SR Substantial or Total Loss of Operation / 10M SR and
Other Consequential Losses No disruption to operation / 1000 SR to Less than 10k SR 100k SR Partial Shutdown/100k SR to Less than 1M SR To Less than10M SR more
LIKELIHOOD Examples (Consider Near-Hits as well as actual events) RISK RATING / PROFILE
(5) ALMOST CERTAIN The unwanted event has occurred frequently : Occurs in order of (1) or more per year & is likely to reoccur within 1 year
5 (M) 10 (H) 15 (H) 20 (Ex) 25 (Ex)
(4) LIKELY The unwanted event has occurred infrequently : Occurs in order of less than once per year & is likely to reoccur within 5
yrs. 4 (M) 8 (H) 12 (H) 16 (Ex) 20 (Ex)
(3) POSSIBLE The unwanted event has occurred in the business at some time: or could happen within 10 years.
3 (L) 6 (M) 9 (H) 12 (H) 15 (Ex)
(2) UNLIKELY The unwanted event has occurred in the business at some time: or could happen within 20 years.
2 (L) 4 (M) 6 (M) 8 (H) 10 (H)
(1) RARE The unwanted event has never known to occur in the business or it is highly unlikely to occur within 20 years.
1 (L) 2 (L) 3 (L) 4 (M) 5 (M)
RA TEAM (Names) DESIGNATION SIGNATURE RISK RATING RISK LEVEL GUIDELINES FOR RISK MATRIX
Stop operation and review controls- Eliminate, avoid risk & implement high
1. - 15 to 25 (Ex) - Extreme priority action plans
Proactively manage & implement specific controls/action plans-Review after 7 days
2. - 8 to 12 (H) - High
Actively manage & monitor – Additional controls is advised & review after 14 days
3. - 4 to 6 (M) - Medium
Risk acceptable – Monitor & manage as appropriate with frequent review
4. - (L) - Low 1 to 3
APPROVED BY /
Review by: Signature: Date: MANAGER or DATE: NEXT REVIEW DATE:
SUPERVISOR
Identify the hazard on the given task and conduct assessment of the actual site condition, all identified risk should provide with a plan to eliminate or control the risk.

HAZARD IDENTIFICATION CONTROL RISK ASSESSMENT RISK REDUCTION ACTION PLAN

Risk Ranking /

Risk Ranking /
Consequence

Consequence
Risks Issue Likelihood

Likelihood
Improve existing

Profile
Profile
Work Activity (Possible incident) Follow up by Whom Controls Implemented
Item # (Process, Equipment, Hazards [What can go wrong] Existing Controls controls / implement new (name) & By When (date) Yes/No
Materials) (Accident / ill health to persons, fire controls
or property loss)

1 0 0 0 0 Yes or No

0 0
2 0 0 Training
0 0 Yes or No

0 0
3 0 0 Select Control Methods
0 0 Yes or No

0 0
4 0 0 Select Control Methods
0 0 Yes or No

0 0
5 0 0 Select Control Methods
0 0 Yes or No

0 0
6 0 0 Select Control Methods
0 0 Yes or No

0 0
7 0 0 Select Control Methods
0 0 Yes or No

0 0
8 0 0 Select Control Methods
0 0 Yes or No

0 0
9 0 0 Select Control Methods
0 0 Yes or No

0 0
10 0 0 Select Control Methods
0 0 Yes or No

0 0
11 0 0 Select Control Methods
0 0 Yes or No

0 0
12 0 0 Select Control Methods
0 0 Yes or No

0 0
13 0 0 Select Control Methods
0 0 Yes or No

0 0
14 0 0 Select Control Methods
0 0 Yes or No

0 0
15 0 0 Select Control Methods
0 0 Yes or No

0 0
16 0 0 Select Control Methods
0 0 Yes or No

0 0
17 0 0 Select Control Methods
0 0 Yes or No

0 0
18 0 0 Select Control Methods
0 0 Yes or No

0 0
19 0 0 Select Control Methods
0 0 Yes or No

0 0
20 0 0 Select Control Methods
0 0 Yes or No

0 0
21 0 0 Select Control Methods
0 0 Yes or No

0 0
22 0 0 Select Control Methods
0 0 Yes or No

0 0
23 0 0 Select Control Methods
0 0 Yes or No

0 0
24 0 0 Select Control Methods
0 0 Yes or No

0 0
25 0 0 Select Control Methods
0 0 Yes or No

0 0
26 0 0 Select Control Methods
0 0 Yes or No

0 0
27 0 0 Select Control Methods
0 0 Yes or No

0 0
28 0 0 Select Control Methods
0 0 Yes or No

0 0
29 0 0 Select Control Methods
0 0 Yes or No

0 0
30 0 0 Select Control Methods
0 0 Yes or No

0 0
31 0 0 Select Control Methods
0 0 Yes or No

0 0
32 0 0 Select Control Methods
0 0 Yes or No

0 0
33 0 0 Select Control Methods
0 0 Yes or No

0 0
34 0 0 Select Control Methods
0 0 Yes or No

0 0
35 0 0 Select Control Methods
0 0 Yes or No

0 0
36 0 0 Select Control Methods
0 0 Yes or No

0 0
37 0 0 Select Control Methods
0 0 Yes or No

0 0
38 0 0 Select Control Methods
0 0 Yes or No

0 0
39 0 0 Select Control Methods
0 0 Yes or No

0 0
40 0 0 Select Control Methods
0 0 Yes or No

0 0
41 0 0 Select Control Methods
0 0 Yes or No

0 0
42 0 0 Select Control Methods
0 0 Yes or No

0 0
43 0 0 Select Control Methods
0 0 Yes or No

0 0
44 0 0 Select Control Methods
0 0 Yes or No

0 0
45 0 0 Select Control Methods
0 0 Yes or No

0 0
46 0 0 Select Control Methods
0 0 Yes or No

0 0
47 0 0 Select Control Methods
0 0 Yes or No

0 0
48 0 0 Select Control Methods
0 0 Yes or No

0 0
49 0 0 Select Control Methods
0 0 Yes or No

0 0
50 0 0 Select Control Methods
0 0 Yes or No

0 0
51 0 0 Select Control Methods
0 0 Yes or No

0 0
52 0 0 Select Control Methods
0 0 Yes or No

0 0
53 0 0 Select Control Methods
0 0 Yes or No

0 0
54 0 0 Select Control Methods
0 0 Yes or No

0 0
55 0 0 Select Control Methods
0 0 Yes or No

0 0
56 0 0 Select Control Methods
0 0 Yes or No

0 0
57 0 0 Select Control Methods
0 0 Yes or No

0 0
58 0 0 Select Control Methods
0 0 Yes or No

0 0
59 0 0 Select Control Methods
0 0 Yes or No

0 0
60 0 0 Select Control Methods
0 0 Yes or No

0 0
61 0 0 Select Control Methods
0 0 Yes or No

0 0
62 0 0 Select Control Methods
0 0 Yes or No

0 0
63 0 0 Select Control Methods
0 0 Yes or No

0 0
64 0 0 Select Control Methods
0 0 Yes or No

0 0
65 0 0 Select Control Methods
0 0 Yes or No

0 0
66 0 0 Select Control Methods
0 0 Yes or No

0 0
67 0 0 Select Control Methods
0 0 Yes or No

0 0
68 0 0 Select Control Methods
0 0 Yes or No

0 0
69 0 0 Select Control Methods
0 0 Yes or No

0 0
70 0 0 Select Control Methods
0 0 Yes or No

0 0
71 0 0 Select Control Methods
0 0 Yes or No

0 0
72 0 0 Select Control Methods
0 0 Yes or No

0 0
73 0 0 Select Control Methods
0 0 Yes or No

0 0
74 0 0 Select Control Methods
0 0 Yes or No

0 0
75 0 0 Select Control Methods
0 0 Yes or No

0 0
76 0 0 Select Control Methods
0 0 Yes or No

0 0
77 0 0 Select Control Methods
0 0 Yes or No

0 0
78 0 0 Select Control Methods
0 0 Yes or No

0 0
79 0 0 Select Control Methods
0 0 Yes or No

0 0
80 0 0 Select Control Methods
0 0 Yes or No

0 0
81 0 0 Select Control Methods
0 0 Yes or No

0 0
82 0 0 Select Control Methods
0 0 Yes or No

0 0
83 0 0 Select Control Methods
0 0 Yes or No

0 0
84 0 0 Select Control Methods
0 0 Yes or No

0 0
85 0 0 Select Control Methods
0 0 Yes or No

0 0
86 0 0 Select Control Methods
0 0 Yes or No

0 0
87 0 0 Select Control Methods
0 0 Yes or No

0 0
88 0 0 Select Control Methods
0 0 Yes or No

0 0
89 0 0 Select Control Methods
0 0 Yes or No

0 0
90 0 0 Select Control Methods
0 0 Yes or No

0 0
91 0 0 Select Control Methods
0 0 Yes or No

0 0
92 0 0 Select Control Methods
0 0 Yes or No

0 0
93 0 0 Select Control Methods
0 0 Yes or No

0 0
94 0 0 Select Control Methods
0 0 Yes or No

0 0
95 0 0 Select Control Methods
0 0 Yes or No

0 0
96 0 0 Select Control Methods
0 0 Yes or No

0 0
97 0 0 Select Control Methods
0 0 Yes or No

0 0
98 0 0 Select Control Methods
0 0 Yes or No

0 0
99 0 0 Select Control Methods
0 0 Yes or No

0 0
100 0 0 Select Control Methods
0 0 Yes or No

0 0
101 0 0 Select Control Methods
0 0 Yes or No

0 0
102 0 0 Select Control Methods
0 0 Yes or No

0 0
103 0 0 Select Control Methods
0 0 Yes or No

0 0
104 0 0 Select Control Methods
0 0 Yes or No

0 0
105 0 0 Select Control Methods
0 0 Yes or No

0 0
106 0 0 Select Control Methods
0 0 Yes or No

0 0
107 0 0 Select Control Methods
0 0 Yes or No

0 0
108 0 0 Select Control Methods
0 0 Yes or No

0 0
109 0 0 Select Control Methods
0 0 Yes or No

0 0
110 0 0 Select Control Methods
0 0 Yes or No

0 0
111 0 0 Select Control Methods
0 0 Yes or No

0 0
112 0 0 Select Control Methods
0 0 Yes or No

0 0
113 0 0 Select Control Methods
0 0 Yes or No

0 0
114 0 0 Select Control Methods
0 0 Yes or No

0 0
0 0 Select Control Methods
0 0 Yes or No

0 0
0 0 Select Control Methods
0 0 Yes or No

0 0
0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No

0 0 0
Select Control Methods
0 0 0
Yes or No
 SEVERITY / CONSEQUENCE (Impact/Hazard Effect) (Where an event has more than one ' Loss Type ', choo
Loss Type Additional "Loss Types" may exist for
an event: Identify & rate accordingly (1) Insignificant (2) Minor
Medical Treatment Case
(S/H) Harm to People (Safety/Health)
First Aid Case/Exposure to Minor Exposure to Major Health Risk
Health Risk

(EI) Environmental Impact

Minimal environment harm incident Material Environment harm (RST)
with workplace

(BI/MD) Business Interruption / Material / Fire Damage & No disruption to operation / 1000 SR Brief Disruption to Operation / 10k
Other Consequential Losses to Less than 10k SR SR to Less Than 100k SR

LIKELIHOOD Examples (Consider Near-Hits as well as actual events)

(5) ALMOST CERTAIN The unwanted event has occurred frequently : Occurs in order of (1)
or more per year & is likely to reoccur within 1 year 5 (M)
(4) LIKELY The unwanted event has occurred infrequently : Occurs in order of
less than once per year & is likely to reoccur within 5 yrs. 4 (M)
(3) POSSIBLE The unwanted event has occurred in the business at some time: or
could happen within 10 years. 3 (L)
(2) UNLIKELY The unwanted event has occurred in the business at some time: or
could happen within 20 years. 2 (L)
(1) RARE The unwanted event has never known to occur in the business or it is
highly unlikely to occur within 20 years. 1 (L)

RISK RISK LEVEL GUIDELINES FOR RISK MATRIX

RATING
Stop operation and review controls- Eliminate, avoid risk &
15 to 25 (Ex) - Extreme implement high priority action plans

Proactively manage & implement specific controls/action

8 to 12 (H) - High plans-Review after 7 days
Actively manage & monitor – Additional controls is advised
4 to 6 (M) - Medium & review after 14 days
Risk acceptable – Monitor & manage as appropriate with
1 to 3 (L) - Low frequent review
than one ' Loss Type ', choose the ' Consequence' with the highest rating)

2) Minor (3) Moderate (4) Major (5) Catastrophic

Treatment Case Loss Time Injury / Single Fatality or
o Major Health Risk Reversible Impact on Loss of Quality of Multiple Fatalities / Impact on
Health Life / Irreversible health Ultimately Fatal
impact on Health
Material Environment
Major
ironment harm (RST) harm (RST) Serious environmental Major environmental harm –
environmental harm incident (RLT) Incident Irreversible
incident (RMT)
Partial Loss of
Operation/1M SR
on to Operation / 10k Partial Shutdown/100k To Less than10M SR Substantial or Total Loss of
ss Than 100k SR SR to Less than 1M SR Operation / 10M SR and more

RISK RATING / PROFILE

5 (M) 10 (H) 15 (H) 20 (Ex) 25 (Ex)

4 (M) 8 (H) 12 (H) 16 (Ex) 20 (Ex)

3 (L) 6 (M) 9 (H) 12 (H) 15 (Ex)

2 (L) 4 (M) 6 (M) 8 (H) 10 (H)

1 (L) 2 (L) 3 (L) 4 (M) 5 (M)

Area/Department
Date Compiled Date Revised
Compliled by:
Management Action
Priority Risk
Ref No. Description of Risk Action Responsible person
Rating Score
 Target Action
Responsible person
date complete