APPENDIX E

RISK ASSESSMENT FORM

Company: CH M&E Group Pte Ltd Conducted by:
Process/Location: Lift Modernisation work/ Euro Asia Court Sohag, Site Supervisor
(Names, designations)
Cai Chang Hong 12 Dec 2021
Approved by: (Date)
Director
(Name, designation) (Date) Last Review Date: 12 Dec 2021 Next Review Date: 11 Dec 2023
18 Dec 2021

1. HAZARD IDENTIFICATION 2. RISK EVALUATION 3. RISK CONTROL

1a. 1b. 1c. 1d. 2a. 2b. 2c. 2d. 3a. 3b. 3c. 3d. 3e. 3f.
Possible Accident / Action Officer,
Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)

Vehicle driven by personnel 5 2 10 Supervisor to ensure

Fatality/ Bodily 5 1 5 Site Supervisor
Traffic Accident Injury with valid driving licence. compliance and strictly
Transport of Observe traffic rules & follow LTA rules and
equipment regulation regulations.
and Workers fall off Fatality/ Bodily 5 2 10
1 back of vehicle Do not exceed number of Ensure max. Height if seated 5 1 5 Site Supervisor 30 June ‘22
personnel to Injury passengers allowed. Barrier to worker less than 1.1m from
job site and prevent falls carriage deck.
back Disturbance to Lead to traffic jam Signalman to ensure smooth
passer-by and and distress 5 1 5 Signalman
Deploy the Traffic Signalman 5 2 10 flow of traffic
Traffic

Deploy sufficient manpower to

carry. Use mechanical aids
Heavy and bulky Musculoskeletal such as trolley whenever 3 2 6 3 1 3 Site Supervisor
Manual Provide Training on SWP03
load injury possible.
Handling of LIFTING HEAVY EQUIPMENT
2 30 June ‘22
equipment
and materials Sharp edges of Cuts on hands and Wear hand gloves, safety shoes 3 1 3 Frequent review 3 1 3 Site Supervisor
materials limbs and proper clothing

Barricade shaft entrance. Wear

Fall from Height Serious injuries or safety harness and anchor to
4 1 4 Frequent review 4 1 4 Site Supervisor
fatality designated anchor point.
Access/Egress Permit to work system
and working implement
3 30 June ‘22
in the lift
Provide close supervision
shaft Breathing
Working in Ensure adequate lighting in the and regular risk
difficulties or 4 2 8 4 1 4 Site Supervisor
confine space lift shaft. Workers to rotate communication
Claustrophobia
every 4 hrs

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 1 OF 13
 APPENDIX E

* Note: S = Severity; L = Likelihood; R = Risk Level

1. HAZARD IDENTIFICATION 2. RISK EVALUATION 3. RISK CONTROL
1a. 1b. 1c. 1d. 2a. 2b. 2c. 2d. 3a. 3b. 3c. 3d. 3e. 3f.
Possible Accident / Action Officer,
Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)

Wear safety harness and

Fall from height Serious Injuries or anchor to designated anchor 4 1 4 Frequent Review 4 1 4 Site Supervisor
fatality points
Caught in Provide close supervision
Access/Egress between moving Physical Injury Use of PPE eg Safety shoes,
4 2 8 and regular risk 4 1 4 Site Supervisor
and working objects helmet, gloves.
4 communication 30 June ‘22
from the lift
pit Breathing
Working in difficulties or Ensure adequate lighting in the Provide close supervision
Confine space Claustrophobia lift shaft. Workers to rotate 4 2 8 and regular risk 4 1 4 Site Supervisor
work every 4 hrs communication

Tripping hazard
from trunking and Bruises and minor Familiarization of work area.
wiring running cuts from trips Cover trip hazards with 2 3 6 3 1 3 Site Supervisor
Provide close supervision
Working in along the floor wooden ramp or mark out trip
and regular house keeping
5 lift motor hazards with yellow paint 30 June ‘22
room
Expose electrical Electric shock 4 1 4 Frequent review 4 1 4 Site Supervisor
wirings Ensure all electrical panels are
closed and secured

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 2 OF 13
 APPENDIX E

Implement SWP05
Tools to be kept in tool box WORKING AT HEIGHT. Site Supervisor
Serious injuries or 5 2 10 5 1 5
Falling Objects after use. No debris or waste Secure tools & components
fatality to be accumulated on the work when necessary
platform. Barricade work area

Access/Egress
6 and working Serious injuries or Engage qualified scaffold 30 June ‘22
from scaffold Fall from height fatality contractor to erect scaffold.
Apply “Working at height Implement SWP05
WORKING AT HEIGHT Site Supervisor/Scaffold
permit”. Ensure safe-to-use tag 5 2 10 5 1 5
Provide close supervision Supervisor
is in order before start work.
Use safety harness and anchor and regular risk
to designated anchor point communication

1. HAZARD IDENTIFICATION 2. RISK EVALUATION 3. RISK CONTROL

1a. 1b. 1c. 1d. 2a. 2b. 2c. 2d. 3a. 3b. 3c. 3d. 3e. 3f.
Possible Accident / Action Officer,
Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)

Ensure scaffold is approved for

use by scaffold supervisor Implement SWP05
before use. Implement permit WORKING AT HEIGHT Site Supervisor/Scaffold
Collapse of Serious injury or to work system. Wear safety Supervisor
5 2 10 Provide close supervision 5 1 5 30 June ‘22
scaffold fatality harness and anchor point. and regular risk
Never overload the scaffold communication

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 3 OF 13
 APPENDIX E

Apply permit to work at

Serious injury or Implement SWP05
heights. Wear Safety harness
fatality WORKING AT HEIGHT Site Supervisor
Fall from Height and anchor to designated 4 2 8 4 1 4
Provide close supervision
anchor points
and regular risk
Install and communication
use of manual Deploy sufficient manpower to
chain hoist to carry. Use mechanical aids Site Supervisor
Heavy and bulky Musculoskeletal Provide Training on SWP03
7 support and such as trolley whenever is 3 2 6 3 1 3 30 June ‘22
Load injury LIFTING HEAVY EQUIPMENT
hoist possible
equipment
and materials Barricade lifting zone and
Ensure chain block used is
Serious injury or post warning signs. Riggers
Falling object tested and certified by Site Supervisor
fatality 5 2 10 and lifting supervisor to 5 1 5
while hoisting authorized testing agency.
ensure load is properly
Rigger carried out by qualified
secure before lifting
rigger only

Flying fragments Eye Injury

3 3 9 Supervision to enforce use of 3 1 3 Site Supervisor
Use of and sparks To provide of safety
PPE
electrical goggles/glasses
8 30 June ‘22
hand held Excessive noise
grinder Noise induced Supervision to enforce use of
generated by Provision of Ear Plugs/Muff 3 3 9 3 1 3 Site Supervisor
deafness PPE
grinding works

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 4 OF 13
 APPENDIX E

* Note: S = Severity; L = Likelihood; R = Risk Level

1. HAZARD IDENTIFICATION 2. RISK EVALUATION 3. RISK CONTROL
1a. 1b. 1c. 1d. 2a. 2b. 2c. 2d. 3a. 3b. 3c. 3d. 3e. 3f.
Possible Accident / Action Officer,
Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)
Remove all flammable or
Burns and heat combustible material. Fire
High temperature related injuries Implement SWP10 WELDING
extinguishers within easy reach 5 2 10 5 1 5 Site Supervisor
(Hot works) WORK
of work area. Work carried out
by competent and experienced
personnel
Implement SWP10 WELDING
Electrical burns or
Electricity Proper insulation of wiring and WORK.
Use of shocks
9 maintenance of welding 3 2 6 Use industrial multi-socket 3 1 3 Site Supervisor 30 June ‘22
welding kit
machine
Breathing
Fumes and gases difficulties of
personnel in vicinity Use of fans or work in a well- 3 1 3 3 1 3 Site Supervisor
Frequent Review
ventilated area

Eye injuries, 3 1 1 Frequent Review 3 1 1 Site Supervisor

Electrical Arcing Use welding gloves and mask
electrical burns
when working

Eye injuries and cuts 3 1 3 Frequent Review 3 1 3

Provision and use of PPE eg. Site Supervisor
Flying Debris
Safety goggles and hand gloves

Electrical burns or Regular maintenance of Implement SWP08 SAFE

Use of Damage machine shocks equipment. Inspection of WORKING ON ELECTRICAL Site Supervisor
4 2 8 4 1 4
10 electrical or power cord electrical drill before use EQUIPMENT. Use of 30 June ‘22
hand drill Industrial multi-socket

Work carried out by competent

personnel. Proper clothing to Site Supervisor
Hand injuries, loose
be worn. Use of PPE eg hand 3 1 3 Frequent Review 3 1 3
Rotating drill bit clothing caught by
glove when working.
rotating parts

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 5 OF 13
 APPENDIX E

* Note: S = Severity; L = Likelihood; R = Risk Level

1. HAZARD IDENTIFICATION 2. RISK EVALUATION 3. RISK CONTROL
1a. 1b. 1c. 1d. 2a. 2b. 2c. 2d. 3a. 3b. 3c. 3d. 3e. 3f.
Possible Accident / Action Officer,
Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)

Cuts on hands and Wear hand gloves, safety shoes 3 1 3 Frequent Review 3 1 3
Sharp edges of Site Supervisor
limbs and proper clothing
components
Implement SWP05
Apply permit to work at WORKING AT HEIGHT
Serious injuries or heights. Wear safety harness Provide close supervision Site Supervisor
Centering & Fall from height 4 2 8 4 1 4
fatality and anchor to designated and regular risk
11 Plumbing of 30 June ‘22
anchor points communication
lift shaft

Heavy and bulky Deploy sufficient manpower to

Musculoskeletal carry. Use mechanical aids
load 3 2 6 3 1 3
injury such as chain blocks wherever Provide Training on SWP03
Site Supervisor
possible LIFTING HEAVY EQUIPMENT

Heavy and bulky Musculoskeletal Deploy sufficient manpower to

load injury carry. Use mechanical aids 3 2 6 Provide Training on SWP03 3 1 3 Site Supervisor
such as chain blocks wherever LIFTING HEAVY EQUIPMENT
Install and
12 align guide possible 30 June ‘22
rail
Sharp edges of Cuts on hand and Wear hand gloves, safety shoes 3 1 3 Frequent review 3 1 3 Site Supervisor
material limbs and proper clothing

* Note: S = Severity; L = Likelihood; R = Risk Level

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 6 OF 13
 APPENDIX E

1. HAZARD IDENTIFICATION 2. RISK EVALUATION 3. RISK CONTROL

1a. 1b. 1c. 1d. 2a. 2b. 2c. 2d. 3a. 3b. 3c. 3d. 3e. 3f.
Possible Accident / Action Officer,
Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)

Heavy and bulky Musculoskeletal Deploy sufficient manpower to

load injury carry. Use mechanical aids 3 2 6 Provide Training on SWP03 3 1 3 Site Supervisor
Install such as chain blocks wherever LIFTING HEAVY EQUIPMENT
Counter possible
13 30 June ‘22
Weight
Frame
Sharp edges of Cuts on hand and Wear hand gloves, safety shoes 3 1 3 Frequent review 3 1 3 Site Supervisor
material limbs and proper clothing

Deploy sufficient manpower to

Heavy and bulky Musculoskeletal 3 2 6 3 1 3 Site Supervisor
carry. Use mechanical aids
load injury Provide Training on SWP03
such as chain blocks wherever
possible LIFTING HEAVY EQUIPMENT

Install lift car Sharp edges of Frequent review

Cuts on hand and Wear hand gloves, safety shoes
14 crosshead, materials 3 1 3 3 1 3 Site Supervisor 30 June ‘22
limbs and proper clothing
sling & panels
Implement SWP05
Apply permit to work at WORKING AT HEIGHT
heights. Wear safety harness Provide close supervision
Fall from height Serious injuries or
and anchor to designated and regular risk
fatality 4 2 8 4 1 4 Site Supervisor
anchor points communication

Cuts on hand and Wear hand gloves, safety shoes

Sharp edges of limbs 3 1 3 3 1 3 Site Supervisor
and proper clothing Frequent review
components
Dismantle
and/or install
15 Deploy sufficient manpower to 30 June ‘22
landing jamb
& sill carry. Use mechanical aids 3 2 6 Provide Training on SWP03 3 1 3
Heavy and bulky such as chain blocks wherever
Musculoskeletal LIFTING HEAVY EQUIPMENT Site Supervisor
load possible
injury

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 7 OF 13
 APPENDIX E

1. HAZARD IDENTIFICATION 2. RISK EVALUATION 3. RISK CONTROL

1a. 1b. 1c. 1d. 2a. 2b. 2c. 2d. 3a. 3b. 3c. 3d. 3e. 3f.
Possible Accident / Action Officer,
Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)

Cuts on hand and Wear hand gloves, safety shoes

Sharp edges of limbs 3 1 3 3 1 3 Site Supervisor
and proper clothing Frequent review
components
Dismantle
16 and/or install Deploy sufficient manpower to 30 June ‘22
car header carry. Use mechanical aids 3 2 6 3 1 3
Provide Training on SWP03
Heavy and bulky such as chain blocks wherever
Musculoskeletal LIFTING HEAVY EQUIPMENT Site Supervisor
load possible
injury

Cuts on hands and Wear hand gloves, safety shoes 3 1 3 Frequent Review 3 1 3 Site Supervisor
limbs and proper clothing
Sharp edges of
components
Physical injury Use of PPE eg. Safety shoes,
Implement SWP07 L.O.T.O.
helmet and gloves
4 2 8 Provide close supervision 4 1 4 Site Supervisor
Caught in and regular risk
Install between moving
17 landing/car Deploy sufficient manpower to communication 30 June ‘22
objects Musculoskeletal
Door injury carry. Use mechanical aids
such as chain blocks wherever 3 2 6 3 1 3
Provide Training on SWP03
Heavy and bulky possible
LIFTING HEAVY EQUIPMENT Site Supervisor
load
Wear safety harness and
Fall from height Serious injuries or anchor to designated anchor
fatality points 4 1 4 Frequent Review 4 1 4 Site Supervisor

* Note: S = Severity; L = Likelihood; R = Risk Level

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 8 OF 13
 APPENDIX E

1. HAZARD IDENTIFICATION 2. RISK EVALUATION 3. RISK CONTROL

1a. 1b. 1c. 1d. 2a. 2b. 2c. 2d. 3a. 3b. 3c. 3d. 3e. 3f.
Possible Accident / Action Officer,
Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)

Use of L.O.T.O. system. Work

Electrical Electric shock carried out my qualified 4 1 4 Frequent review 4 1 4
Site Supervisor
electrical worker
Install
18 electrical 30 June ‘22
wiring Wear hand gloves, safety shoes 3 1 3 Frequent review 3 1 3
Sharp edges of Cuts on hands and
and proper clothing Site Supervisor
components limbs

Musculoskeletal Deploy sufficient manpower to

Heavy and bulky injury carry. Use mechanical aids 4 1 4 Frequent review 4 1 4
load such as trolley whenever Site Supervisor
possible
Install lift
19 30 June ‘22
machine
Cuts on hands and Wear hand gloves, safety shoes 3 1 3 Frequent review 3 1 3
Sharp edges of limbs Site Supervisor
components and proper clothing

Apply permit to work at height. Implement SWP05

Serious injuries or Wear safety harness and 4 2 8 4 1 4 Site Supervisor
Fall from height WORKING AT HEIGHT
fatality anchor to designated anchor Provide close supervision
point and regular risk
communication
Install main
Sharp edges of
hoist and Cuts on hands and Wear hand gloves, safety shoes Frequent review
20 components 3 1 3 3 1 3 Site Supervisor 30 June ‘22
governor limbs and proper clothing
ropes

Provide Training on SWP03

Deploy sufficient manpower to LIFTING HEAVY EQUIPMENT
Heavy and bulky carry. Use mechanical aids 3 2 6 3 1 3 Site Supervisor
Musculoskeletal
load such as trolley whenever
injury
possible

* Note: S = Severity; L = Likelihood; R = Risk Level

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 9 OF 13
 APPENDIX E

1. HAZARD IDENTIFICATION 2. RISK EVALUATION 3. RISK CONTROL

1a. 1b. 1c. 1d. 2a. 2b. 2c. 2d. 3a. 3b. 3c. 3d. 3e. 3f.
Possible Accident / Action Officer,
Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)
Implement SWP05
Apply permit to work at WORKING AT HEIGHT
Serious injuries or heights. Wear safety harness
Fall from height Provide close supervision
fatality and anchor to designated 5 2 10 5 1 5 Site Supervisor
and regular risk
anchor points communication
Install
21 travelling 30 June ‘22
cables Deploy sufficient manpower to
Heavy and bulky carry. Use mechanical aids
Musculoskeletal 3 2 6 Provide Training on SWP03 3 1 3
load such as chain blocks wherever
injury LIFTING HEAVY EQUIPMENT Site Supervisor
possible

Apply permit to work at height. Implement SWP05

Serious injuries or Wear safety harness and 5 2 10 WORKING AT HEIGHT 5 1 5
Fall from height Site Supervisor
fatality anchor to designated anchor Provide close supervision
point and regular risk
communication

Sharp edges of
Install shaft Cuts on hands and Wear hand gloves, safety shoes
22 components 3 1 3 Frequent review 3 1 3 30 June ‘22
wirings limbs and proper clothing Site Supervisor

Deploy sufficient manpower to Provide Training on SWP03

Site Supervisor
Heavy and bulky carry. Use mechanical aids 3 2 6 LIFTING HEAVY EQUIPMENT 3 1 3
Musculoskeletal
load such as trolley whenever
injury
possible

* Note: S = Severity; L = Likelihood; R = Risk Level

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 10 OF 13
 APPENDIX E

1. HAZARD IDENTIFICATION 2. RISK EVALUATION 3. RISK CONTROL

1a. 1b. 1c. 1d. 2a. 2b. 2c. 2d. 3a. 3b. 3c. 3d. 3e. 3f.
Possible Accident / Action Officer,
Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)

Wear hand gloves, safety shoes 3 1 3 Frequent Review 3 1 3

Cuts on hands and and proper clothing Site Supervisor
Sharp edges of
limbs
components
Implement SWP05
Apply permit to work at WORKING AT HEIGHT
heights. Wear safety harness Provide close supervision Site Supervisor
Install car top Serious injuries or and anchor to designated 4 2 8 and regular risk 4 1 4
23 Fall from height 30 June ‘22
wiring fatality anchor points communication

Use of L.O.T.O. system. Work

Electricity carried out by qualified
Electric shock 4 1 4 Frequent Review 4 1 4
electrical workers Site Supervisor

Apply permit to work at height.

Serious injuries or Wear safety harness and 4 2 8 Implement SWP05 4 1 4
Fall from height Site Supervisor
fatality anchor to designated anchor WORKING AT HEIGHT
point Provide close supervision
and regular risk
communication
Install Sharp edges of
Cuts on hands and Wear hand gloves, safety shoes
24 compensation components 3 1 3 Frequent review 3 1 3 30 June ‘22
limbs and proper clothing Site Supervisor
chains/ropes

Deploy sufficient manpower to Provide Training on SWP03

Site Supervisor
Heavy and carry. Use mechanical aids 3 2 6 LIFTING HEAVY EQUIPMENT 3 1 3
Musculoskeletal
bulky load such as trolley whenever
injury
possible

* Note: S = Severity; L = Likelihood; R = Risk Level

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 11 OF 13
 APPENDIX E

Possible Accident / Action Officer,

Existing Risk Control
No. Work Activity Hazard Ill Health & S L R Additional Risk Control S L R Designation Due Date
Persons-at-Risk (if any)
(Follow-up date)

Operating the Use of PPE, eg Safety shoes, Implement SWP07 L.O.T.O.

Caught in
lift via helmet and gloves. Attend Provide close supervision Site Supervisor/ Trainer
25 between Physical Injury 4 2 8 4 1 4 30 June ‘22
inspection training from lift company on and regular risk from Lift Company
moving objects
control the operation of lift. communication

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 12 OF 13
 APPENDIX E

* Note: S = Severity; L = Likelihood; R = Risk Level

Likelihood definition table: Severity definition table:

Likelihood Level Description Severity Level Description

Almost Catastrophic 5 Fatality, fate diseases or multiple major injuries.
5 Continual or repeating experience.
Certain
Major Serious injuries or life-threatening occupational disease (includes
Frequent 4 Common occurrence. 4 amputations, major fractures, multiple injuries, occupational
cancer, acute poisoning).
Occasional 3 Possible or known to occur Moderate Injury requiring medical treatment or ill-health leading to disability
3 (includes lacerations, burns, sprains, minor fractures, dermatitis,
deafness, and work-related upper limb disorders).
Remote 2 Not likely to occur under normal circumstances.
Minor Injury or ill-health requiring first-aid (includes minor cuts and
2
bruises, irritation, ill-health with temporary discomfort).
Rare 1 Not expected to occur but still possible. Negligible Not likely to cause injury or ill-health.
1

Risk scoring table:

Likelihood
Rare Remote Occasional Frequent Almost
(1) (2) (3) (4) Certain (5)
Severity
Catastrophic
Medium (5) Medium (10) High (15) High (20) High (25)
(5)
Major
Medium (4) Medium (8) Medium (12) High (16) High (20)
(4)
Moderate
Low (3) Medium (6) Medium (9) Medium (12) High (15)
(3)
Minor
Low (2) Medium (4) Medium (6) Medium (8) Medium (10)
(2)
Negligible
Low (1) Low (2) Low (3) Medium (4) Medium (5)
(1)

CH M&E Group Pte Ltd – RA-01 LIFT INSTALLTION RISK ASSESSMENT REV01 PAGE 13 OF 13